Over the last several months, due to increased recent popularity, quite a few patients have been asking, “Doc what’s your opinion on oil pulling?”. To be honest, when the first patient asked the question, I really did not know much about the topic, except that it was a natural ancient remedy used for cleansing the mouth. So, I decided to put on my research cap and found out all that I could about this trending topic. Many people swear by this ancient technique and say it has improved their oral health markedly. Let’s see what all this excitement is about.
Oil pulling is an ancient Indian folk practice or remedy, practiced for centuries. It involves swishing one (1) tablespoon of an edible oil such as coconut, sesame, olive or sunflower oil around the mouth for anywhere between 5-20 minutes. As the oil becomes thin and milky it is then expectorated, in a similar way to mouthwash. It is advised not to swallow the oil as it contains bacteria. Some ‘experts’ recommended spitting the oil into a paper towel and disposing of it in a trash can, as oil can clog pipelines. Others recommend rinsing with warm saline water or tap water, whereas, some recommend teeth brushing after oil-swishing to remove any oils or toxins that remain. It is proposed to have been around for thousands of years and is known as an Ayurvedic technique. This oil-swishing technique also claims to remove bacteria and encourage saliva production.
The American Dental Association, due to the lack of scientific evidence and not enough high-quality corroboration and conclusive research to-date on the topic of oil-pulling, does not support it. More extensive studies with a greater cohort are required. Hence, adequate evidence is still outstanding. Don’t you agree that any remedy for oral ailments should be sufficiently backed by supportive facts?
The Journal of Traditional and Complimentary Medicine, on the other hand, claims that results can be observed in as little as two weeks and up to forty-five (45) days. Other similar literature propose that coconut and olive oil are the most effective oils, compared to sesame and sunflower oils. Coconut oil usage, however, has been lauded as most popular, proposing to coat the teeth and gums, inhibit plaque development, freshen breath, prevent decay and gum disease; reduce oral candidiasis; assist with reduction in dental pain, whiten teeth and reduce bad breath.
Coconut oil contains lauric acid which has antimicrobial and anti-inflammatory properties. Therefore, it is claimed that oil-pulling also decreases anaerobic and other disease-causing bacteria.
According to the Journal of Indian Association, Dr. F. Karach was the individual responsible for making oil-pulling or swishing popular in the 1990s. It claims that he was convinced that pulling oil could cure approximately 30 systemic diseases, including headache, migraine, thrombosis, eczema, intestinal infection, asthma and diabetes.
The article entitled, “Oil pulling-A traditional method on the edge of evidence” (2017) as their method for research, collected articles related to Oil-pulling as a keyword search in Google and Medline and out of 21 articles gathered up to the year 2016, only 6 out of the 21 articles were recognized as noteworthy or having proper study designs and were used for analysis. The studies were still, however, unreliable for several reasons such as incorrectly interpreted results due to small sample sizes etc. Therefore, proper scientific evidence was lacking.
In clinical practice, I have observed that the people who are more inclined to gravitate to this increasingly popular technique are those who prefer naturopathic and herbal methods. There are several folks who prefer to use herbal toothpastes such as neem-based toothpastes and charcoal toothbrushes. This demographic usually have questions about the use of fluoride (this will be another topic for discussion coming soon) and the toxic effects of amalgam restorations (which we do not use). This portion of my patients usually ask about “oil-pulling”. Moreover, due to the lack of scientific evidence I cannot recommend it as a reliable oral hygiene method. However, as new information and reliable studies surface my opinion may be subject to change. There are many small-scale studies that conclude that this oil-pulling practice is a substantial oral hygiene method. However, please note that it should not be used as a replacement method for flossing and brushing.
While there are no known side effects to oil-pulling apart from the discomfort of rigorously swishing around the oil in your mouth for up to 20 minutes; it is not recommended that the ingestion of the swished oil be practiced, as it may contain bacteria which can cause diarrhea or upset stomach.
Conclusively, as mentioned above, if you use this ayurvedic technique, be reminded that it should not be used as a primary oral hygiene method. Always comply with the recommendations of your dental professional. If you have concerns or questions about oil-pulling in relation to your oral health, feel free to ask your attending dentist. Also, I would advise that you keep in mind that there is no magic formula for keeping your teeth white, your breath fresh or your gums and teeth in optimal condition. It is imperative that you practice good oral hygiene such as flossing and brushing 2-3 times daily. The use of proper brushing technique is important. The modified Bass technique which involves holding the head of your toothbrush at a 45-degree angle while using a circular, up and down motion to massage any food debris and plaque from the gingival sulcus is highly recommended. Ensure that your diet is also healthy and not filled with excess sugar and starchy foods which can be broken down into simple sugars by plaque bacteria. The frequency and duration with which these foods are eaten will play a major role in the rate of plaque development, decay, gingivitis and by extension periodontitis.
Plaque and calculus development is one of the main players in the cause of gum disease both gingivitis (early gum disease) and periodontitis (advanced gum disease) and dental caries or decay. Many people are not adequately educated on the significance of not only practicing good oral hygiene, but also complementing good oral hygiene practices with proper diet and the other factors mentioned above.
Some patients present to our dental office only on the event of sensitivity, pain, swelling or tooth mobility. At this point, disease has already progressed too far and either root canal therapy or extraction is required. Oil-pulling cannot and will not assist at this point. Subsequently, it does not matter how much oil-pulling you incorporate into your oral hygiene regime. If good oral hygiene habits such as flossing and brushing are not incorporated and proper care is not taken to ensure that your diet is adequate, you will run the risk of eventually having complicated dental issues which require more extensive and costly dental treatment in the long term.
Remember “Be true to your teeth and they won’t be false to you!”
By: Dr. P. Stuart-Hewitt
DDS, PGDip (Implantology), FICOI