Caledonia, Minnesota, USA:

My seven year old son was diagnosed with type 1 diabetes three weeks ago, and I have noticed he has bad breath, even just after brushing. I know this is a symptom of diabetes, but will it always be present? Does it indicate a problem with his blood sugars that we are perhaps missing because we are so new at this?

There can be several causes for bad breath or malodor from the mouth. The most obvious being the production of acetone breath due to DKA [diabetic ketoacidosis], a life threatening diabetes complication. However, there will be other acute symptoms.

Bad breath at this age may be due to changes in the types of sulfur-producing bacteria in the mouth. These may be harbored in the grooves of the tongue, tonsils, or loose baby teeth trap bacteria under them. Sometimes there may be sinus drainage and this could be the cause of the problem. My recommendation would be to seek the consultation of a pediatric dentist in your area that can further evaluate your child to evaluate the source of the odor.

FV