The Keto Diet and Oral Health

Low-carbohydrate and Keto diets have been trendy for over a decade. Due to their popularity, patients sometimes ask us questions about the connection between a Keto diet and oral health. In this blog post, we will share the dental pros and cons of a low carb diet and offer some strategies to mitigate the cons.

Keep in mind this post isn’t intended to replace the advice of a physician or registered dietitian. We always urge people to seek medical advice since the human body is complicated and not every diet is appropriate for every person.

For many people, these low carb diets provide an opportunity to lose weight without feeling deprived. There are multiple variations of Keto, or low-carbohydrate, diets. Some are more restrictive like the Atkins and other Keto diets with strictly limit the carbohydrates the dieter consumes. On the other end of the spectrum, there are lower-carb diets that promote excluding or limiting refined sugars and simple carbohydrates while still allowing the dieters to eat some complex carbohydrates like vegetables and moderate quantities of fruit.

Typically, a Keto diet involves very low carb consumption along with high-fat consumption. The goal of promoting ketosis is to force the body to burn stored fat reserves rather than glucose. The body prefers to burn glucose as a fuel source so people following a Keto diet make intentional and specific choices. Some common nutrient ratios include 60-80% fat, 20-30% protein with just 5-10% of the total calories consumed coming from carbs.

Now that you know a little about ketosis, we will start with the cons before moving on to the pros.

Cons or Downsides: Keto Diet and Oral Health

The primary downside to a Keto diet is the risk of developing “dragon’s breath” or Keto breath. Halitosis or bad breath is an unfortunate side effect of ketosis.

To prevent Keto breath, it helps to understand a little about what is going on. The liver makes ketones that can be used by the body as a fuel source if glucose isn’t available. Ketosis typically happens at night while we sleep, if we fast, or while dieting.

During ketosis, the body converts fat cells into three types of ketones. Acetone is one of the three, but the body can’t use it as a fuel source so it is released and expelled through the lungs and urine. The result is “Keto breath.” Fortunately, there are a few ways to relieve it.

Ways to prevent bad breath:

1. Sip water during the day and evening.
2. Maintain good oral hygiene, including brushing, flossing, and possibly using a mouthwash.
3. Consider a diet that allows you to eat more complex carbohydrates like vegetables.
4. Try infusing herbs into water or herbal tea. Some popular options include cloves, mint, cinnamon, or fennel which all traditionally serve as natural breath fresheners.
5. Consider chewing sugar-free gum or sugar-free mints to stimulate saliva.

Beyond Bad Breath

As we mentioned above, bad breath is a pretty big con of the Keto diet. However, it goes beyond just the smell. We can easily cover up the smell with gum or mints as mentioned above, but the cause of the bad breath can permanently impact your teeth.

Keto breath is acidic. Why is this a problem? When your teeth are constantly exposed to acid, it can be harmful to your dental health. Acid exposure can cause your teeth to erode. Over time, erosion will lead to permanent enamel loss. Once you begin to lose enamel on your teeth, other painful and aesthetically displeasing events can occur. Your teeth can begin to look worn as well as become more sensitive to temperature and texture.

We are by no means saying that if you are on the Keto diet for a few weeks, that you will permanently ruin your teeth. However, it is important to understand the potential damage you may cause to your teeth from an extended period of time following this diet.

Pros or Upsides: Keto Diet and Oral Health

Now that we discussed the downside of a Keto diet, let’s look at the upside. Since this diet limits sugars and other refined carbs, it also helps prevent tooth erosion and tooth decay.

When you consume sugar, it promotes bacteria in the mouth. These bacteria feed on the sugar and the byproduct is acid. This acid output erodes and demineralizes the teeth causing a breakdown of the enamel and eventually cavities. Even healthy foods like fruits because of the sugar and acid levels can have a negative impact on the teeth unless you take care to keep your teeth clean.

Now for an interesting twist. The “Paleo” diet is another popular low-carb diet that is a little less restrictive than Keto. People who follow Paleo tend to limit refined carbs, grains, and sugars but they eat more vegetables than typically allowed in the introductory phases of a Keto diet. This variation may benefit the gums as well as the teeth.

A 2009 study on the impact of the paleo diet on dental health from the American Academy of Periodontology. For four weeks, study subjects followed a paleo diet and were not allowed to perform standard oral hygiene. Not surprisingly plaque increased, but more surprisingly gum bleeding decreased. Imagine the results these participants may have experienced if they maintained daily brushing and flossing routines while cutting simple carbs from their diet.

Of course, the study looked at Paleo, not Keto so it is entirely possible that Atkins and other Keto diets might have the same or similar results.

We hope you found this discussion about the relationship between the Keto diet and oral health helpful. As with any health choice, there are pros and cons. A low carbohydrate diet may benefit the health of your teeth and gums while you reach or maintain a healthy weight.

Of course, consistently following your at-home oral care routine helps enhance the benefits and mitigate the risks. After all, we don’t suggest that anyone avoid brushing or flossing for four weeks! Remember to brush and floss daily while you reap the dental rewards of consuming less sugar.

Finally, whether you follow a low-carb diet or not, a cornerstone to good oral health is professional dental care.

Schedule Your Examination Today

Chances are you want a healthy smile to match your healthy body. A dental examination and professional cleaning are essential. If you live in or near Charlotte, NC and are and are looking for a dental provider, don’t hesitate to contact us today.

For a decade, the team at Southview Dentistry has had the privilege of helping Charlotte residents enjoy fresh breath and a confident smile. Contact us today at to schedule your appointment.