RELATED: If You See This on Your Nails, It Could Be a Tell-Tale Sign of Diabetes. Bone metabolic disorders are common in those with diabetes, affecting roughly 50 percent of diabetic patients. In fact, one 2020 study published in the journal Frontiers in Endocrinology found that in addition to osteoporosis and other types of diabetic osteopathy (OP), many diabetes patients experience oral bone loss. Most frequently, this occurs in the alveolar bone, a portion of the mandibular and maxillary bone which forms the tooth sockets and keeps the teeth affixed to the gums. Experts warn that as the alveolar bone erodes, teeth can become loose, or can even fall out as a result of diabetes. Those with diabetes may also experience “lower bone mass, destruction of bone microstructure, greater bone fragility, and a higher risk of fracture,” in their teeth as a result of OP, the study says. “Indeed, it is the principal cause of adult tooth loss,” the team writes. RELATED: If You Notice This on Your Legs, Get Checked for Diabetes Now, Experts Say. When alveolar bone loss occurs, it not only increases your risk of loose or lost teeth, it also makes those teeth more difficult to replace with implants. “The systemic bone loss that occurs in diabetes includes alveolar bone resorption,” the researchers write. This can trigger atrophy of the alveolar ridge, and cause the bone tissue to break down. “Alveolar bone resorption often occurs in association with denture restoration, periodontal surgery, and the insertion of dental implants, which not only increases the difficulty of prosthetic treatment but also affects the prognosis,” the study explains.ae0fcc31ae342fd3a1346ebb1f342fcb The team adds that abnormal bone metabolism and inflammation around the implant can develop as a result of hyperglycemia. This can result in “serious alveolar bone defects in the region of the implant and ultimately lead to a failure of osseointegration, making diabetes a relative contraindication for implant repair,” the team writes. Those with diabetes should also be vigilant for other oral symptoms associated with diabetes—in particular periodontitis or gum disease, which can also contribute to tooth loss. “Epidemiologic studies have confirmed that diabetes is an important risk factor for periodontitis, and it has been recognized that periodontitis is the sixth-most frequent complication of diabetes,” says the Frontiers study, noting that those with diabetes are most likely to develop the condition. “Compared with those with normal blood glucose, the characteristics of periodontitis are more severe, periodontal tissue is obviously damaged, and the disease develops rapidly,” the team writes. Ultimately, this can lead to tooth loss and a range of other dental problems. “The clinical manifestations are gingival swelling and bleeding, root exposure and bifurcation lesions in severe cases, and recurrent periodontal abscesses, which eventually lead to tooth loosening and loss. Diabetic patients with poorly controlled blood glucose are at a higher risk of tooth loss, which is more significant in people aged 18–44,” say the researchers. For more health news sent directly to your inbox, sign up for our daily newsletter. Though bone loss in general tends to be associated with later stages of poorly managed diabetes, experts note that the oral cavity is often “one of the earliest sites” where diabetes-related bone loss occurs. “More specifically, the jaw may manifest OP first, followed by reabsorption of alveolar bone,” says the researchers. However, bones throughout the rest of the body can also become affected over time. “People with diabetes, particularly type 1 diabetes, often have poorer bone quality and an increased risk of fractures. Those with long-standing disease and poor blood sugar control, and who take insulin have the highest fracture risk,” says the National Institute of Health’s Osteoporosis and Related Bone Diseases National Resource Center. Speak with your doctor now if you suspect that any of your oral or orthopedic symptoms may be related to diabetes. RELATED: If You Notice This in the Bathroom, Get Checked for Diabetes, Experts Say.