Diabetes dental care is easy. Make sure you do these simple things.

Managing blood sugar isn’t just important for keeping your energy up and staving off conditions such as heart disease. It’s important for teeth and gum health, too. In fact, studies have shown that people with diabetes are nearly three times as likely to develop periodontitis, a disease that can cause teeth and gum decay over time. 

But if you take an active role in your oral health and schedule regular checkups with your dentist, these types of problems can be avoided. “Many people just don’t brush long enough. Most of us brush for less than a minute,” says Cynthia Sherwood, D.D.S., a spokesperson for the Academy of General Dentistry (AGD).

She offers these three big strategies for keeping your mouth healthy when you have diabetes.

1. Floss first

It may seem like a hassle, but it’s a necessity for a healthy mouth. “Flossing is just as important as brushing. Not flossing puts you at an increased risk of developing gum disease,” Dr. Sherwood says. Floss goes where your brush can’t — between your teeth — to remove plaque and debris, and it can also help reduce bad breath.

Floss before you brush, both in the morning and before bed, to remove any accumulated food and plaque. Make sure you floss up and down and around your teeth, to ensure you’re getting in all the nooks and crannies.

Your doctor may recommend using mouthwash if you have issues with bad breath or need fluoride. The AGD recommends avoiding mouthwashes that contain high levels of alcohol (18 to 26 percent), which can dry out the mouth and produce a burning sensation. To get the full benefits, swish for 30 seconds, and avoid eating or drinking for 30 minutes after spitting it out.

2. Brush for two minutes, twice a day

When you brush, and for how long, matters. “To effectively reach all areas and scrub off cavity-causing bacteria, it is recommended to brush [after breakfast and before bed] for at least two minutes,” Dr. Sherwood says.

If your gums are bleeding, the most likely culprit is plaque caused by inadequate brushing and flossing. “If plaque sits on teeth and under the edges of the gums for more than 24 hours, it forms toxins that cause inflammation and bleeding. So, the soreness and inflammation just get worse and worse,” Dr. Sherwood says. “I see a lot of patients who tell me that if their gums bleed, they try not to brush them because they are afraid that it will make it worse and it will hurt,” she says. Instead, make sure you’re brushing thoroughly and for at least two minutes — and if it doesn’t get better after a week, head to your dentist for professional help.

There is, however, such a thing as brushing too thoroughly. Avoid sawing back and forth and pressing too hard, and instead make gentle circular motions across each tooth. After brushing, swish with water to remove any excess toothpaste. Choose soft bristles (harder bristles can damage gums) and replace your brush whenever it begins to show wear, or after 90 days — whichever comes first.

3. Steer clear of sugary drinks and foods

While flossing and brushing are musts for everyone, what you eat can hurt or help your teeth. And that’s especially true for those with diabetes.

“Sports drinks, energy drinks, and soda can cause harm to teeth. The high acidity levels in those drinks erode tooth enamel, the glossy outer layer of the tooth,” Dr. Sherwood says. “Damage caused to tooth enamel is irreversible, and without the protection of enamel, teeth become overly sensitive, prone to cavities, and more likely to decay.”

Talk to your dentist about how your food choices impact your teeth. If you do sip soft drinks, opt for a straw to avoid as much contact with your teeth as possible. The American Dental Association also recommends eating nutritious, acidic foods like tomatoes and citrus fruits with a meal, rather than on their own. And rinse your mouth with water after your meals.