What Does Bad Breath Have To Do With Diabetes?

Bad breath, also known as halitosis, is an unpleasant experience that could scar one’s social life and self-esteem. Having bad breath could be an early warning regarding your lifestyle and health.

Halitosis is often attributed to bad oral hygiene, smoking or consuming tobacco products, the choice of food we eat, and so much more. 

While all of these are possible causes of bad breath, did you know that bad breath could also be a sign of a medical disorder?

Bad breath can also be a symptom of gum infection, kidney and liver diseases, lung cancer, asthma, and Diabetes. Sweet fruity smells have been attributed to an acute complication of Diabetes known as ketoacidosis.

What are the causes of bad breath in diabetic patients?

While people blame all bad breath on onion and garlic, dry mouth, hormonal changes, and medications, there are two major causes of bad breath related to Diabetes. They are periodontal diseases and high amounts of ketones in the blood. 

What are Periodontal Diseases?

In simple words, periodontal diseases can be described as gum diseases. These diseases include periodontitis and gingivitis.  They are mostly caused by the accumulation of plaque and tartar around the teeth. If they are not removed and treated, they become hardened and then host bacteria that attack the gums and bones, depending on how long the condition was left untreated. 

Advanced cases of periodontitis could result in damage to the jaw bone and eventually cause tooth loss. At an advanced stage, the patient would require periodontal surgery or periodontal laser surgery to remove the bacteria that have eaten deep into the bone.

As the bacteria attack the bones and tissues around the teeth, it results in inflammation, which can spike blood sugar levels and worsen Diabetes.

Diabetes is known to damage blood vessels in the body, including those in the mouth. This results in a shortage of blood supply to the gums as such, making them weak and prone to bacterial attack and infection.

Also, diabetes increases the amount of glucose in the mouth, which creates a conducive environment for bacteria to thrive. 

An increase in blood sugar levels hinders the body from sufficiently resisting attack (from infection and diseases). As such, if someone with Diabetes has periodontal diseases, the gums heal slower than in non-diabetics.


This condition starts with the inability of the body to produce insulin, and when this happens, the body cells don’t get enough glucose to carry out their duties. 

As a backup plan, the body starts to burn fat since sugar is not available. When the body begins to burn fat, it results in the production of alternative fuel molecules known as ketones, which start to build up in the blood and urine.

This is similar to what happens when people fast or go on high-protein and low carbohydrate diets even though it’s entirely dissimilar to diabetic ketoacidosis.

It’s these ketones that cause bad breath, and when ketone levels are not checked and promptly controlled, it degenerates to a medical condition known as Diabetic Ketoacidosis (DKA).

Some of the symptoms of DKA include 

  • Sweet and fruity odor on your breath
  • High glucose in the blood
  • Abdominal pain, nausea
  • Urinating more often than usual and
  • Having difficulty with breathing

If you notice any of these symptoms, you should visit a doctor immediately. 

Managing bad breath from Diabetes

Having seen how periodontal diseases are complications of Diabetes, one should also know how to control bad breath related to it.You can either prevent the causes or lessen the severity of periodontal diseases. Here are some steps you can take:

  • Brush your teeth twice every day and floss frequently
  • Water is your friend! Drink water frequently to keep your mouth moist
  • If you like mint, stick to non-sugar mints – they help in stimulating saliva production
  • Smoking is a complicated treatment of periodontal diseases – don’t smoke and try to quit if you already do!
  • Visit your dentist regularly and stick to your prescription. 

Bad breath could be your body trying to tell you that something is wrong. If you already have Diabetes, be cautious of your breath and see a doctor if you notice anything. You could just be saving yourself from advanced gum diseases or DKA.

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