Ketogenic Diet and Your Oral Health

The ketogenic diet is all the rage right now. But it has both advantages and disadvantages for your general health and for your oral health. Many doctors like the positive aspects of this diet. Most people using the diet are, however, more interested in the weight-loss benefits.

The ketogenic diet calls for very low carb intake, and high fat intake. The absence of sugar or of sugars produced by keto diet - sm - paid - Depositphotos 189396892 s-2019digesting carbs is good for your teeth and gums.

A number of fad diets introduced in recent years have helped people lose weight for the short run, but they have also contributed to a number of harmful effects as well. The keto diet also has advantages and drawbacks.


Ketogenic Diet and Oral Health

The Ketogenic diet offers several oral health benefits. These include:

  • Reduction of plaque buildup. Plaque is caused by the presence of bacteria and tartar on teeth and gums. Those following the strict keto diet limit carbs as much as possible. The carbs are a primary offender because your digestive system converts them to sugar in your bloodstream and in your mouth.
  • Less cavities. As a result of the reduction of plaque buildup, you will have fewer cavities. Over an extended period, you may develop cavities, but the decay process will be slowed by the absence of plaque. Because the keto diet is high in fat and includes lean meat and few carbs, they produce little to no sugars. Without the sugars, cavities do not develop.

There are also drawbacks associated with the keto diet.

  • Because the keto diet is not “balanced,” your pH becomes more acidic. This will likely cause your saliva to taste acidy instead of the sweeter taste you are accustomed to.
  • If you have dry mouth or when your saliva is acidic, there are negative consequences for your teeth and gums. Saliva fights off bacteria and prevents harm to teeth and gums. This will cause problems that your dentist will need to address.
  • “Keto breath” or “dragon breath” is a side-effect of the diet. Typically, your breath will smell acidy or fruity or acetone. If there is bacteria in your mouth, you will intensify this bad breath effect.

Keto Breath

This “keto breath” problem is usually a temporary side effect and it occurs when your body is not using all of the ketones produced by your liver. When your body adapts to the keto diet, it will begin to use the ketones to fuel muscles and your brain. Once your body has fully adapted to the keto diet, the bad breath should disappear. Most people report that it lasts only a week to a month. During the time when you have keto breath, there are steps you can take to prevent or control this side-effect.

  1. Drink more water. When you eat less, you mouth becomes dryer. A dry mouth allows bacteria to accumulate in your mouth. Drinking water will help to rinse bacteria from your mouth and keep you hydrated.
  2. Be meticulous in your oral hygiene regimen. You might want to brush after each meal and floss carefully. Use of an alcohol-free mouthwash is recommended because the alcohol in some commercial mouthwashes will further dry out your mouth.
  3. Chew sugar-free gum or mints occasionally.
  4. If you can “ease into” the diet by eliminating carbs gradually, you may give your body time to adapt to the change and not release as many ketones at once.
  5. Control your stress. Stress reduces saliva and slows digestion of proteins. Stress can also cause acid-reflux, which is bad for your teeth. Learn how to control your stress to help you prevent keto breath.

If you are beginning a keto diet, ask your dentist about how to manage the side-effects of the new diet.

Is Gargling with Salt Water Effective?

We are often asked if gargling with salt water is effective and safe. Salt Water Rinses and Gargles are generally safe for many people. They are effective for some purposes and conditions.

A salt water rinse or gargle is an inexpensive, safe and easy way to relieve the mild pain associated with a number of gargling woman - paid - shutterstock 696604468problems affecting the mouth and throat. It has been used as a remedy for generations. Some people prefer it over the medicated gargles available in drug stores. It is a simple mixture of water and table salt. Anyone can make it, and most people can use it.

Salt water gargles are a helpful treatment for normal discomfort due to a sore throat. The American Cancer Society recommends it to soothe sore throats. It can help to keep the mouth clean and to prevent infections in people undergoing radiation therapy or chemotherapy.

Gargling with salt water is generally used effectively for

  • Minor sore spots or irritation in the mouth.
  • Common sore throat.
  • Canker sores.
  • Inflammation due to allergies.
  • Upper respiratory infections (common colds, flu, sinus infections, mononucleosis). The salt water can mitigate symptoms and may help to prevent these infections.

In dental hygiene, gargling with salt water regularly can help to remove bacteria from the gums. This helps to clean the gums and the teeth and prevent any buildup of plaque and tartar. After a dental procedure, dentist commonly suggest rinsing the mouth with a warm salt water solution to keep the site clean and to prevent infection.

Gargling with salt water may kill some bacteria, but not all mouth and throat bacteria. The salt solution can, however, help to bring bacteria to the surface of the gums, teeth, and throat. By bringing the bacteria to the surface, some of it washes out when you spit out the salt water.

Recipe for Salt Water Gargle

Salt water solutions are easy to make with simple table salt and water.

The American Dental Association suggests this recipe:

  • ½ teaspoon of salt
  • 8 ounces of warm water
  • Mix until combined

The American Cancer Society recipe is:

  • 1 quart water
  • 1 teaspoon salt
  • 1 tsp baking soda

Gargling Tips

  • Use only a comfortable amount of water in your mouth at once.
  • Gargle it around the back of your throat.
  • Rinse the solution around your mouth and gums.
  • Spit out the solution. (It is safe to swallow, but probably better to spit it out.)

Who Should Not Gargle with Salt Water?

Gargling with salt water is generally believed safe for both children and adults. People who have difficulty gargling should not use this solution. Young children may find gargling difficult. Ask your pediatrician or your dentist when it is safe for your child to gargle. People with high blood pressure or other medical conditions that suggest limiting salt intake, should discuss it with your doctor or dentist before using. If you cannot tolerate the flavor of salt water, you can add a small amount of honey to the solution to improve the flavor.

We are happy to discuss with you any questions you have about gargling with salt water or other solutions.

What Is Tooth Erosion?

One of the most basic things you need to know about oral health and caring for your teeth concerns tooth erosion. Many people have incorrect information about the causes and prevention of tooth erosion.


Tooth erosion is the irreversible wearing away of the outer enamel of the tooth. According to the American Dental Association (ADA), more than one-third of adults and children in the U.S. have some level of tooth erosion. Tooth erosion can cause several types of damage to teeth, and the most common symptom is often pain or sensitivity. The good news is that tooth erosion can be prevented in many cases.

Causes of Erosion

Tooth Erosion is caused by diet – specifically by acids in your mouth. Most often, these acids are introduced in carbonated drinks, fruit juices, alcohol, and energy drinks. It can also be caused by poor oral hygiene, eating disorders (bulimia or anorexia) and by stomach disorders (acid reflux) that produce acid in the digestive system. The erosive properties of these acids may be exacerbated by swishing these liquids in your mouth before swallowing. The ADA also says that people who are regularly exposed to “environments with higher levels of acid” (factory workers, swimmers) may also experience tooth erosion. Special note: beware sour candy. Some sour candies are “almost as acidic as battery acid.” (ADA)

The chart below gives examples of the amount of acid in many foods and beverages. [Image source: ADA patient education brochure Tooth Erosion: The Harmful Effects of Acid – W301*]

Acidity of beverages chart ADA

Types of Tooth Wear

In addition to the erosion of your teeth caused by contact of acids with your teeth, there are other kinds of tooth wear that contribute to loss of tooth enamel. Three major types of wear are:

  1. Attrition occurs with tooth-to-tooth contact. This often occurs with teeth grinding or inability to bite correctly. Attrition tends to break down the enamel and flatten the chewing surfaces of your teeth.
  2. Abfraction results when regular grinding or a mis-aligned biting action creates an unbalanced or otherwise abnormal load on a particular tooth. This typically causes a notch on the side of the tooth at the gumline. This can be addressed in one of two ways: use of a customized night guard or orthodontic treatment to align the teeth so they meet correctly.
  3. Abrasion looks like abfraction. It is caused, however, by a mechanical force, such as brushing too hard or with a toothbrush that has hard bristles. Your brushing technique can be modified easily, and your hygienist or dentist can show you how to brush correctly.

Symptoms of Tooth Erosion

  1. Early Symptoms
    1. Discoloration
    2. Sensitivity
    3. Rounded teeth
    4. Transparent appearance
    5. Sandblasted appearance
  2. Advanced Symptoms
    1. Cracked tooth
    2. Dents in teeth
    3. Extreme Sensitivity

What Tooth Erosion Does to Your Teeth

Depending upon the cause of the erosion, the effect on your teeth will likely be:

  • Pain or sensitivity when drinking sweet, hot, or cold beverages.
  • Yellowish discoloration of the teeth.
  • Changes in fillings.
  • Greater risk of more cavities in time.
  • In extreme cases, development of an abscess.
  • Tooth loss, also in extreme cases.

Treatment of Tooth Erosion

Treatment for tooth erosion focuses on restoration of function of the tooth and, perhaps, its appearance. Lost enamel cannot be replaced (yet). Often a filling will be placed over the eroded tooth surface to protect it against additional wear. Another approach is applying fluoride at each regular six-month dental visit. Using a toothpaste with fluoride will help with sensitivity. Your dentist may recommend special products that will help you protect your teeth.

In some cases, the treatment will be more radical. Sometimes your dentist may recommend veneers to protect the tooth. If the tooth is very damaged, your dentist may recommend a root canal and crown to protect the interior structure and elements of the tooth.

Your dentist may choose to measure and watch affected teeth for changes. This will enable him or her to determine when treatment options are necessary.

What You Can Do to Protect Your Teeth from Erosion

Reducing and controlling the amount of acid in your mouth by controlling stomach acid reflux, limiting acidic drinks and foods, and following your dentist’s instructions with regard to brushing, flossing, and care of your teeth. These steps may include:

  • After consuming acidic foods or beverages, rinse your mouth with water. This will neutralize some of the effects of acid.
  • Wait at least one hour before brushing your teeth after consuming acidic food or beverage to allow time for your teeth to remineralize after exposure to acid.
  • Reduce consumption of carbonated drinks, replacing them with water, milk, unsweetened tea or unsweetened coffee.
  • Use a straw when consuming acidic beverages. This allows the liquid to go directly to the back of your mouth instead of washing over our teeth. Swallow these acidic drinks quickly and so not swish them around in your mouth.
  • Chewing sugar-free gum can help dry mouth and increase flow of saliva.
  • Using a soft toothbrush and toothpaste with fluoride.
  • Manage acid reflux.
  • Talk with your dentist about food and beverage substitutions that can protect your teeth.

By understanding tooth erosion and the damage it causes to your teeth, you and your dentist can determine the adjustments that will help to protect your teeth from erosion.

Can a Minipig Save Your Gums?

Difficult as it may be to believe, a minipig may be able to save your gums (and your teeth). A new therapy currently under development at Tohoku University in Japan suggests that stem-cells from minipigs may regenerate periodontal tissue in humans. This will, they say, heal gum tissue faster and at lower cost. It will also improve the quality of the minipig- pixabay cco free - 3986310 1280new tissue, according to scientists.

Periodontitis is one of the most common human dental diseases. It has been estimated that as much as 75 percent of the adult population in the USA has periodontitis. It is a painful disease. It results from bacterial inflammation of the gums and, eventually, loss of gums and supporting structures around the teeth. This inflammation creates infected pockets that cause erosion of bone and tooth loss. But this inflammation has been connected with heart disease, Alzheimer’s Disease, and more.

Current treatments for gum disease include infection fighting, use of growth factors, and tissue regeneration using autologous mesenchymal stem cells (a patient’s own bone marrow stem cells from cartilage, bone and fat. The goal, of course, is to regenerate whatever tissue has been lost to the disease. Side effects have been limited, but they have caused some defects.

The scientists developing this treatment report that their new treatment can regenerate gum tissue safely and more efficiently than any other treatment currently available. If this treatment proves effective, it can save the gums and prevent tooth loss in millions of patients.

The new treatment does not use an organism’s own stem cells. Instead, stem cells from a healthy organism are transplanted into an affected organism. These “allogeneic stem cells” overcome the shortcomings of current treatments. Specifically, this treatment uses stem cells derived from fat tissue transplanted from healthy minipigs. The treatment has thus far been safe and effective for treatment of gum disease.

The study is “a powerful first step towards further development of stem cell-based therapy for the treatment of periodontal disease,” according to one of the researchers. The researchers plan to take the next step and conduct a clinical trial in humans to demonstrate the positive results of transplanting stem cells and stimulation of successful periodontal tissue regeneration.

This kind of significant advance in treatment could change the oral health and the lives of many Americans. We will be eager to see the results of the next step in development of the treatment. We will keep you informed.

New Appliance Reduces Episodes of Sleep Apnea by Half

A new oral appliance has been developed at the Hiroshima University Hospital for sleep apnea patients. This new treatment for mild to moderate sleep apnea has proven effective in opening the airways. In obstructive sleep apnea, causes throat muscles to relax. This narrows the airways while you sleep. Indicators of the condition include snorting, choking or gasping while sleeping. If you have obstructive sleep apnea, you do not sleep properly. You will notice dailySleep Apnea effects - paid - Depositphotos 51055441 s-2019 fatigue and a short attention span due to lack of sleep. In more serious forms of the condition the effects can be far more severe, even causing death in some cases.

Primary treatments at this time include CPAP (Continuous positive airway pressure) machines and single-piece oral appliances (typically made by your dentist). This new appliance brings the jawbone forward and enlarges the air passages at the back of your mouth. The new appliance is custom made for each patient. The new device allows movement of the jaw. This, unlike current oral appliances, eliminates effects on your teeth and eliminates changes in the shape of your face.

In a number of previous studies, measurement of the airways was accomplished while the patient was standing. This does not replicate the changes to the airways when sleeping. In the new study, measurements were made while patients were lying down. Based upon these measurements, the device was designed to widen the air passageways in sleep apnea patients. Researchers found that patients using the devices almost halved the number of sleep apnea episodes during the night because it widened passageways to facilitate easier breathing.

If you have been diagnosed with mild to moderate obstructive sleep apnea, ask me about these custom appliances.


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