Oral health: Why fluoride matters during fasting

Dr Pooja Acharya

Ramadhan is a month of reflection, discipline and care for both body and soul. During this holy month, changes in eating habits, sleep patterns and hydration can affect oral health, making proper dental care especially important.
As a dentist practicing in Oman, I frequently observe an increase in complaints of dry mouth, bad breath and gum sensitivity during Ramadhan.
These concerns are appropriate, as fasting alters eating patterns and reduces fluid intake for extended hours. Many people in Oman and across the GCC ask an important question: Which toothpaste should be used during fasting?
Most dentists across the world, emphasise that correct toothpaste selection of particularly appropriate fluoride concentration, is central to protecting oral health during fasting.
Ramadhan involves prolonged fasting, altered eating patterns and reduced daytime hydration. These physiological changes affect saliva flow, oral pH balance and bacterial activity, thus, increasing the risk of tooth decay, gum disease and halitosis if preventive oral care is not maintained. Saliva acts as a natural protective fluid by neutralising acids, aiding remineralisation and controlling harmful bacteria.
According to the World Health Organisation (WHO), reduced saliva flow during fasting creates a more acidic oral environment, increasing enamel demineralisation and bacterial growth.
This makes effective plaque control and fluoride exposure especially important during Ramadhan. WHO, FDI, World Dental Federation and American Dental Association (ADA) recognise fluoride toothpaste as the most effective and economical method for preventing dental caries. Fluoride can help in strengthening tooth enamel, enhance remineralisation, reduce acid attack after sugar consumption and suppresses the activity of cavity causing bacteria, hereby reducing the risk of dental caries.
These effects are particularly important during Ramadhan, when sugar intake is often concentrated at iftar and suhoor. The ideal toothpaste during Ramadhan should contain 1,000–1,450 ppm fluoride, should have low abrasion properties and be mild flavoured to reduce discomfort while fasting.
Toothpaste for sensitive teeth is recommended for individuals experiencing pain with hot or cold foods. Whitening toothpastes should be used occasionally, not daily, as they may increase enamel wear and sensitivity — especially in a dry mouth environment.
To optimise fluoride protection and plaque control during Ramadhan, brushing is recommended after suhoor, after iftar and before bedtime. This schedule minimises bacterial growth and supports enamel repair. Fasting-related bad breath is caused by reduced saliva and increased production of volatile sulfur compounds.
Clinical studies show that fluoride toothpaste, gentle tongue cleaning, adequate hydration between iftar and suhoor significantly reduce halitosis. Use of herbal toothpastes like Miswak provides mechanical plaque removal and antimicrobial benefits and is permissible during fasting.
However, it does not provide fluoride. Herbal toothpastes may support gum health but should not replace fluoride toothpaste, particularly in populations with moderate to high cavity risk, as stated in WHO preventive guidelines.
Children are especially vulnerable to cavities due to frequent sugar intake and irregular brushing routines. International pediatric dental guidelines recommend twice-daily brushing with age-appropriate fluoride toothpaste.
Limiting sugary foods after iftar can benefit in decreasing caries risk. Using the correct toothpaste — particularly one with optimal fluoride content — is the cornerstone of preventing tooth decay, gum disease and bad breath during fasting.
At iftar and suhoor, opt for foods rich in calcium and vitamins — like yoghurt, cheese, nuts and fresh vegetables. Limit sticky sweets and sugary desserts that cling to teeth and fuel bacteria growth.
Ramadhan is a time to strengthen discipline and wellbeing. Maintaining proper oral hygiene with the right toothpaste is a simple yet powerful step toward better health. When in doubt, consult your dentist for personalised advice — before, during, or after Ramadhan.
The holy month embodies balance — nurturing the soul while safeguarding the body. Oral health should be viewed as an integral component of overall health rather than a secondary concern.
Preventive care remains the cornerstone of dental wellbeing and consistent hygiene practices can effectively prevent complications during the fasting month.
By adopting disciplined oral care routines and making informed dietary choices, individuals can maintain both their spiritual commitments and their dental health with confidence. May this blessed month bring continued health, reflection and peace to everyone.