From diabetes to stress: What your mouth is telling you about your health

Bad breath, dry mouth and gum problems may be the warning signs of other serious health conditions such as stress or diabetes. Source: Getty

Whether it’s brushing twice a day, flossing after meals or regularly visiting the dentist, most people know exactly what they need to do to protect their teeth and maintain good oral hygiene.

While these practices usually keep teeth clean, prevent bad breath and protect the gums, other health conditions can lead to ongoing issues within the mouth. In these cases, usual oral hygiene practices such as gargling mouth wash or brushing with an electric toothbrush simply mask problems rather than fixing them.

It’s important to pay attention to any changes in the mouth as they could point to a bigger health issue contributing to poor oral health.

Bad breath

Halitosis, commonly known as bad breath, can be caused by bacteria issues in the mouth or other health issues in the body.

“General health conditions such as respiratory disorders and diabetes have been known to cause changes to breath,” Dr Mikaela Chinotti, Australian Dental Association Oral Health Promoter and Dentist, tells Starts at 60.

High blood sugar levels caused by diabetes can increase glucose levels in saliva. Bacteria in the mouth feasts on this saliva and increase levels of dental plaque – which gives off an unpleasant scent.

Because people with diabetes have less insulin in their blood, some will develop ketoacidosis – where higher levels of blood acids called ketones are produced. Ketones cause an array of symptoms including excessive thirst and bad breath.

Bad breath can also be the sign of respiratory problems, with infections, bronchitis, inflammation of the sinuses, asthma and even lung cancer impacting odours in the mouth.
“If breath cannot be improved at home with oral hygiene, it’s best to visit your dentist to check for possible underlying causes,” Chinotti says.

A lady using mouth wash to treat her bad breath
Usual oral hygiene practices may only mask bad breath rather than fix more serious health issues. Source: Shutterstock

Dry mouth

Xerostomia, or dry mouth as it’s more commonly known, can be caused by medication. Blood pressure and cholesterol medications, tricyclic antidepressants, antihistamines, and anticholinergics are the main culprits, while people who have previously undergone cancer treatment may also experience dry mouth.

“Cancer treatment involving radiation therapy to the head and neck region can cause damage to salivary glands, which can result in decreased saliva production and xerostomia,” Chinotti says.

Saliva protects the teeth and when levels decrease, the risk of bacteria growth and dental decay increases. Some infections and health conditions, such as Sjogren’s syndrome, Parkinson’s disease and AIDs, can also cause dry mouth.

Read more: Causes, symptoms and treatments for dry mouth

medication that causes bad breath
A side effect of many mediations is bad breath, so always discuss options with a health professional. Source: Pixabay

Tongue colour and coating

The tongue is one of the most hard-working organs in the body and is responsible for the way we talk, eat, and what we taste. A healthy tongue should be light-pink in colour and free of any thick coating.

Different health issues can cause the coating on the tongue to change in colour, which is why it’s important to monitor changes and seek medical advice if it doesn’t return to normal within a few weeks.

“Many changes are benign, however, should individuals notice a lesion such as an ulcer on their tongue that’s been present greater than two weeks, it’s best they consult a dental practitioner,” Chinotti says.

A pale tongue can indicate vitamin and nutrition deficiencies, while a white tongue typically points to fungal infection or dehydration.

Grey tongues can indicate problems in the digestive tract, while a bright red tongue, different to the usual pink colour of the tongue, can be a sign of infection, disease or inflammation.

In some cases a yellow coating can indicate stomach or liver issues, while blue or purple can be the result of lung or kidney issues.


Ulcers occur when the delicate tissue lining of the mouth is damaged in some way. The most common type are Aphthous ulcers, and while experts are yet to determine an exact cause, it’s believed they may be brought on by stress, spicy or acidic foods, mineral and vitamin deficiencies and even hormonal changes.

“Generally, ulcers will just disappear with time and no treatment is needed,” Chinotti says.

They can also be caused by trauma such as biting the soft tissue of the lip or inner-cheek or even hitting the gum with a toothbrush.

A health professional should be consulted if ulcers are lasting longer than two weeks.

A man getting an ulcer because he's stressed
People experiencing stress may develop mouth ulcers. Source: Shutterstock

Sore gums

Sore, red and inflamed gums often point to gum disease such as periodontitis and gingivitis and is primarily caused by plaque and bacteria in the mouth.

“You may need to have your teeth professionally cleaned or you may have more advanced gum disease requiring professional treatment,” Chinotti says.

Similar to its impact on bad breath, the increase of glucose in saliva in people with diabetes increases bacteria in the mouth and left untreated, can increase the risk of gum disease.

Research published in the BMJ Open Diabetes Research & Care Journal also shows that severe gum disease can be an early warning sign for type 2 diabetes.

Diabetes can increase the risk of gum disease
Diabetes can increase the risk of gum disease. Source: Pixabay

Meanwhile, researchers from the University of Bergen in Norway recently discovered a connection between gingivitis and Alzheimer’s disease and for the first time were able to show the gum condition plays a decisive role in whether someone develops Alzheimer’s or not.

“It’s important to have regular dental visits, not just for dentists to check for tooth decay, but also gum disease, cancerous or pre-cancerous lesions and review of oral hygiene practices for best at-home care,” Chinotti says.

Read more: The definitive dental guide for over-60s

When was the last time you went to the dentist?

IMPORTANT LEGAL INFO This article is of a general nature and FYI only, because it doesn’t take into account your personal health requirements or existing medical conditions. That means it’s not personalised health advice and shouldn’t be relied upon as if it is. Before making a health-related decision, you should work out if the info is appropriate for your situation and get professional medical advice.

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