Nutrition Myths
Oil pulling – effective remedy for oral hygiene?

SUMMARY

  • Oil pulling, or swishing, is a scientifically proven method to improve oral health.
  • You can use any edible oils, but preferably those that have extra health benefits, such as sesame oil and coconut oil.
  • Studies show that you need to swish for at least 10 minutes every day for at least 2 weeks.
  • Oil pulling doesn’t draw toxins from the blood and hasn’t been proven to whiten teeth.
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Oil pulling – effective remedy for oral hygiene?

What is Oil Pulling?

Oil pulling originated from ancient Ayurvedic medicine and was known under the names of Kavala graha or Gandoosha. It has been used to improve oral health. (1, 2)

This ancient oral hygiene method was popularized only recently – in 1990s in Russia and in recent years in western societies.

It is popularly believed that oil pulling prevents tooth decay, promotes oral hygiene, reduces bad oral odor, dryness of throat and bleeding gums, whitens teeth, prevents lips from cracking and strengthens teeth, gums and jaws.

It is also thought to cure about 30 systemic diseases, such as migraine, diabetes or asthma. (3)

Evidence supports only some of these claims, while some have been proven to be wrong.

There is a growing trend of using oil pulling techniques in place of the usual chemotherapeutic agents.

Please note that neither chemical mouthwash nor oil pulling are a replacement for tooth brushing.

They are rather a supplemental method to improve teeth, gum and overall oral hygiene.

How do you oil pull?

The procedure involves slowly pulling (swishing, rinsing) one tablespoon of oil between the teeth back and forth without swallowing it for 10-15 minutes.

The oil is then spat out and followed by normal brushing to complete the cleaning.

NOTE: plumbers don’t recommend pouring any oil into the sink pipes.  Therefore, you should spit it into the rubbish bin! (4)

Oil pulling may seem difficult at first, but with practice it becomes easier.

At the end of pulling, the oil becomes thinner and white. This makes it easier to swish.

Some sources recommend that it should be done on an empty stomach to avoid getting nauseous. After all, swishing oil is not the most pleasant sensation.

Swishing oil for a long time may be uncomfortable because your jaw may get tired or you might find it unpleasant to swish oil in your mouth.

To overcome that, swish oil for as long as you find it comfortable.  You should increase the time gradually in the following days, until you reach 10-15 minutes.

MAIN POINTS

  • Swish one tablespoon of edible oil for 10-15 minutes every day before brushing your teeth.
  • Spit out the oil at the end of the procedure.

Which is the best oil for pulling?

Although sesame oil has traditionally been used, any edible oil is acceptable (e.g. sunflower, flaxseed, olive or coconut oil). (5)

Although flaxseeds have shown to be beneficial for our health, there are no studies that show any additional advantage of pulling with this oil.

Each of the edible oils have slightly different properties, depending on their components.

Sesame oil contains significant amounts of polyunsaturated fatty acids and three lignans: sesamin, sesamolin and sesaminol which act as antioxidants. (6)

Coconut oil is known to have anti-oxidant, anti-bacterial, anti-viral and anti-inflammatory properties and has been shown to be as effective as sesame oil in reducing bacteria, such as Streptococcus mutans, in the saliva. (7, 8)

Sesame oils have been used traditionally for hundreds of years, while coconut oil has become popular in recent years.

Sesame, coconut and olive oil have been shown to have similar results in reducing S. mutans count, lactobacillus count, plaque scores, and gingival scores. These results are comparable with those of chlorhexidine mouthwash. (7, 9)

Pulling with Sunflower oil reduces plaque after 15 days, but only significantly after 45 days. Sesame and coconut oils have been shown to have significant results after two weeks. (10)

Since they have similar effects, it comes down to your individual palate.

MAIN POINTS

  • Sesame and coconut oils are the most extensively tested oils for oil pulling, have extra properties, and seem to be the preferred oils to use for a better therapeutic outcome and overall oral hygiene.

Oil pulling with coconut oil – a tasty alternative to sesame oil

Coconut oil contains about 45% lauric acid, which has anti-inflammatory and anti-microbial effects.(11, 12, 8)

Lauric acid reacts with sodium hydroxide in the saliva forming sodium laureate,  which is the main component of soap.

Although the action of coconut oil is not entirely clear, scientists believe that its effects are due to the emulsification, saponification, antioxidant and antimicrobial action of its constituents.

While there were a few reports of sesame oil pulling causing health complications, there were no adverse effects reported on coconut oil pulling.(13)

This doesn’t mean, however, that similar complications cannot happen with coconut oil. Sesame oil is simply more widely used.

MAIN POINTS

  • Coconut oil is as effective in oil pulling as sesame oil
  • Besides acting as a soapy cleanser, coconut oil has antioxidant, antimicrobial and anti-inflammatory properties
  • Some people prefer to oil pull with coconut oil since they prefer the taste

Does oil pulling work – what has been proven to work and what is just a theory?

Scientific studies on oil pulling are still limited. However, more and more studies have started to emerge in recent years due to its increasing popularity.

The results of these studies are rather inconsistent, with some studies showing no effects  from oil pulling.

The different outcomes of the studies were mainly due to the different lengths of the process used to study the effects of oil pulling . (14, 9)

 The effectiveness of oil pulling may depend on each individual. However, the general rule is that you need to swish oil for at least 10 minutes for at least two weeks to see significant results for coconut, olive and sesame oils.

Since the effects of oil pulling are significant for a period of over two weeks, studies should be designed over a longer period of time. (14)

The most recent (2016, 2017) clinical trials and systematic reviews found that oil pulling has beneficial effects on oral and dental hygiene. (14, 15, 16)

Unlike chlorhexidine mouthwash, oil pulling works best, if adopted on an ongoing basis as part of your daily tooth-brushing routine.

Overall ,most available studies have shown that oil pulling is an effective natural method of oral-dental hygiene and a cost-effective substitute for Chlorhexidine mouthwash. (17, 18)

MAIN POINTS

  • The majority of available studies show that oil pulling is as effective as the most effective chemical mouthwash chlorhexidine, in maintaining oral health and hygiene
  • Studies that show insignificant effects of oil pulling had some flaws, such as an insufficient duration of the trial.

How does oil pulling work? – a scientific explanation

The exact mechanism on how it works is still not clear.

However, there are a few theories.

  • Theory 1: The viscosity of the oil prevents bacterial adhesion and plaque co-aggregation.
  • Theory 2: The alkalis in the saliva react with the oil, leading to saponification.

    This process forms a soap-like substance that enhances the cleansing action of the oil.

    The emulsified oils are then broken down to minute droplets, which enhance the surface area of the oil. Oil film is formed on the tooth surface, reducing plaque adhesion and bacterial aggregation. (19)

  • Theory 3: Sesame oil contains sesamin, sesaminol and sesamolin which may have antioxidant and anti-inflammatory properties, protect against infections, detox toxins, potentiate vitamin E and prevent lipid peroxidation. (3, 20)
  • Theory 4: Bacterial infections, such as gingivitis, produce an immune response, causing the production of large amounts of free radicals and leading to oxidative damage of the gingival tissues.

    The antioxidant properties of these oils reduce the effects of free radicals, and potential pathological changes to the gingiva, teeth, and other tissues in the mouth.

Benefits of oil pulling – evidence based

Many of the health claims of oil pulling haven’t been proven by scientific studies, although there may be some connection between oral hygiene and overall better health.

The following is a list of benefits of oil pulling: (3, 21, 22):

  1. Reduces Streptococcus Mutants in plaque and saliva.

    Sesame Oil pulling has shown to be effective in reducing Streptococcus mutans bacteria in  plaque and saliva.h

    It requires at least one week of oil pulling to reduce this bacteria in the plaque and two weeks to reduce it in the saliva. (23)

  2. Reduces bad odor (halitosis)

    Oil pulling is as effective in reducing halitosis due to oral bacteria as using chlorhexidine mouthwash. (24, 25)

  3. Removes stains

    The removal of stains may occur due to the cleansing action of the oils enhanced by saponification and emulsification. (26)

  4. Reduces plaque induced gingivitis (3)
  5. Reduces plaque (3, 9)
  6. Reduces the total colony count of aerobic microorganisms in the plaque of adolescents with plaque-induced gingivitis. (3)
  7. Reduces Lactobacillus count

    There is a strong link between the saliva Lactobacillus count and dental caries. Oil pulling reduces the lactobacillus count.(5)

  8. Decreases lesions and periodontal inflammation

    Due to better oral hygiene, there is a decreased occurrence of periodontal inflammation and carious lesions. (6)

MAIN POINTS

  • Evidence shows that oil pulling reduces plaque, gingivitis, bad odor, bacteria in the plaque and saliva, removes stains from the teeth and decreases lesions and inflammation.

Common health claims of oil pulling not proven by science

There are two popular health claims that have been shown to be incorrect:

  1. Oil pulling draws blood toxins

    For the toxins to be drawn from the blood, they would have to pass through oral mucosa. However, since oral mucosa is not semi-permeable, toxins can’t pass through this membrane and so cannot be “drawn from the blood”. (23)

  2. Oil pulling whitens teeth

    One study has shown that neither coconut, sesame, safflower, linseed and sunflower oils whiten teeth. (27) More studies may be needed.

MAIN POINTS

  • Oil pulling doesn’t draw toxins from the blood and doesn’t seem to whiten teeth

Risks of oil pulling

Generally this oral hygiene routine is very safe.  It is safer than using chemicals, such as mouthwashes.

However, there are some very rare cases where it may lead to a rare type of pneumonia called lipoid pneumonia. (28, 29)

These cases are only related to pulling with sesame oil, which may be because sesame oil is the most common product used in this method.

MAIN POINTS

  • Rare cases of lipoid pneumonia have been reported caused by sesame oil pulling

Advantages of oil pulling over using chlorhexidine and other mouthwashes

Chlorhexidine mouthwash is considered the most effective mouthwash in reducing plaque and gingivitis. (30)

The main advantage of using chlorhexidine mouthwash is that significant a reduction of bacteria and plaque is observed only after 24 hours, while oil pulling takes over 2 weeks to achieve similar results. (23)

Also, it only takes 30 seconds to swish while oil pulling takes 10 to 15 minutes.

Overall, studies show that oil pulling is as effective (or closely) and is a great preventative home therapy for oral hygiene that can substitute for chemicals. (31)

Here as some points to consider when using other mouthwashes:

  • Chlorhexidine may interact with substances found in toothpaste, such as fluoride and sodium lauryl sulfate. Therefore, for safety reasons it should be used after 30 minutes to two hours of brushing with toothpaste.
  • Chlorhexidine mouthwash should only be used for a short period of time. Long term use has many side-effects, such as staining of the teeth and soft tissue and mucosal irritation and can increase calculus deposition. (32, 33)
  • Chlorhexidine is not ideal for tooth crowns or caps made of materials that stain, such as composite or glass ionomer. (34)
  • There are other alternative and effective methods, such as rinsing with herbal or fluoride mouthwashes.

    This study shows that oil pulling is not as effective as herbal and fluoride mouthwash. However, it is not clear how long the pulling was performed. More studies with a longer duration of swishing are needed.

  • Many other mouthwashes (non-chlorhexidine) can be used daily over a long period of time, unlike chlorhexidine.

    However, most of them are designed for fresh breath and are not as effective in reducing bacteria or plaque. (34)

Advantages of oil pulling:

  • doesn’t stain the teeth
  • doesn’t cause an allergy
  • there is no unpleasant chemical aftertaste that lingers long after swishing
  • is five times cheaper then mouthwash
  • is readily available in most households

MAIN POINTS

  • Oil pulling is a safe alternative to chemical mouthwashes with many advantages that should be considered
  • Other good alternatives to keep your teeth and gums healthy are herbal mouthwashes

NUTRITION FACTS VS NUTRITION MYTHS

You will find a summary of the most common nutrition myths and evidence-based nutrition facts here.

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