Oil Pulling, And What The Dental Research Shows

Oil pulling is the practice of swishing oil around the mouth for several minutes as part of the morning routine. It has attracted more dental research than most traditional practices, with modest results.

The practice as described

A spoonful of sesame or coconut oil is held in the mouth and moved between the teeth for several minutes, then spat out rather than swallowed.

The texts group it with the mouth-holding procedures, gandusha and kavala, which also use decoctions, medicated oils and salt water depending on the purpose.

It is placed after tooth cleaning and tongue scraping in the morning sequence, not as a replacement for either of them.

The proposed mechanisms

Oil is a solvent for lipid-soluble material, and mechanical agitation may loosen plaque biofilm in the way any vigorous rinsing does.

A saponification argument is sometimes offered, in which oil reacts with saliva to produce a mild soap-like effect, though this is asserted more often than it is demonstrated.

Some plant oils contain compounds with antibacterial activity in laboratory conditions, but activity in a dish is not the same as an effect in a mouth.

What the trials report

Small trials have found reductions in plaque scores, gingival indices and counts of certain oral bacteria after several weeks of daily practice.

Most compared oil pulling with a mouthwash or with no additional treatment, and the studies are generally short, small and conducted in a limited number of settings.

Where oil pulling has been compared directly with chlorhexidine rinse, it has usually performed less well, which is the more useful comparison for a reader to hold.

What it does not do

Claims that oil pulling draws toxins from the bloodstream, whitens teeth substantially or treats systemic disease have no support and should be set aside.

It does not remove calculus, does not reach below the gumline, and cannot address decay that has already begun in enamel or dentine.

Substituting it for brushing, interdental cleaning and dental visits is the one way the practice becomes genuinely harmful, by delaying treatment that is needed.

Practical notes and cautions

Oil should not be swallowed, since it now carries whatever it has loosened, and it should not go down a sink where it will solidify in the trap.

Cases of lipoid pneumonia following accidental inhalation of oil have been reported, which is a reason for care in anyone with swallowing difficulty.

As an addition to ordinary oral hygiene it is cheap and low-risk; as a replacement for it, the trade is a bad one.