The Link Between Diabetes and Bad Breath

How Is Bad Breath Related to Diabetes

Bad breath can often be caused by the foods and drinks we consume during the day. However, it can also be a sign of an underlying condition you may not be aware of – one of which could be diabetes.

Many people with diabetes have sweet or chemical breath, and there are two main reasons for this: periodontal disease and ketoacidosis.

Let’s discuss the connection between bad breath and diabetes.

Periodontal Disease

Periodontal diseases are, in fact, inflammatory gum diseases such as gingivitis and mild and advanced periodontitis.

You may wonder how diabetes can cause gum disease. Untreated diabetes damages your blood vessels and affects the blood flow to your gums. Since they aren’t receiving enough blood, the gums and teeth become weak and prone to infections. Additionally, raised glucose levels lead to the growth of bacteria and don’t allow the gums to heal properly.

Bad breath isn’t the only sign of periodontal disease. Other signs include:

  • Sensitive gums and teeth
  • Receding gums
  • Bleeding gums

Gum disease is common for people with diabetes. According to research, one in three people with diabetes will develop periodontal disease. If untreated, the condition will continue to worsen and can lead to tooth loss.


If your body can’t produce insulin, your cells aren’t getting enough glucose, which is essential for proper functioning. Since the body recognizes this problem, it turns towards an alternative: burning fat instead of sugar. This process is called ketosis, and its byproducts are ketones.

Ketones aren’t necessarily related to diabetes. They can also be produced if you’re on a high-protein, low-carb diet.

High ketone levels can often cause bad breath. If you’ve noticed you have nail polish remover breath, the culprit might be acetone, one of the ketones.

When ketone levels are too high, you risk developing diabetic ketoacidosis or DKA. Typically, this condition affects those that have type 1 diabetes because their bodies don’t produce insulin.

DKA symptoms are:

  • Frequent urination
  • Sweet and fruity breath
  • Abdominal pain or cramps
  • Dry skin
  • Fatigue
  • Dry mouth
  • Difficulty breathing
  • Excessive thirst

If it’s not treated on time, diabetic ketoacidosis can become life-threatening. If you’ve noticed any of the symptoms mentioned above, it’s essential to seek medical help as soon as possible.

Diabetes Medication and Bad Breath

People with type 2 diabetes are often prescribed metformin, a medication that controls blood sugar levels. Those who take this medication regularly have reported a fishy aftertaste that causes bad breath.

 If you suspect metformin or any other diabetes medication is causing bad breath, talk to your doctor about potential alternatives.

How to Manage Bad Breath From Diabetes

You can get bad breath from diabetes under control in numerous ways. But keep in mind none of them will be long-lasting if you don’t treat the cause. Managing diabetes and regulating blood sugar levels is necessary to truly eliminate bad breath.

Additionally, you need to maintain your dental hygiene at a high level:

  • Brush your teeth at least twice a day. Ideally, brush them after every meal, especially if you’re wearing braces.
  • Brushing isn’t enough. Don’t forget to floss to remove plaque and food debris between your teeth.
  • Drink enough water, as this will prevent bacteria growth.
  • Use a tongue scraper to clean your tongue thoroughly.
  • Stimulate saliva production by using sugar-free mints or gum.
  • Go to the dentist regularly to ensure you don’t have any cavities.

Should You Visit a Doctor?

If you’ve noticed you have bad breath and suspect it’s due to diabetes, you should check your blood sugar levels. If the results show more than 240 milligrams per deciliter, it’s recommended to check ketone levels. High ketone levels mean you need to visit a doctor as soon as possible.

Additionally, if your breath worsens over time, seek medical help even if the ketone levels are in order.

Bad Breath: A Hidden Sign of Diabetes

Bad breath can often be one of the first signs of numerous conditions and diseases, including diabetes. If bad breath becomes more intense over time, don’t hesitate to visit your doctor. By acting on time, you can prevent gum disease or ketoacidosis.

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