The keto diet (ketogenic diet) is a low-carb, high-fat diet that has grown in popularity over the past several months. Many people have found this type of eating can help with weight management. Many have also found it can come with a particularly unpleasant side-effect: “keto breath.”

Ketosis breath is typically described as smelling of acetone or ammonia and may come with a metallic taste in the mouth. Partially a result of ketones being released through respiration, this breath can make close encounters very uncomfortable and may even make some people feel ill.

The liver creates three types of ketones, one of which is acetone. While it is the least abundant, it is also the most volatile and is often excreted through the oral passageway. This type of keto breath is usually temporary and often subsides within the first few weeks of the diet. The second type, however, is a direct result of the foods favored in the keto diet.


The types of food eaten on a keto diet can encourage halitosis in two ways:

  1. Excess protein is not always easily digested. Undigested protein fermenting in the gut will produce ammonia that can be fairly potent on the breath. Ammonia is also one of the ketones created by the liver. The only solution for this is eating less protein. The issue can be mitigated by chewing gum and frequent tooth brushing
  2. Volatile organic compounds (VOC), like those found in patients with black hairy tongue, can also cause bad breath in people on the keto diet. Bacteria will ferment protein sources stuck in between the teeth and in the crevices of the mouth. This fermentation process will produce volatile organic compounds, like sulfur, which cause halitosis. This issue can be treated through proper oral hygiene

Denver dentist Dr. Michael DeWitt and his team understand how embarrassing halitosis can be. When it is a consequence of dietary choices, changes in diet can make all the difference. When it is a consequence of poor oral hygiene, however, there are a number of things that may need to be done to address the issue.

Professional and Daily Care

The first step in battling halitosis is brushing your teeth. To do this:

  • Select a soft-bristled toothbrush
  • Choose an appropriate fluoride toothpaste (i.e. No abrasives if you have veneers or crowns)
  • Brush for two minutes with a manual brush or one with an electric
  • Repeat when you wake, after every meal, and again before bed

Brushing alone will make a significant impact, but flossing should not be overlooked. Those protein sources stuck in between the teeth are the largest cause of VOCs and they are best removed with floss. Use a clean selection of floss to run from below the gum line to the tip of each tooth’s crown. Floss before you brush your teeth both morning and night.

Lastly, visit our Denver dentist for professional cleanings every six months to help keep halitosis and keto breath under control. During these visits, we will carefully clean all surfaces of your teeth and remove tartar and plaque from below the gum line. This helps keep the teeth optimally clean and can significantly reduce halitosis related to a protein-heavy diet. These visits also give us an opportunity to address underlying oral health issues like tooth infection, gum disease, and cavities that may contribute to chronic bad breath.

Contact our Denver Dentists

If you are ready to schedule an appointment, call Dewitt Dental Associates at 303-321-5656 today. Located in the Cherry Creek area, we welcome patients from Englewood, Highlands Ranch, Littleton, and all Metro Denver communities.

Categories: General Dentistry