There are some links between bad breath and diabetes. People with diabetes may be at risk of several oral conditions that can cause bad breath. Bad breath can also be a sign of undiagnosed diabetes.

Diabetes is a chronic condition that affects how a person’s body regulates their blood sugar levels. It can cause chronically high blood sugar levels. Without treatment, this can increase the risk of complications throughout the body.

Halitosis is the medical name for bad breath that does not go away. Bad breath can be a sign of several health conditions, including diabetes.

Read on to learn more about the connection between bad breath and diabetes.

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People living with diabetes may produce less saliva and experience dry mouth. Having less saliva in the mouth can reduce a person’s protection against oral conditions, some of which can cause bad breath.

People with diabetes may also have higher blood sugar levels, which can increase how much glucose is in their saliva. Extra glucose can increase the amount of bacteria in the mouth, resulting in a buildup of dental plaque. Not removing dental plaque can lead to tooth decay and gum disease. These can cause halitosis.

Bad breath can also be a sign of a person having diabetes that is not under control or diagnosed.

Diabetic ketoacidosis (DKA) is a serious and potentially life threatening complication of diabetes. DKA is more common among people with type 1 diabetes. People with type 2 diabetes may also develop DKA.

DKA can develop if the body cannot produce or effectively use insulin to provide energy for cells. Instead, the liver breaks down fats for energy, producing ketones.

If a person’s body produces ketones too fast, they can build up to dangerous levels. One symptom of DKA is having high levels of ketones in a person’s breath. This can cause bad breath.

Typically, bad breath that relates to diabetes may smell fruity due to DKA. The smell can be similar to that of rotten apples or pear drops. Others may describe this scent as similar to acetone, or nail polish remover.

Some people with diabetes have a higher risk of gum disease, also called periodontal disease. People may refer to bad breath from periodontal problems as “perio breath.” This unpleasant smell occurs due to sulfur-producing bacteria in the mouth.

Diabetes may result in bad breath in several ways, including:

  • periodontal disease
  • dry mouth
  • DKA
  • side effects from some diabetes medications, such as metformin

People can manage bad breath by:

  • practicing good oral care and dental hygiene, including:
    • brushing their teeth twice a day with a fluoride toothpaste
    • cleaning between their teeth daily using floss or tiny brushes, picks, or water flossers
  • using mouthwash bearing the American Dental Association (ADA) Seal of Acceptance to help freshen their breath
  • avoiding foods such as:
    • garlic
    • onions
  • limiting their consumption of coffee and alcoholic beverages
  • drinking plenty of water and staying hydrated
  • using sugar-free candies or gum to keep the mouth moist
  • managing their blood sugars to avoid oral complications
  • talking with their dentist if they are concerned about their breath
  • attending regular dental appointments

Other causes of bad breath can include:

  • eating or drinking spicy or strong-smelling foods and drinks
  • smoking tobacco
  • poor oral health care
  • oral health conditions, such as:
    • holes in the teeth
    • oral infections
  • certain health conditions, including:
    • tonsillitis
    • acid reflux

Diabetes can cause body odor to worsen. Additionally, some evidence suggests that certain diabetes medications may affect a person’s body odor.

If a person notices any changes in their body odor, they may want to consider consulting a doctor.

Diabetes may cause bad breath due to diabetes-related oral health conditions. People with diabetes may also have DKA. Bad breath related to diabetes may smell fruity or sweet.

If a person has symptoms of DKA, they may have undiagnosed diabetes. They should also seek emergency medical attention immediately.

People can manage bad breath in many ways, including practicing good oral hygiene.