How dietary interventions impact oral conditions: a systematic review

Oral diseases, including periodontal disease, salivary gland dysfunction and oral squamous cell carcinoma, are characterized by chronic inflammation and metabolic dysregulation. Dietary interventions have demonstrated systemic anti-inflammatory and metabolic benefits; however, their effects on the oral cavity remain insufficiently explored.

A systematic review was conducted in PubMed and Web of Science to identify relevant studies published up to September 2025 assessing the effects of fasting, caloric restriction, and ketogenic diet on oral conditions. The search strategy combined MeSH terms and keywords related to these dietary interventions and oral health conditions. Data on study characteristics, interventions, outcomes, and limitations were extracted and synthesized.

Fourteen studies were included, comprising preclinical in vitro and in vivo studies as well as a limited number of clinical trials. Caloric restriction and intermittent fasting were generally associated with improvements in periodontal inflammation and metabolic parameters, without significant effects on oral microbiota composition. Alternate-day fasting demonstrated beneficial effects on salivary gland function and inflammatory responses in preclinical models. In oral squamous cell carcinoma, fasting-related interventions enhanced treatment sensitivity and reduced tumor growth in experimental studies; however, clinical evidence remains scarce, and feasibility, particularly for ketogenic diet, is limited and mainly derived from small pilot studies with methodological constraints.

Caloric restriction and intermittent fasting may exert potential beneficial effects in oral health by modulating inflammation, tissue regeneration, and metabolic pathways. However, current evidence remains largely preclinical and heterogeneous. Well-designed clinical trials and mechanistic studies in humans are required to establish their clinical relevance and to support their integration into evidence-based oral health practice.

This review was registered in PROSPERO (Registration ID: 1085293) and conducted in accordance with PRISMA 2020 guidelines [1].