Fasting is directly linked to bad breath. This is because not eating for extended periods of time impacts the amount of saliva we produce.
"Our saliva plays an important role in protecting our mouth and reducing bacteria growth. During fasting, the saliva flow is reduced and, therefore, we have less protection against bacteria, which can cause bad breath," explains Ciara Hendy, a dental hygienist at Dental Studio in Dubai.
Here are some expert-recommended tips to maintain oral hygiene on fasting days and beyond.
Hydrate, hydrate, hydrate
Hendy stresses the importance of drinking sufficient water during iftar and non-fasting hours. Not only can this keep you hydrated between sunrise and sunset, but it also helps keep bad breath at bay.
"Water helps to wash away food particles – another cause of bad breath – and hence avoid halitosis," says Hendy, who recommends drinking up to three litres a day even during Ramadan.
Dr Rumana Abbas Dawasaz, an aesthetic and cosmetic dentist from Zulekha Hospital in Dubai, says that avoiding caffeine, excess salt and other foods that lead to dehydration will hold you in good stead, both when you're fasting and for oral hygiene purposes.
Don’t brush immediately after eating
Swishing water around the mouth right after you eat or drink something, especially foods that can cause your teeth and tongue to stain, is a top tip from Dr Hosam Ali Baeshen, an orthodontist from King Abdulaziz University who works with Align Technology.
Rinsing and gargling is also important because you should never brush your teeth immediately after eating, whether or not you’re fasting.
As Dr Maisa Zobeidi, a dentist at Zulekha Hospital in Sharjah, explains: “It is recommended to wait for 30 to 60 minutes after eating before you brush. The reason is that after we eat, the acid levels in the mouth rise and our teeth are at their weakest state.
“Brushing at this stage can cause considerable damage to the tooth enamel. Waiting will allow the saliva to neutralise the oral environment and help the recovery from acids.”
Zobeidi says that chewing sugar-free gum during this time could help refresh the mouth as it returns to its normal pH level, without causing any damage.
Keep your mouth clean all day
Dawasaz notes that mouth odour mostly emanates from the tongue, so recommends that a tongue scraper be used daily.
While brush and flossing 30-60 minutes after iftar and suhoor can reduce plaque build-up, Hendy says using a tongue scraper, floss and interdental aids even during fasting hours can help keep your mouth clean.
If you want to use a toothbrush during the day, Baeshen recommends doing so “with very little toothpaste applied on the toothbrush. Ensure the mouth is rinsed properly thereafter, so no remnants or taste of the paste is swallowed.”
He adds: "There are also traditional ways of maintaining oral hygiene without the need for toothpaste or even added water. Try using miswak stick, the soft bristles on either end of the twig can be used to clean the teeth. And use the sunnah siwaak – tooth stick – without paste throughout the day."
Foods that cause bad breath
In addition to the effect fasting can have on our breath, certain foods are more prone to causing mouth odour.
Zobeidi says: “Bad breath can be reduced by reducing the consumption of ingredients such as garlic, onions and chillies. The chemicals associated with these foods tend to enter the bloodstream and move to the lungs, and are then breathed out, with their effect lasting for a long time.
“Fish also may lead to bad breath. Squeezing a lemon on the fish may help in reducing this.
“Caffeinated beverages are another culprit. These cause the mouth to become dry and so give out an unpleasant odour. The effect of this may be reduced by drinking water after consumption,” says Zobeidi.
Dawasaz recommends breaking your fast with water and dates, and consuming more fruits and vegetables, as well as probiotics such as yoghurt.
“Mouthwash can dry the oral tissue,” she says, “so use it with oral probiotic to form healthy bacteria and maintain oral health.”
Don’t put off visits to the dentist
Dr Tamer Mohsin Abusalah, a general practitioner – dental & HOD at Burjeel Hospital, has observed that many people put off dental treatments during Ramadan. “This can lead to gum disease or make existing conditions, such as cavities, worse,” he says. “Moreover, people eat a lot more sugary food and meat [during Ramadan], so we advise not to put off dental treatments.
“If you are worried a session will affect your fast, consider going to the clinic after sunset; most dental clinics are open until late to accommodate patients after iftar. Importantly, if you were getting treatment for gum disease or cavities before Ramadan, make sure you continue to visit the dentist.”
What your dental routine should look like
Baeshen outlines what an effective oral hygiene routine looks like: “Set and stick to a solid tooth brushing routine,” he says. “Regard flossing your teeth as important as brushing. Use a fluoride toothpaste and a good mouth rinse. Drink plenty of water and only water just before bed. Schedule routine dental check-ups and cleanings.”
Hendy adds: “A person’s oral hygiene routine should consist of twice daily brushing for two to three minutes with a fluoride toothpaste and a soft-medium toothbrush, which should be changed every three months.”
Finally, Dawasaz is a fan of electronic toothbrushes that, she says, help with “thorough cleaning”.