What Does Bad Breath Have to Do with Diabetes?

April 01,2021 |
Man outside drinking water.

Diabetes is a chronic medical condition where your body is unable to efficiently process or produce the insulin needed to maintain a healthy blood glucose level. Under normal health conditions, blood glucose extracted from food is transformed into energy for your cells thanks to the hormone insulin. If you’re living with diabetes, this transformation process doesn’t work as well and therefore, the glucose remains in your bloodstream. This deprives cells of the energy they need to function properly. When blood glucose levels are too high for too long in people living with diabetes, complications can occur. Sometimes, these complications can be fatal, which is why it’s essential to be aware of any changes or warning signs of a problem. To further elaborate one warning sign, we’ll explore what bad breath has to do with diabetes.

What Causes Bad Breath in People with Diabetes?

Your breath gives a surprising amount of insight into your health. Different odors can indicate different problems. For example, sweet, fruity breath that smells similar to acetone can be an indication of ketoacidosis. Breath smell similar to ammonia can be a warning sign for kidney disease. Anorexia nervosa gives off a very foul, yet mildly fruity odor and asthma, lung cancer, and even liver disease can impact breath odor.

In general, bad breath is medically known as halitosis. When it’s severe, it can be a diagnostic tool used by doctors. In fact, there are certain technologies that use your breath to help identify prediabetes such as an infrared breath analyzer.

With regard to the relationship between the two, there are a few things that cause bad breath in people with diabetes. Some of them include periodontal disease, ketones, dry mouth, and the increased risk of infection associated with diabetes.

Periodontal Disease

One of the more common causes of bad breath in people living with diabetes is periodontal disease. However, keep in mind that the effects of gum disease can plague anyone regardless of if you’re living with diabetes or not. Periodontal diseases are chronic inflammatory diseases that include gingivitis, mild periodontitis, and advanced periodontitis. In these instances, unchecked oral bacteria begin to attack healthy tissue and bone that surround, support, and protect your teeth. The inflammation associated with periodontal diseases can also lead to worsened diabetes and problems with metabolism.

There have been several studies that reveal a significant link between poorly managed or uncontrolled diabetes and severe stages of periodontal diseases. The problem is that when this happens, many people begin to experience higher rates of complications from diabetes such as heart disease and stroke. Since there is a correlation between heart disease and diabetes, a correlation between oral health and diabetes, and a correlation between heart disease and oral health, the three are interrelated and require the proper preventative care. 

When diabetes is poorly managed, it creates reduced blood flow. This also affects blood flow to the gums. Without an adequate amount of nutrients from healthy circulation, teeth can weaken, and infection rates increase. Periodontal disease can be prevented and treated when caught early. To avoid any problems, always practice healthy oral hygiene habits and see your dentist regularly. If you have any signs of periodontal disease, such as bad breath, talk to your dentist about how you can treat or reverse the problem.


When your cells are deprived of energy from glucose, they begin to burn fat instead. This fat burning process creates a byproduct called ketones, which is a type of acid produced by the liver. Ketones tend to produce an odor that’s similar to acetone. This type of bad breath isn’t unique to people with diabetes. It’s also a common side effect of following a low-carb, high-protein “keto” diet. However, in the case of diabetic ketoacidosis, this odor is much more pungent.

To further understand the relationship between diabetes, ketones, and bad breath, we need to consider ketoacidosis. This is when your ketone levels are extremely elevated and occurs due to too little insulin, not enough food, low blood glucose, or a combination of the three. The longer that this occurs, the more likely it is for someone to experience diabetic ketoacidosis (DKA). If you experience any symptoms of DKA, seek medical attention immediately. DKA is extremely dangerous and can be fatal when untreated. Some common symptoms of diabetic ketoacidosis include:

  • Breath that smells fruity or like acetone
  • Increased urination
  • Nausea and vomiting
  • Abdominal pain
  • High blood sugar levels
  • Difficulty breathing
  • Confusion
  • Dry or flushed skin
  • Loss of consciousness
  • Coma

Having ketones in your body isn’t harmful as it is a byproduct of burning fat. However, extremely raised levels of ketones can cause serious problems for people living with diabetes. Talk to your doctor before starting a new diet regimen to make sure that it is safe. Always discuss exercise programs and report any other symptoms or unusual side effects as you experience them. If you think that you or a loved one are suffering from diabetic ketoacidosis, seek medical help immediately. 

Dry Mouth

It’s not uncommon for people living with diabetes to experience an increased rate of dry mouth. This is often due to high blood sugar or medications. Saliva is one of the best ways to fend off harmful bacteria, so without it, the acid that’s created as a byproduct can harm your teeth and oral health. Dry mouth also means that there will be less saliva production to help clean your mouth after eating, resulting in increased levels of bacteria growth. If you believe that your medication may be worsening your dry mouth, or you’re unable to alleviate it with water, talk to your doctor about changing your medications.

Increased Risk of Infection

People living with diabetes are at an increased risk of infection due to a weakened immune system. Because of this, oral infection rates increase. In people with uncontrolled diabetes, the rate of healing may also be compromised, which can lead to long lasting infections that persist regardless of external behavior. Specifically, diabetes can increase a person’s risk of developing an oral yeast infection called oral thrush. Oral thrush is a condition in which a type of fungus grows on the tongue and surrounding mucous membranes of your mouth.

While some levels of this fungus are normal, an overgrowth can create noticeable symptoms, such as bad breath. You may also notice white lesions or a tongue that appears “fuzzy.” It’s often not serious, but when left untreated the fungus can lead into your esophagus and throughout the rest of your body. If you notice any signs of oral infection such as oral thrush, contact your dentist as soon as possible to determine an appropriate treatment plan. 

Tobacco use is also associated with increased cases of bad breath. Smoking without underlying problems is dangerous and should be avoided but can cause even more issues for those with medical conditions. Smoking with diabetes can lead to further intensification of complications. If you need help quitting, talk to your doctor for resources or quitting cessation programs. 

How to Manage Bad Breath from Diabetes

Since most instances of bad breath are caused by poor dental hygiene, the first step in managing and preventing bad breath from diabetes is to improve your oral health. If you’re not brushing and flossing daily, you’re going to be at a higher risk for bad breath. It’s also recommended to see your dentist twice a year for professional cleanings and to undergo oral exams. If you’re living with diabetes, you may need to take some extra precautions and schedule more professional cleanings. This is because high blood sugar levels can increase glucose in saliva, which increases food for bacteria and causes a higher build-up of dental plaque.

Staying hydrated throughout the day is another way to help keep bad breath at bay. Drinking water helps to rid your mouth of harmful bacteria and improves dry mouth. In addition to regularly brushing, try using a scraper to eliminate bacteria from your tongue. Chew sugar-free gum or carry mints to help stimulate saliva, avoid mouthwash with alcohol, and make sure that you’re properly managing your diabetes.

For more resources about diabetes management, healthy lifestyle tips, and diabetic meal planning, Byram Healthcare is here to help. As one of the nation’s leading diabetic medical supply companies, we care about our customers.