I avoid tooth decay by brushing twice a day: upon waking up and right before sleep. I also use a tiny brush between teeth everytime I brush my teeth. I use an electric toothbrush, the cheapest OralB and generic brushhead replacements every few months.
Unfortunately, I had bad gums years ago. They’re much better now, but the improvement happened already before keto. I think keto definitely helps, because I suspect the gum bacteria love sugar. Die, bitches, die, starve! Lol