The American Diabetes Association reports diabetes now affects more than nine million Americans, costing $245 billion to diagnose and treat the disease. While there are remedies to help fight or alleviate common symptoms, like high-intensity interval training and cooking a well-balanced meal to maintain a healthy diet and exercise, plenty of Americans still frequently experience high blood pressure, kidney disease, and increased risk for stroke. According to a new study, diabetics may also be losing more of their teeth.

The study, published in Preventing Chronic Disease, examined tooth-loss trends from more than 37,000 people using data from the National Health and Nutrition Examination Survey conducted between 1971 and 2012. Researchers found tooth loss was prevalent in type 2 diabetics, and even more so among African Americans despite an overall decline in the past 40 years. They also reported aging African Americans with diabetes are much more susceptible to losing their teeth than whites or Mexican Americans, while other populations with diabetes experience tooth loss about twice as much as non-diabetics.

"We have more evidence that oral health is related to diabetes," said lead researcher Bei Wu, a professor of nursing and global health at Duke University in Durham, N.C., according to HealthDay. However, Wu and her team were unable to determine why, exactly, there’s a link between diabetes and tooth loss.

Between 1999 and 2000, Wu said people with diabetes were 34 percent less likely to have at least 21 teeth than those who did not have diabetes. Yet Dr. Edmond Hewlett, a spokesperson for the American Dental Association, told CBS News these concerns with oral and overall health are important for the general public to be aware of, not just those with diabetes.

“[The connection between tooth loss and diabetes] is something we've been aware of, but this gives additional strong evidence about that,” Hewlett, who is also a professor at the UCLA School of Dentistry, said. “And the other big thing is health disparities — the rate at which some diseases can affect some racial or ethnic groups more than others."

The ADA reports diabetes “may weaken your mouth’s germ-fighting powers,” making diabetics more susceptible to gingivitis and serious gum disease (periodontitis). The disease causes blood vessels to expand, which slows the flow of nutrients to the mouth and the removal of harmful bacteria. However, the ADA adds this is a two-way street: Gum disease “may also have the potential to affect blood glucose control and contribute to the progression of diabetes.”

“Then let's layer on the access to care issue that some patients face,” Hewlett said. “There's other good evidence showing African Americans have lower access to dental care."

The researchers are using their findings to emphasize how important oral health and hygiene is to those with diabetes. They recommend regular visits to the dentist and proper home care for both teeth and gums, which includes brushing and flossing.

Researchers concluded: “ Given the bidirectional relationship between diabetes and periodontal disease, our study findings highlight the need to improve dental self-care and knowledge of diabetes risks among people with diabetes, especially among non-Hispanic blacks, who had more tooth loss and lost teeth at a higher rate.”

Source: Wu B et al. Forty-Year Trends in Tooth Loss Among American Adults With and Without Diabetes Mellitus: An Age-Period-Cohort Analysis. Preventing Chronic Disease. 2015.