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What are your thoughts on oil pulling?

I have been getting quite a few questions from patients lately on oil pulling. From what I’ve read it has all these healing properties, but it seems kind of fishy to me. Any thoughts on this?



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7 Answers
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Oil pulling is popping up all over the internet lately and I too am starting to have patients ask me about it. In fact, one patient of mine who has been oil pulling is now in need of SRPs as he presented with radiographic calculus, generalized 6mm pockets, mild bone loss, furcation involvement, and recession. I could barely get through perio charting as he was so tender due to infection. I don’t like not having a science-based answer when it comes to patient questions (even though clinically I had my answer) so I began my research into oil pulling.

 

Oil pulling is an ancient Ayurvedic remedy for oral health and detoxification. It involves the use of pure vegetable oils as agents for supposedly pulling harmful bacteria, fungus, and other organisms out of the mouth, teeth, gums, and even throat. As a hygienist, I’d like to focus on the oral health benefit claims as many people are oil pulling instead of brushing and flossing.

First, we need to look at dental plaque. For review: dental plaque is a bacterial biofilm that forms a physical barrier, a polysaccharide matrix, which protects bacteria from the effects of antibiotics, antiseptics (rinses), and your immune system. This is why taking an antibiotic for gum disease is not effective, as the antibiotic cannot break through the biofilm’s protective layer. The claim that oil can break this through this barrier has not been proven. The most effective and proven method to disrupt biofilm is through mechanical/physical means, in other words by brushing and flossing.

 

Next I’d like to comment on the claims of oil pulling “healing” gum disease. Simply rinsing with mouthwash, oil, or any other liquid only reaches 2 mm into a gingival sulcus. Most people have deeper pockets than this, especially when they have gingivitis or periodontitis. This is why rinsing, alone, is not the delivery of choice. Like mechanical removal of biofilm, this has been proven in scientific studies. So why would oil be able to miraculously get deeper into the pocket? Until I see a valid, reproducible, scientific study, again I must hold true to what has been proven thus far.

 

When you read these articles online I hope you notice who they are written by. Were they written by a dental hygienist or dentist? When studies are referenced validating the claims of oil pulling are you able to easily find these studies and fact check? I’ve noticed that the study results referenced in many articles were written in a way to make oil pulling look effective, but the actual results of the research were actually left out! For instance, saying oil pulling was effective after 4 weeks regarding plaque reduction, but leaving out the control group using chlorhexidine was effective at 2 weeks. Further, wouldn’t just swishing with water or any liquid for 20 minutes be just as “effective?” The studies do not delve into if it was the actual oil or the act of swishing that made it effective. Also, what about probing depths, bleeding indices, using a control group of just water or salt water, etc. So many questions unanswered!

 

Finally, brushing for two minutes twice per day along with flossing for a few minutes once per day, simply takes less time. I have a hard time motivating patients to brush for two minutes let alone swish with oil for 20 minutes! So if a patient chooses to oil pull, doing it in conjunction with brushing and flossing and not as a substitute, would be my recommendation as an oral healthcare professional whose job is prevention. A healthy mouth is a healthy body; so until I see scientific research that shows that oil can reach the bottom of a gingival pocket, can break through the barrier of biofilm, among other points of interest, I’m sticking with what is proven!

 

As hygienists, it is our duty to use science-based evidence so I urge you to do your own research and use your critical thinking in combination with what you know to be fact from your hygiene education to base your opinion on this fad.

More Answers

I looked into this as well when one of my maintenance patients asked me about it and I had no idea how to answer her questions. I personally don’t think it works as well as brushing and flossing based on lack or research and my own clinical findings. It may be more beneficial as a preventative adjunct on a patient who has just had a prophy or SRP to remove all deposits because it obviously won’t make them healthier if they have any hard deposits or even plaque because it won’t remove that. And since plaque begins to form immediately after removal I don’t see how much it will accomplish. I advise to stick with what has been proven and will update my recommendations when evidence is available to support it.

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What about a chlorahexadine (sp) rinse? Does this only penetrate 2mm into the sulcus as well? I will often sell bottles to my patients with advanced perio disease. Do we think this will this be helping their deep pockets or just the very mild ones?

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I have seen patients in my office that are oil pulling. The information I have read is very interesting and I intend to do my own study on myself by disclosing after oil pulling to see if in fact plaque is removed. The patients that swear by it do in fact have very little deposits and are in excellent periodontal health. I will keep you posted on my results.

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I tried it on myself once. I was too sore in my tmj afterwards to do it again. I suppose if I were somewhere and it’s all I could do, maybe. For now my Sonicare and floss will do fine!

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One of my patients would come in every 6 months for a prophy and always had 1 -3mm pockets with no bleeding but was always very tender with her cleanings and had gum -line staining (tea drinker). With her last appt she had no staining and no tenderness (I always use the piezo). I asked her what she was doing different and she said oil pulling daily. Only patient I have had that oil pulls. Correct me if I’m wrong but I think I have read that breathing in large amounts of oil can cause a certain type of pneumonia and this may be a concern??

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I would also like to add that the oil, if spit into a sink, will clog drains. Also, swishing with oil can cause lipoid pneumonia. http://www.ada.org/en/science-research/science-in-the-news/the-practice-of-oil-pulling

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