Maintaining oral health this Ramadhan

This article has been sponsored by Philips

Ramadan is a significant religious period that involves daily fasting from dawn (suhoor) until sunset (iftar) for approximately one lunar month. During this time, individuals refrain from eating food and drinks between these times.

As dental professionals, an understanding of the physiological and metabolic effects of fasting, particularly on blood glucose regulation, energy metabolism, and hydration, is essential to providing safe, effective, and culturally acceptable care.

Those who are pregnant or medically compromised, or unwell, are exempt from fasting. Fasting alters normal daily routines, which can have both systemic and oral health implications relevant to dental treatment.

While Ramadan offers numerous spiritual and health benefits, such as improved blood sugar regulation and cholesterol levels, it also presents challenges for maintaining oral health. Essential oral care is crucial during fasting to prevent issues, such as halitosis, xerostomia, periodontal disease, and dehydration.

Fasting affects the body primarily through metabolic changes. During fasting, the body uses stored energy sources, such as glycogen and fat, to sustain itself. This can aid in improving cholesterol levels and enhancing insulin sensitivity.

Ramadan not only fulfils a spiritual purpose but also instils a disciplined fasting habit, very similar to intermittent fasting, which can help to regulate weight and blood sugar.

Dehydration and energy changes

Dehydration is a common physical effect felt whilst fasting due to the lack of water intake during fasting hours, which can, in turn, affect energy levels, concentration, and bodily functions. The changes in energy levels may fluctuate as the body adapts to using fat reserves for fuel.

Fatigue and weakness can occur initially as the body adjusts, but many people report feeling more alert and focused over time.

The metabolic effects of fasting: blood glucose and energy

Under normal conditions, blood glucose levels are maintained by dietary intake of carbohydrates and glucose production within the body. When fasting, the body goes through a period of change. It first uses up glucose for energy, then switches to burning stored fats and then can also break down proteins if the fasting period is long.

Energy levels and fatigue (dental perspective)

Reduced daytime caloric intake and altered sleep patterns can lead to transient fatigue, reduced alertness, and mild dehydration, particularly in the first 1–2 weeks of Ramadan as the body adapts. From a dental perspective, this may affect:

• Patient tolerance of lengthy procedures
• Stress responses during treatment
• Postural hypotension when moving from supine to upright positions

Dental teams should remain attentive to signs of hypoglycaemia, such as dizziness, sweating, confusion, or tremor, especially in diabetic patients.

These things do not break your fast

• Brushing your teeth with toothpaste or a miswak stick
• Cleaning teeth with a toothbrush and toothpaste, and in between the teeth
• Visiting a dentist, dental hygienist, and dental therapist for checkups or treatments, provided water is not swallowed. Treatment under rubber dam, if applicable, is ideal.
• Lightly rinse your mouth during ablution (cleansing before prayer).

The benefit of using an electric toothbrush

I personally use the Philips Sonicare toothbrush and recommend it to my patients. The Sonicare technology uses sonic vibration to create a dynamic fluid action, moving water and toothpaste between teeth to move food particles and plaque biofilm.

This toothbrush can help maintain a fresh breath feeling to combat halitosis during fasting hours. Combining a Sonicare toothbrush with the Philips Cordless Power Flosser will help to remove plaque effectively between the teeth.

How does Ramadan affect oral health?

Oral hygiene tips during Ramadan

Maintain a consistent oral care routine as normal

• Brush twice daily with fluoride toothpaste—once after iftar and again before suhoor
• Wait 30 minutes after eating to brush to avoid enamel erosion.

Use interdental brushes and/or floss

• Clean between teeth to prevent plaque biofilm buildup / remove food debris.
• Alcohol-free mouthwash as an adjunct.

Hydrate between fasts

• Drink water between iftar and suhoor to keep your body and mouth hydrated.

Combat bad breath

• Use a tongue scraper to reduce bacteria on the tongue.
• Chew sugar-free gum (with Xylitol) after evening meals to stimulate saliva.

Choose friendly foods

• Eat Vitamin C-rich fruits like berries, guavas, and oranges
• Avoid sugary and acidic foods that can contribute to tooth decay.
• Include low GI foods such as porridge, lentils, whole grains, yoghurt, eggs, and dates.

Avoid caffeine and excessive salt

• These can increase dehydration, exacerbating dry mouth and gum sensitivity.