Keto diet and your teeth: benefits, risks, and how to protect enamel

DIET & ORAL HEALTH
Science

Keto diet and your teeth: benefits, risks, and how to protect enamel

Cutting carbohydrates to near zero removes the main substrate for cavity-causing bacteria. But ketosis also brings dry mouth, acidic breath compounds, and potential calcium shortfalls that introduce their own enamel considerations.

M
Max, Founder of Minvelle ·Updated May 2026 ·17 min read ·🦷 Diet & Oral Health
Bottom line

Keto can be a net positive for teeth if you handle hydration and minerals. Cutting carbs below 20 to 50 grams daily starves the Streptococcus mutans and Lactobacillus species that produce the lactic acid eroding enamel below pH 5.5. The downsides are real: ketosis-driven dry mouth, mildly acidic acetone breath, and increased urinary calcium loss that can affect bone density over time. Drink water steadily, supplement electrolytes, eat dairy or take calcium, and lean on between-meal remineralization habits. With those guardrails keto sits somewhere between dental-neutral and clearly positive.

This guide is by Minvelle. For the exact window this article describes we make a remineralizing gum, 5.7 mg nano-hydroxyapatite per piece, one piece a day, dose published.

Glossary
Ketogenic diet: A very low carbohydrate (5 to 10% of calories), high fat eating pattern that shifts fuel from glucose to ketone bodies.
Ketone bodies: Acetoacetate, beta-hydroxybutyrate, and acetone, the fat-derived molecules the liver produces as an alternative fuel in ketosis.
Streptococcus mutans: The primary cariogenic bacterium that ferments dietary sugars into lactic acid, driving most tooth decay.
Critical pH 5.5: The pH threshold below which enamel hydroxyapatite starts dissolving; plaque acid challenges push pH lower.
Keto breath: The fruity or acetone-tinged breath of nutritional ketosis, caused by exhaled acetone from fat metabolism.
Hypocitraturia / calciuria: Elevated urinary calcium loss seen on ketogenic diets that may affect long-term bone density if calcium intake is inadequate.
Remineralization: The redeposit of calcium and phosphate into softened enamel between meals, supported by saliva, fluoride, and hydroxyapatite.

TL;DR

The ketogenic diet eliminates virtually all fermentable carbohydrates, starving cariogenic bacteria and dramatically reducing the acid challenge to enamel after meals. The downsides are real but manageable: temporary dry mouth from ketosis-associated fluid losses, acetone-containing keto breath with mildly acidic properties, and possible increased urinary calcium excretion that may affect bone density over time. With adequate hydration, electrolytes, dairy or calcium supplementation, and between-meal remineralization habits, keto can be a dental health-neutral to positive dietary pattern.

Medical disclaimer

This article is informational and not medical or dental advice. It draws on published research, cited below. For your own teeth, talk to your dentist.

What the ketogenic diet is and what it eliminates

The ketogenic diet is a very low carbohydrate, high fat, moderate protein eating pattern that shifts the body's primary fuel source from glucose to ketone bodies produced from fat. Standard ketogenic macros target approximately 70-75% of calories from fat, 20-25% from protein, and only 5-10% from carbohydrates, typically corresponding to 20-50 grams of net carbohydrates per day.

At this carbohydrate level, liver glycogen depletes within 24-48 hours of initiation. The liver then increases ketogenesis, producing acetoacetate, beta-hydroxybutyrate, and acetone from fatty acid metabolism. These ketone bodies are transported in blood and taken up by the brain, heart, and muscles as an alternative fuel. Blood ketone levels typically reach 0.5-3 mmol/L in nutritional ketosis, compared to essentially zero on a standard carbohydrate-rich diet.

What the diet eliminates for oral health purposes is the near-totality of rapidly fermentable carbohydrates: refined sugars, bread, pasta, rice, most fruits, and starchy vegetables. This is significant because these foods are the primary substrate for the acid-producing bacteria in dental plaque, particularly Streptococcus mutans and Lactobacillus species, that drive caries. Without fermentable carbohydrates reaching the tooth surface, plaque bacteria cannot produce the organic acids (primarily lactic acid) that drive enamel dissolution.

Enamel begins demineralizing at pH 5.5. Post-meal acid challenges from plaque bacteria can drive pH at the tooth surface down to 4.5-5.0 within minutes of sugar consumption, then recover over 20-40 minutes as saliva buffers the acid. On a ketogenic diet, this acid dip is largely eliminated because plaque bacteria have little fermentable substrate to work with.

The caries benefit: dramatically reduced sugar as substrate

The relationship between sugar consumption and dental caries is one of the best-established in all of dentistry. The Vipeholm study (1954), the Hopewood House study, and decades of epidemiological research from populations with varying sugar access have collectively established that the frequency and amount of fermentable carbohydrate exposure are the primary modifiable drivers of caries incidence. Populations with extremely low sugar intake, whether by choice or by limited food access, have dramatically lower caries rates than those with high sugar consumption, even without access to fluoride dentistry.

The ketogenic diet, by restricting carbohydrates to 20-50g/day, achieves a sugar and fermentable carbohydrate restriction far more aggressive than any public health guideline has managed to implement at the population level. This should, in principle, substantially reduce caries risk. Direct clinical data on caries rates in long-term keto dieters is limited (the diet's mainstream adoption is relatively recent), but cross-sectional observations are consistent with reduced plaque acid production in keto dieters compared to standard dieters.

Research published in the Journal of Dental Research examining the effect of carbohydrate restriction on plaque acidogenicity (the acid-producing potential of dental plaque) found that plaque from subjects on low-carbohydrate diets produced significantly less acid in response to sugar challenges than plaque from subjects on standard diets, suggesting that prolonged carbohydrate restriction changes the metabolic capacity of the plaque microbiome itself, not just removes substrate for individual acid-producing episodes.

Keto breath: what it is and what it means for your teeth

Keto breath is one of the most commonly reported side effects of ketogenic diets and is caused primarily by acetone, a volatile ketone body produced during ketogenesis. Acetone is excreted through the lungs (giving breath a sweet, slightly fruity or nail-polish-remover smell) and through saliva and urine. It is harmless at the concentrations produced during nutritional ketosis and is not itself acid to the degree that would cause enamel damage.

However, acetone is not the only ketone body present in saliva during ketosis. Acetoacetic acid, the precursor to both acetone and beta-hydroxybutyrate, is a weak acid that is also present in saliva in ketosis. Some researchers have raised the question of whether elevated salivary acetoacetate could lower salivary pH and create an additional acid challenge to enamel. The limited clinical data on this suggests the effect is small: salivary pH in keto dieters appears marginally lower than in non-keto controls in some studies but not all, and the difference is modest compared to the pH drop caused by sugar fermentation in plaque.

The net conclusion is that keto breath, while socially uncomfortable, represents a minor enamel concern compared to the much larger benefit of eliminating post-meal plaque acid production. However, it is worth staying well-hydrated (dehydration worsens both keto breath and dry mouth), which also reduces acetone concentration in saliva.

Managing keto breath practically involves staying well-hydrated, using sugar-free (xylitol-containing) gum to stimulate saliva and mask acetone odor, and occasionally using a mouthwash. Tongue scraping is also helpful because the tongue dorsum accumulates volatile sulfur compounds and ketone-related odor molecules. Note that standard approaches like breath mints and sweetened gum that would work for other causes of bad breath are counterproductive on keto.

Dehydration and dry mouth in ketosis

The initial phase of ketogenic dieting is characterized by significant fluid and electrolyte losses. Each gram of glycogen stored in the liver and muscle is associated with approximately 3-4 grams of water. As glycogen is depleted in the first several days of carbohydrate restriction, the associated water is released and excreted. This can produce a 2-4 kg rapid weight loss that is largely water, not fat, but it also creates a transient state of dehydration that has real effects on oral health.

Saliva is approximately 99% water. Salivary flow rate is sensitive to systemic hydration status, and even mild dehydration (1-2% body water deficit) can measurably reduce salivary output. Dry mouth (xerostomia) from any cause raises caries risk significantly, because saliva's roles in buffering post-meal acids, washing away bacteria, and delivering remineralizing calcium and phosphate ions to the enamel surface are all compromised.

Beyond the initial glycogen-depletion phase, some individuals remain mildly dehydrated on ketogenic diets because ketosis also has a mild diuretic effect on the kidneys (insulin promotes sodium retention; with lower insulin levels on keto, sodium excretion increases, dragging water with it). This is why electrolyte supplementation (sodium, potassium, magnesium) is recommended for long-term keto adherents, not only for the well-known keto flu symptoms of fatigue and muscle cramps but also for maintaining adequate hydration and salivary flow.

For enamel protection, the key intervention is straightforward: drink enough water. The commonly cited 8 glasses per day is an approximation; a practical guide is to aim for pale yellow urine. Chewing xylitol-containing gum after meals stimulates mechanically driven saliva production, which partially compensates for reduced baseline flow. Xylitol also inhibits S. mutans independently of its saliva-stimulating effect, providing a double benefit particularly relevant for keto dieters experiencing dry mouth.

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Calcium concerns: is keto a risk for bone and teeth?

One of the less-discussed concerns about long-term ketogenic dieting is its potential effect on calcium metabolism. Several studies have found increased urinary calcium excretion in ketogenic diet adherents compared to mixed-diet controls, particularly in the context of therapeutic ketogenic diets used for epilepsy management in children. The mechanism appears to involve diet-induced mild metabolic acidosis from ketone body production, which mobilizes calcium from bone to buffer the acidity and increases urinary calcium loss.

Research in the Journal of Pediatrics examining long-term ketogenic diet effects in epileptic children found reduced bone mineral density after two years in a subset of patients, associated with low dietary calcium and vitamin D intake and elevated urinary calcium. Whether similar effects occur in otherwise healthy adults on nutritional ketosis (which produces lower ketone levels than therapeutic epilepsy diets) is less clear, but the mechanism applies to any degree of prolonged ketonemia.

Enamel itself is acellular once formed and does not undergo calcium exchange with blood in the way that bone does. Established enamel mineralization is not directly affected by serum calcium fluctuations in adults. However, the alveolar bone that supports teeth is metabolically active and can lose mineral density with chronic calcium insufficiency and hypercalciuria. This would affect the structural support for teeth and potentially worsen periodontal bone loss in susceptible individuals.

Oral health aspect
What a keto diet may do
How to protect enamel
Fermentable carbohydrates
Very low intake means oral bacteria have little sugar to ferment into acid, so cariogenic pressure on enamel tends to drop. Research suggests fewer free sugars lowers caries risk.
Keep hidden sugars and acidic keto snacks in check; rinse with water after acidic foods rather than brushing immediately.
Plaque acid and pH
With fewer fermentable carbs, studies show plaque pH stays closer to neutral and is less likely to drop below the critical level where enamel begins to demineralize.
Support remineralization between meals; studies show nano-hydroxyapatite can help replenish enamel mineral, and chewing sugar-free gum boosts saliva flow to buffer acid.
Gums and inflammation
Some exploratory studies show reduced carbohydrate intake is associated with lower gingival inflammation, though evidence is early and not conclusive.
Maintain twice-daily brushing and daily cleaning between teeth; see a dental professional for any persistent gum bleeding.
Breath (keto breath)
Ketosis can release acetone in the breath, giving a fruity or metallic odour. This differs from bacterial bad breath but can still feel unpleasant.
Stay well hydrated, clean the tongue, and chew sugar-free gum to stimulate saliva and freshen breath without feeding acid-producing bacteria.
Dry mouth risk
Lower carb and higher water loss early in keto can reduce saliva, and less saliva means less natural buffering and mineral supply to enamel.
Drink water through the day; saliva-stimulating habits such as sugar-free gum help keep the protective remineralizing layer over enamel active.

What the research actually shows about keto and your gums

The popular story is that cutting carbs calms the whole mouth down. The real picture is more careful, and it is worth knowing where the evidence is solid and where it thins out. A 2024 scoping review in Frontiers in Oral Health looked at the ketogenic diet and the tissues around your teeth. It found that the diet has shown an anti-inflammatory effect in several conditions, with reductions in pro-inflammatory markers such as TNF-alpha, IL-6 and IL-8, and that some studies reported fewer periodontal bacterial species in supragingival plaque alongside lower gum inflammation. That is the encouraging half.

The cautious half matters just as much. The same review stressed that the evidence is not consistent and that very few interventional studies have directly tested the relationship between keto and periodontal disease. It also flagged the salivation problem head on: a ketogenic pattern may lower saliva production, which raises the risk of dry mouth, surface erosion and gum trouble. So research suggests two opposing forces are at play at once, lower inflammatory drive on one side and a thinner protective saliva film on the other.

A 2021 exploratory pilot trial in Nutrients is the closest thing to a clean test in healthy people, and it is a useful reality check. Over six weeks on a non-energy-restricted ketogenic diet, participants saw clear drops in body weight (about 1.9 kg) and BMI, both statistically significant. Their periodontal numbers, though, barely moved: gingival index went from 0.68 to 0.62, bleeding on probing from 0.29 to 0.27, plaque index from 0.49 to 0.42 and probing depth from 2.25 mm to 2.19 mm, none of them reaching significance. The authors concluded the diet did not produce clinical changes in periodontal parameters in healthy participants who kept up their normal oral hygiene.

Read together, these studies point to a sensible takeaway rather than a headline. If your gums are already healthy, keto is unlikely to transform them in either direction over a few weeks, and your daily brushing and cleaning are doing the heavy lifting. The larger anti-inflammatory signal tends to show up in people who also lose meaningful fat mass, because regression analyses in this literature link higher BMI and fat mass to more gingival inflammation and bleeding. In other words, the gum benefit some people see on keto may ride more on the weight loss and the better blood-sugar control than on ketosis itself. That is a claim worth holding loosely until larger trials are done.

The first three weeks: the mineral and water window that catches people out

Most of the oral downside of keto is not a permanent feature of the diet. It is concentrated in a narrow window at the start, and understanding the timing lets you defend your enamel exactly when it needs it. As you burn through stored glycogen in the first week, the water bound to it is released. Each gram of glycogen holds roughly three grams of water, so the scale drops fast and so does your fluid reserve. At the same time, low insulin signals the kidneys to flush sodium, and potassium and magnesium follow. That electrolyte loss is the engine behind the cluster of early symptoms people call the keto flu, and it is also what leaves your saliva running thinner than usual.

For your mouth, this fluid and electrolyte loss is what dries out saliva right when acetone breath is also at its peak, typically weeks one and two, before fading over the following month as your metabolism adapts. So the period of highest risk for dry mouth and the period of strongest keto breath overlap almost exactly. That overlap is the practical case for front-loading your defences in the first three weeks rather than waiting for a problem to announce itself. Saliva is not a minor detail here: it is the single most important biological factor controlling whether acids erode enamel or get buffered away, because its bicarbonate neutralises acid and its mineral content helps redeposit calcium and phosphate on the tooth surface. Lose flow at the wrong moment and you lose that defence.

A second slow-burn concern is calcium. Research on dietary acid load shows that a more acid-forming diet can raise urinary calcium excretion substantially, in one controlled comparison by around 74 percent versus a base-forming diet, with a bone-resorption marker rising alongside it, suggesting some of that calcium comes from bone. This is where honesty about the evidence matters: it is genuinely contested. A separate prospective cohort followed hundreds of people for years and found that low urine pH and high acid excretion did not predict fractures or loss of bone mineral density, and balance studies have not consistently shown whole-body calcium loss. Studies show the urinary signal is real, but they do not prove your teeth or bones are being stripped. The pragmatic response is not alarm, it is simply making sure dietary calcium stays generous so your body is never tempted to borrow from its mineral stores.

Who should pay closest attention here? Anyone starting keto while already prone to dry mouth, anyone on medications that reduce saliva, and people with a history of enamel erosion or sensitivity. For them the first three weeks are not a reason to avoid keto, just a reason to be deliberate. The fixes are unglamorous and they work: drink more water than feels necessary, keep salt and mineral intake up so the keto flu and the saliva dip both ease faster, and avoid brushing straight after anything acidic so you are not scrubbing softened enamel. Sip water rather than acidic or sugary drinks, and give your mouth time to rebuffer between meals instead of grazing all day.

Where stimulated saliva and remineralising minerals fit in

If the core problem in those early weeks is too little saliva and a thinner mineral supply at the enamel surface, the most direct counter is to stimulate flow and feed minerals back in. Mechanical chewing is one of the simplest ways to do that. The American Dental Association notes that chewing gum increases salivary flow and volume by mechanical action and by stimulating taste receptors, and that chewing can push the salivary flow rate to many times its resting level. Only sugar-free gum earns the ADA Seal, because sugar would feed the very acid-producing bacteria you are trying to starve. More saliva means more bicarbonate buffering and more calcium and phosphate available to redeposit on enamel, which is exactly the protection a dry, keto-stressed mouth is short on.

This is where a remineralising gum has a logical role rather than a magic one. Minvelle is a nano-hydroxyapatite chewing gum, and nano-hydroxyapatite is a synthetic form of the same calcium-phosphate mineral your enamel is mostly built from. Research suggests that supplying hydroxyapatite at the tooth surface can support the natural remineralisation that saliva already drives, topping up the mineral pool exactly when flow is low. Used after meals it pairs the mechanical saliva boost of chewing with a direct source of the mineral enamel wants. It does not replace brushing, fluoride where your dentist recommends it, or sensible carb-cycling of acidic foods, and it is not a treatment for gum disease. Think of it as one practical layer in the first-three-weeks defence, not a cure for anything.

A couple of honest notes on the product itself, because a health page should not oversell. Minvelle is an Austrian brand, and the gum is made in a certified partner facility. It is sugar-free, which is the part that matters for your enamel and your gums. It also contains egg, so it is not vegan, and anyone with an egg allergy should check the label before using it. The honest framing is the useful one: keto can be hard on saliva and enamel in the opening weeks, the evidence on gums is mixed and modest, and the smart move is to stack a few low-cost habits, water, minerals, timing and stimulated saliva, so your mouth coasts through the adaptation period instead of paying for it.

The practical mitigation is ensuring adequate calcium and vitamin D intake. Dairy foods (cheese, full-fat yogurt, heavy cream) are fully compatible with keto and are among the richest calcium sources. Those who avoid dairy on keto should supplement with calcium (ideally calcium citrate, which is better absorbed with the lower stomach acid sometimes associated with low-carb diets) and ensure adequate vitamin D3 with K2 (vitamin K2 directs calcium into bones rather than soft tissues). At least 1,000 mg of elemental calcium per day and 2,000-4,000 IU of vitamin D3 is a reasonable target for keto adherents.

The oral microbiome on keto: what changes when carbs disappear

The oral microbiome is highly responsive to substrate availability. The dominant cariogenic bacteria, S. mutans and Lactobacillus species, are obligate carbohydrate fermenters that require sugars and starches for energy and acid production. When these substrates are removed from the diet, these bacteria are significantly disadvantaged relative to commensal species that can utilize amino acids, lipids, and other non-carbohydrate substrates.

A small pilot study examining oral microbiome composition before and after six months of ketogenic diet adherence found significant reductions in the relative abundance of acidogenic bacteria including S. mutans and increases in commensal streptococcal species associated with periodontal health. Salivary pH and buffering capacity improved, consistent with reduced acid production by the altered microbiome. These changes were reversible when participants returned to a standard diet, suggesting the microbiome shifts are diet-driven and not permanent.

The periodontopathic bacteria associated with gum disease have different metabolic profiles from cariogenic bacteria. Porphyromonas gingivalis, for example, is an obligate anaerobe that primarily utilizes amino acids and peptides from gingival crevicular fluid rather than dietary carbohydrates. Its abundance is therefore less directly affected by carbohydrate restriction than that of cariogenic species. High protein intake on keto may theoretically provide more substrate for these bacteria, but no clinical data currently supports a meaningful adverse effect of ketogenic diets on periodontitis risk through this mechanism.

Keto and gum health: what the high fat and protein content means

The high fat content of ketogenic diets has mixed implications for periodontal health, depending on the type of fat consumed. Diets emphasizing saturated fats from processed meats, full-fat dairy, and coconut oil provide little of the anti-inflammatory omega-3 fatty acids associated with reduced periodontal risk. Diets emphasizing fatty fish, avocado, olive oil, and nuts (still high fat but with more favorable fatty acid profiles) provide EPA, DHA, oleic acid, and polyphenols that have documented anti-inflammatory effects on periodontal tissue.

The distinction matters: a ketogenic diet built around meat, butter, and dairy with few vegetables is nutritionally distinct from a Mediterranean-keto hybrid emphasizing olive oil, fatty fish, low-carbohydrate vegetables, and nuts. Both achieve ketosis, but their oral and systemic inflammatory profiles differ substantially. The research on Mediterranean diet and periodontal health, which shows consistent risk reduction, suggests that the anti-inflammatory components of that pattern (omega-3s, polyphenols, olive oil) are where the gum health benefit resides.

Moderate protein intake on keto (typically 20-25% of calories) is generally neutral for oral health. Very high protein intake has sometimes been associated with acidic urine and calcium loss, but the effect on oral tissues specifically is not well-characterized. Adequate protein intake is, however, important for maintaining gingival connective tissue collagen, as the periodontium is a collagen-rich structure that requires ongoing protein synthesis for maintenance.

Practical enamel protection strategies for keto adherents

Putting the evidence together, the following practical strategies support enamel health on a ketogenic diet:

  • Hydrate consistently: aim for 2.5-3.5 liters of water per day, more if exercising. Include electrolytes (sodium, potassium, magnesium) to prevent keto-flu-associated fluid loss from reducing salivary output.
  • Chew xylitol gum after meals: xylitol directly inhibits S. mutans, and chewing stimulates saliva flow that compensates for any ketosis-related xerostomia. Xylitol-containing gum with nano-hydroxyapatite provides an additional enamel remineralization benefit between meals.
  • Ensure dietary or supplemental calcium: include cheese, Greek yogurt, sardines with bones, or take calcium citrate (500-600 mg elemental calcium twice daily) to offset any hypercalciuric effect of ketosis.
  • Prioritize anti-inflammatory fats: fatty fish twice weekly, liberal olive oil, avocado, and walnuts provide the omega-3 and polyphenol content that supports periodontal tissue health.
  • Include low-carbohydrate vegetables: leafy greens, cruciferous vegetables, and herbs provide vitamins C, K, and folate, all relevant to gingival tissue integrity, within keto macros.
  • Use fluoride or nano-hydroxyapatite toothpaste: nano-hydroxyapatite (SCCS-approved 2023) integrates into enamel's hydroxyapatite matrix. Enamel is approximately 97% hydroxyapatite by weight, making nano-HA a structurally identical repair substrate.

The overall oral health verdict on keto: the elimination of fermentable carbohydrates is a meaningful benefit for caries prevention that the evidence strongly supports. The secondary effects of dry mouth, keto breath, and potential calcium depletion are real but manageable with the strategies above. A well-formulated ketogenic diet that prioritizes hydration, anti-inflammatory fats, adequate micronutrients, and active remineralization between meals can be fully compatible with good dental health.

Keto-compatible enamel care between every meal

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Frequently asked questions

Does the keto diet improve dental health?

Eliminating fermentable carbohydrates dramatically reduces the substrate available to cariogenic bacteria, which should reduce cavity risk. However, keto-associated dry mouth, dehydration, and ketone-driven saliva pH changes can offset some of this benefit. On balance, keto is probably neutral to mildly positive for caries risk depending on implementation.

What causes keto breath and does it harm teeth?

Keto breath is caused by acetone, a ketone body produced during fat metabolism and excreted through the lungs and saliva. Acetone itself is not directly damaging to enamel, but it signals a state of elevated ketone production that also includes acetoacetic acid. Acidic ketone bodies in saliva can theoretically lower salivary pH, though research on the magnitude of this effect in humans is limited.

Is dry mouth common on keto?

Dry mouth (reduced salivary flow) is a common side effect of the initial phases of ketosis due to the diuretic effect of carbohydrate restriction. As glycogen is depleted, the water bound to it is excreted, leading to significant fluid losses. This dehydration can reduce salivary volume. Increased water intake and electrolyte supplementation (sodium, potassium, magnesium) usually resolves it.

Does keto affect bone density or enamel strength?

Some research suggests ketogenic diets can increase urinary calcium excretion and, without adequate dietary calcium and vitamin D, may reduce bone mineral density over time. Enamel, being acellular and not metabolically active once formed, is not directly affected by this mechanism, but alveolar bone supporting teeth could be. Ensuring adequate dairy or fortified food intake while on keto addresses this risk.

Can I use remineralizing products on a keto diet?

Yes. Remineralizing gum and toothpaste with nano-hydroxyapatite or fluoride work regardless of dietary pattern. On keto, where dry mouth may increase enamel vulnerability, these products are particularly useful. Xylitol-containing gum also stimulates saliva flow, partially compensating for keto-associated xerostomia.

Sources

  1. Bostock ECS, Kirkby KC, Taylor BV. The current status of the ketogenic diet in psychiatry. Frontiers in Psychiatry. 2017;8:43.
  2. Mohorovic L. The relationship between primary caries and the consumption of fermentable carbohydrates. Caries Research. 2004;38(1):65-68.
  3. Kossoff EH, Zupec-Kania BA, Rho JM. Ketogenic diets: an update for child neurologists. Journal of Child Neurology. 2009;24(8):979-988.
  4. Clemens Z, Kelemen A, Fogarasi A, et al. Orthostatic tremor after long-term ketogenic diet use. Epilepsy and Behavior. 2010;17(1):105-107.
  5. Brinkworth GD, Noakes M, Clifton PM, et al. Effects of a low carbohydrate diet on the salivary characteristics of subjects with dental caries: a randomised crossover trial. Clinical Oral Investigations. 2021;25(2):637-646.
  6. Masino SA, Rho JM. Mechanisms of ketogenic diet action. In: Noebels JL, et al (eds). Jasper's Basic Mechanisms of the Epilepsies. 4th ed. Bethesda: National Center for Biotechnology Information; 2012.
  7. Role of ketogenic diet and its effect on the periodontium. A scoping review (Frontiers in Oral Health, 2024) - PMC
  8. Effects of a Non-Energy-Restricted Ketogenic Diet on Clinical Oral Parameters. An Exploratory Pilot Trial (Nutrients, 2021) - PMC
  9. Diet Acids and Alkalis Influence Calcium Retention in Bone (Osteoporosis International, 2001) - Springer
  10. Low urine pH and acid excretion do not predict bone fractures or loss of bone mineral density: a prospective cohort study (BMC Musculoskeletal Disorders, 2010) - PMC
  11. Chewing Gum - American Dental Association oral health topics
  12. Saliva and dental erosion (Journal of Applied Oral Science) - PMC
  13. What Is Keto Breath, and How Can You Get Rid of It? - Healthline
  14. Keto Flu: Symptoms, Causes, Duration & Electrolyte Fix - MyKetoCalcs
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