BY JOANN R. GURENLIAN, RDH, PhD
Last week, my brother-in-law told me he had been oil pulling with sesame oil for a few weeks and wanted to know if there was any therapeutic benefit to this practice. I had heard of oil pulling, but never really did any research about it. If one Googles oil pulling, there are plenty of blogs and articles written about it, none of them from the scientific literature.
Oil pulling is not a new concept. It is an ancient traditional remedy that has been practiced for centuries in India and southern Asia as a holistic Ayurvedic technique. Oils such as sesame, olive, sunflower, and coconut can be used. Several blogs favor sesame oil as the best product to use, while others claim that coconut oil is preferred because 50% of the fat in this oil has lauric acid, which is "well known" for its antimicrobial action. Some recommend alternating the oils every few days to maximize benefit.
Several teaspoons to one tablespoon are swished in the mouth for approximately 20 minutes. The oil is "pulled" through the teeth and oral cavity, purportedly removing toxins from the saliva as well as harmful bacteria in the mouth.
The natural health blog from the Global Health Center reported that oil pulling may increase saponification in the mouth - a soapy environment that removes harmful bacteria and reduces fungal overgrowth, helps in cellular restructuring, and the proper functioning of lymph nodes and internal organs.
Other resources have reported multiple oral health benefits of oil pulling, including:
• Teeth whitening
• Overall strengthening of the teeth, gums, and jaws
• Prevention of caries, gingivitis, bad breath, and dryness of the lips, mouth, and throat
• Treatment for TMJ
• Reducing hypersensitivity
Systemic benefits of oil pulling mentioned on websites include relieving migraine headaches, treating sinusitis, supporting hormone imbalances, reducing inflammation in joints and bones, treating gastroenteritis, supporting normal kidney function, improving vision, promoting normal sleep patterns, reducing hangover after alcohol consumption, detoxifying the body, improving the skin, and protecting against heart disease and Alzheimer's disease.
Apparently, there are few downsides of oil pulling other than taste preference, time involved, upset stomach or diarrhea if one swallows the oil, and clogged pipes if the oil is spit into the sink.
While all these articles found on the Internet claim that there are multiple scientific studies showing the efficacy of oil pulling therapy, I had difficulty finding any credible research on this topic. Several studies are available, but the findings are limited by small sample size, absence of negative controls, lack of blinding, etc. Similarly, the medical literature does not have peer-reviewed scientific evidence of the claimed health benefits of oil pulling.
Given all the literature available through the media, what do we tell our patients about oil pulling? First, there is simply not enough science that has addressed the safety and efficacy of oil pulling. The reported oral and general health benefits may be real or a placebo effect. We do not have sufficient research to know if oil pulling does, in fact, reduce gingivitis and caries. We do, however, have ample science to know that routine brushing, interdental cleansing, and use of antiseptic mouthrinses improves oral health. Further, this routine oral home-care regimen takes minutes to accomplish, not 20 minutes. So, why pull when one can brush and rinse with equally healthy alternatives that have been scientifically studied?
The American Dental Association does not advocate the use of oil pulling as a supplementary oral hygiene practice, noting that oil pulling is not a replacement for standard, time-tested modalities. The ADA recommends patients use a standard oral hygiene regimen that includes twice daily toothbrushing with fluoride toothpaste and cleaning between the teeth once daily with floss or another interdental cleaner. They advocate using ADA-accepted products and adding an ADA-accepted mouthrinse if more help is needed to reduce gingivitis.
It is important to consider alternatives to current practice and to keep an open mind when there are new discoveries. However, it is equally important to establish safety and efficacy of products and practices. In the case of oil pulling, anecdotal reporting is not an answer.
JOANN R. GURENLIAN, RDH, PhD, is president of Gurenlian & Associates, and provides consulting services and continuing education programs to health-care providers. She is a professor and dental hygiene graduate program director at Idaho State University, and president of the International Federation of Dental Hygienists.