Diabetic Bad Breath

Do I have diabetic bad breath?

90 percent of the population has bad breath at some time. There are many causes of bad breath, including strong or odorous foods, drinking, smoking, and some diseases, among other causes.

However, diabetic bad breath is directly caused by the disease, and it comes out of the mouth. It's easy to say “just keep your blood sugar down on the A1C to your target number,” but it's not that easy to do. Here are a few facts regarding unpleasant breath and diabetes.

Diabetes, breath and the mouth

Since breath is about air, let's break that down first. The temperature in the human mouth goes up to approximately 98 degrees Fahrenheit. Exhaling deals with humidity coming out of the body. It reaches approximately 96 degrees Fahrenheit. Those temperatures are ideal for harboring and growing bacteria. The mouth houses over 500 species of bacteria, only of which around 37 are actually dealt with by doctors. The majority of mouth bacteria are good guys, breaking down sugars and starches and sending them on their way to help the body.

Alternatively, now that an oven is basically prepared for bacteria, add food to the equation. When the bad bacteria binds to the foods, it forms a film over the teeth called plaque. If the mouth isn't cleaned regularly, the plaque causes oral problems with the gums such as gingivitis and periodontitis. Dental problems and/or infections weaken the immune system. If a diabetic's blood sugar is out of control, his/her body is weakened and cannot fight off infections.

Diabetic bad breath symptoms

This is the part where it comes out of the mouth. Some other symptoms of diabetic mouth problems are (and they cause unpleasant breath in and of themselves):

  • The beginnings of gum disease, or gingivitis
  • Full-fledged gum disease, or periodontitis
  • Loose teeth
  • A different taste in the mouth or a bad taste in the mouth
  • Bad breath not helped by brushing

Diabetes, breath and the mouth, part two

When the body can't produce its own insulin, then the incoming sugars and starches can't be processed naturally. Therefore, the body goes on overdrive and burns fat instead of sugar for fuel. The result is ketones, which are excreted by the body as waste. It comes out of the body through the urine or out of the mouth as halitosis. Ketones either smell fruity, or they smell like acetone, one of the ingredients of nail polish remover. This is largely found in Type 1 diabetics, but may be found in Type 2 diabetics who have endured trauma or stress. If left untreated, or when the blood sugar is out of control, this produces an extremely dangerous illness called ketoacidosis. Diabetic coma and even death may result from ketoacidosis if left untreated.

Another source of ketones causing unpleasant breath is from a high protein, low carbohydrate diet. Cutting carbs while retaining the proper amounts of protein in a diabetic diet is one of the cornerstones of the diabetic life. However, when proteins break down, they, too, cause ketones to be released into the body. They come out of the mouth smelling like ammonia. Volatile sulphur compounds, or VSCs, result from the breakdown of components in our diet. Studies have shown that these VSCs result largely from the breakdown of proteins. If you notice your urine or breath smelling like Mom's floor cleaner, then it's time to see the doctor.

The cure for diabetic bad breath

It will take time, but there is a cure for bromopnea (Greek for “stink breath”). Most doctors will tell you to treat the cause of the unpleasant breath or work on your oral hygiene.

Some tips would be:

  • Keep your blood sugar down to the level advised by your doctor, usually in the 120s.
  • Eat healthy meals and snacks, incorporating raw fruits and veggies and whole grains.
  • Cut out sugary sweet drinks like sodas and juices to avoid their binding to bacteria in the mouth.
  • Drink plenty of water, which washes bacteria out of the mouth.
  • Brush and/or scrape the tongue, on which bacteria like to grow and gets passed into the body.
  • Sugarless gums and candies use the mouth's saliva, which washes away harmful bacteria which causes unpleasant breath.
  • Brush at least twice a day and if possible after meals or snacks. Brush the tops, fronts and backs of the teeth to remove plaque.
  • Floss at least once a day. Pass the floss up and down the tooth and around the bottom of the tooth next to the gum to get all of the plaque.
  • Stop smoking.
  • See a dentist twice a year, explaining your diabetes and coordinating care with your primary healthcare provider.
Last Reviewed:
June 20, 2017
Last Updated:
October 11, 2017
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