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Randomized Controlled Trial
. 2025 May;52(5):681-694.
doi: 10.1111/jcpe.14151. Epub 2025 Mar 9.

Intermittent Fasting Regimes Reduce Gingival Inflammation: A Three-Arm Clinical Trial

C L Pappe  1 , J Maetschker  1 , S Dujardin  2 , B Peters  3   4 , O Pivovarova-Ramich  3   4   5 , F Kandil  6 , A Michalsen  6   7 , C Breinlinger  6 , N Steckhan  8   9 , D Koppold  4   6   7   10   11 , H Dommisch  1
Affiliations
Randomized Controlled Trial

Intermittent Fasting Regimes Reduce Gingival Inflammation: A Three-Arm Clinical Trial

C L Pappe et al. J Clin Periodontol. 2025 May.

Abstract

Aim: To evaluate the effect of religious Bahá'í dry fasting (BF) or 16:8 time-restricted eating (TRE) compared with a regular diet (CG) on periodontal parameters during a modified experimentally induced gingivitis.

Material and methods: All participants were asked to refrain from oral hygiene (3 sextant) for 9 days (T1-T2) and were followed for a total of 19 days (T3) while adhering to fasting or a regular diet and resuming oral hygiene. The primary outcome was bleeding on probing in the test sextant (BOP_s), Rustogi plaque index (RPI), gingival crevicular fluid (GCF), blood pressure (BP), body weight (BW), HbA1c and C-reactive protein (CRP) were measured (T1-T3) and ANCOVA and post hoc comparison were applied.

Results: Sixty-six healthy participants were recruited. Forty-three were randomly assigned to TRE (n = 22) and CG (n = 21), while 23 followed BF, avoiding food and drinks during the day. At T2, BF demonstrated significantly less increase in BOP_s, and GCF increased in CG only. Analysis revealed significant differences in change for BOP_s between BF and CG (-9.48% [-17.18; -1.79]) and BF and TRE (-9.19% [-15.07; -3.32]) as well as for GCF between BF and CG (-0.06 μL [-7.22; -0.66]) and TRE and CG (-0.08 μL [-0.17; -0.00]).

Conclusion: This study indicates beneficial effects of different fasting protocols on oral experimental gingivitis and metabolic parameters, but results are limited by randomisation issues and potential bias in the BF group.

Keywords: Bahá'í fasting; bleeding on probing; crevicular fluid; experimental gingivitis model; gingival inflammation; intermittent fasting/16:8 fasting.

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Conflict of interest statement

D.K. and A.M. are members of the steering committee of the German Medical Association for Fasting and Nutrition (ÄGHE). D.K. has co‐founded the Academy of Integrative Fasting (AIF), an institution for the qualification of medical staff in clinical fasting applications. D.K. serves as a consultant for a mobile application on intermittent fasting (FASTIC) as well as a company producing plant‐based supplements (EVERYYIN). A.M. is also co‐founder of the SALUFAST company and serves as a consultant for Lanserhof.

Figures

FIGURE 1
FIGURE 1
Study protocol. BIA, bioimpedance analysis; BMI, body mass index; BOP, bleeding on probing; BP, blood pressure; BW, body weight; GCF, gingival crevicular fluid; HbA1c, glycated haemoglobin; OHIP, oral health impact profile; PCR, plaque control record; PMPR, professional mechanical plaque removal; PSI, periodontal screening index.
FIGURE 2
FIGURE 2
CONSORT flow diagram of the number of included participants and after correction for excluded participants and dropouts.
See this image and copyright information in PMC

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