Problems and solutions for Ramadan oral health care

During Ramadan, oral health benefits from special attention.

In this article, dentist Aryaan Khalid explains the changes that can occur in the mouth during the holy month of fasting. Below, he outlines the problems that can occur, and how best to prevent them.

Dentist Aryaan Khalid offers expert oral health advice for people who are fasting during Ramadan.

To encourage regular dental attendance and preventive care, Aryaan is encouraging more patients to join Denplan with him at either SpaDental Ledbury or SpaDental Ross on Wye.

Aryaan enjoys all areas of general dentistry and particularly likes seeing patients benefit from his restoration work.

Problems occurring in the mouth during Ramadan

• Dehydration: Inadequate fluid consumption can lead to gum disease, tooth decay and bad breath (halitosis).
• Reduction in quantity of saliva: Saliva has anti-bacterial properties, as well as possessing anti-fungal and anti-viral systems. Dry mouth (xerostomia) means reduced anti-bacterial activity in the mouth which can result in gum disease, tooth decay and bad breath.
• Higher risk of oral diseases: Incidences of tooth decay, gum disease, halitosis and oral thrush can increase. Neglect of oral hygiene practices, such as brushing and interdental cleaning, poor attendance for dental appointments as well as a decline in accepting dental treatments, increase risk.
• An increase in the production of sulphur-containing compounds: Both dehydration and reduced oral hygiene can create an oral environment producing volatile sulphur compounds associated with bad breath.
• Increased risk of severe gum disease (periodontitis), tooth decay and halitosis in diabetic patients: Diabetes is a major systemic risk factor for periodontal disease. Poorly controlled diabetes can lead to periodontal disease. High blood sugar level can also increase glucose levels in saliva, leading to tooth decay. Diabetes-related halitosis is caused by high levels of ketones in the blood.

Advice regarding diet

During periods of non-fasting during Ramadan, plan your nutrition and meal times to protect your ongoing oral health.

Try to eat and drink:

• Drink plenty of plain water during non-fasting hours to rehydrate yourself.
• Stick with a diet rich in fresh fruit and vegetables. They are a good source of vitamins and fibres which encourages good overall health. They also produce saliva which rinse away bacteria and food particles.
• Eating a small piece of cheese after food helps to repair enamel (the outer layer of the tooth) and neutralise the acid that is produced in the mouth by sugary food and drinks. The chewing action of cheese also helps to produce more saliva in the mouth. This reduces the potential for tooth decay and gum disease.

Try to avoid:

• Spicy, salty food and caffeinated drinks which can lead to dehydration.
• Foods that lead to bad breath, such as onion and garlic.
• Sticky food, such as chocolates and toffee. They can cause the maximum damage to teeth due to prolonged exposure of teeth to sugar.
• Fruit juices – they contain a lot of sugar and cause tooth decay. Fruit juices that claim to be sugar-free are a problem too. They are acidic and cause tooth wear. The same is true for fruit-based teas.
• Smoking, as it can cause dehydration. Moreover, it is identified as one of the major risk factors for the development and progression of periodontal disease.

Advice regarding oral hygiene

Ramadan oral health routines need to be considered as you plan your routines. As sleeping and eating patterns change, it’s important to remember to brush teeth directly before sleeping, and also leave half an hour between eating and brushing, so the teeth can re-mineralise.

• Brush teeth twice a day with a fluoride based toothpaste such as Colgate, Sensodyne or Oral-B. Spit out the toothpaste but do not rinse mouth. This is because the fluoride forms a protective layer over the teeth which reduces your chances of getting tooth decay.
• Clean between the teeth either with floss or little brushes, such as TePe, at least once a day. This helps to remove food particles from between the teeth which the toothbrush cannot get to.
• Use a tongue scraper daily to remove sulphur-containing compounds from the tongue and reduce bad breath.
• The use of alcohol-free, anti-bacterial mouthwash, such as Listerine, helps to combat bad breath too.
• Denture wearers should keep dentures out of their mouth as much as possible as it is not hygienic and can lead to oral thrush. Dentures should be cleaned with ordinary soapy water. Avoid the use of hot water and toothpaste with dentures. When not wearing them, dentures should be placed in cold water to keep them hydrated.
• Visit the dentist for regular dental check-ups and advice, at a time when it’s suitable for you.

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