Does Oil Pulling Help Dental Plaque or Gingivitis?

Oil pulling is put to the test head-to-head against chlorhexidine mouthwash for oral and dental health measures.

What are the potential risks and benefits of the ancient practice of oil pulling, in which oil is swished or “pulled” between the teeth for 15 minutes or so and then spit out? There are wild, unsubstantiated claims online and even in the medical literature, including the British Dental Journal. I can believe oil pulling is good exercise for your tongue and cheek muscles, but it seems a little crazy to suggest “it heals cells, tissue and all organs simultaneously.” Talk about tongue in cheek!

A respondent in the British Dental Journal expressed “surprise” in reading that “swishing…oil around the mouth…can ‘effectively treat … meningitis, heart and kidney disorders, women’s hormonal disorders, and chronic diseases like cancer, AIDS etc.’” It’s certainly possible that oil pulling may help in some way, but in order to enter into evidence-based medicine, we need a little something called evidence “without being distracted by illusory effects ascribed to them by their advocates.” This is particularly relevant when other respondents shared their experience of a case of severe inflammatory gingivitis that worsened after oil pulling. After the subject stopped oil pulling, however, her gingival inflammation got better. The researchers felt some of the oil had gotten stuck under her gums, worsening her condition. Regardless, perhaps people should hold off on oil pulling until we actually have some evidence.

Thankfully, as I discuss in my video Oil Pulling Benefits for Plaque and Gingivitis, the Centre for Evidence-Based Medicine at Oxford recently compiled all of the controlled trials. Controlled? Why is it so important for studies to have control groups? Without a control group against whom to compare findings, it may be the case that reported declines in gingivitis and plaques with oil pulling are simply due to the fact that the subjects had dentists looking over their shoulders and faced recurring check-ups, so they may have just upped their brushing and flossing game.

At 1:52 in my video, I present the kind of study we need. Researchers observed no changes before and after in the control group, but there was a drop in plaque and gingivitis scores in the oil-pulling group. That’s more like it! Okay, so there does seem to be an effect, but what do those scores mean? When you test a new drug, it isn’t enough just to show it works better than nothing, or better than a sugar pill. Ideally, you want to know whether the new drug works better than the current best drug out there for the same condition. Otherwise, what’s the point of a new therapy? This is why drug companies are often forced to use so-called active controls, comparing their drug head-to-head against the leading drug instead of pitting it against a placebo. In the study I just mentioned, oil pulling was compared to doing nothing. How about oil pulling compared to chlorhexidine?

An antiseptic chemical used in medicated mouthwash, chlorhexidine is considered to be the “gold standard” in the fight against plaque, cavities, and gingivitis. Talk about a head-to-head battle! What happened when researchers investigated oil pulling against chlorhexidine, measuring each treatment’s ability to lower the number of cavity-producing bacteria on people’s teeth? As you can see at 3:07 in my video, researchers found that chlorhexidine worked faster, resulting in a significant drop in plaque within just 24 hours, whereas it took a week for the oil pulling to really start working. By two weeks, though, the oil pulling may end up just as efficacious as the gold standard, as you can see at 3:18 in my video. In fact, they appeared to work so similarly that the skeptic in me wondered, Wait a second. Maybe it’s just the physical act of swishing that disrupts the plaque?

If only the researchers had included a third group who swished with plain water. They did! And? Swishing with water had no effect.

Now, it wasn’t exactly fair. The researchers had the oil-pulling group swish for ten minutes, whereas the other two groups only swished for one minute. So, for all we know, swishing with plain water for ten minutes might be as good as swishing with oil.

What’s more, one could look at this and argue that chlorhexidine actually worked ten times better than oil because it got the same effect swishing for one-tenth of the time. Chlorhexidine has side-effects, though. In fact, it has potentially serious side effects, like painful desquamation, meaning peeling of the mucous membranes in your mouth, as well as discoloration of the teeth or tongue, which you can see at 4:11 in my video (but be warned because they aren’t pretty sights).

So, “oil pulling has certain benefits over commercially available mouthrinses such as non-chemical, non-alcoholic, low cost, and non-staining, yet the effectiveness…[is] unclear.” Hold on. Oil pulling has been shown to significantly drop the number of cavity-causing bacteria on the teeth. Yes, but does that translate out into fewer actual cavities, which is what we really care about? It hasn’t been studied. Researchers did pair up oil pulling versus chlorhexidine against plaque and gingivitis, however, and found both were able to help to a similar degree. And, plaque-induced gingivitis is a reasonable predictor of future dental health, thereby explaining Oxford’s Centre for Evidence-Based Medicine’s conclusion that, indeed, “oil pulling may have beneficial effects” on oral and dental health.

KEY TAKEAWAYS

The ancient practice of oil pulling, swishing or “pulling” edible oil between the teeth before spitting it out, has been said to be an effective treatment for meningitis, heart and kidney disorders, and such chronic diseases as cancer and AIDS, without any scientific evidence.
Chlorhexidine, an antiseptic chemical used in medicated mouthwash, is considered to be the gold standard in the fight against plaque, cavities, and gingivitis, yet has potentially serious side effects, including painful peeling of your mouth’s mucous membranes.
When oil pulling was pitted head-to-head against chlorhexidine, researchers found that although chlorhexidine worked faster than oil pulling in reducing plaque, by two weeks, the oil pulling may be just as effective as the antiseptic chemical.
The act of swishing alone may have caused the plaque disruption, however the oil-pulling group swished for ten minutes compared with only one minute for the chlorhexidine and water-only groups, so we cannot know for certain if swishing with plain water for ten minutes might be as effective as swishing with oil.
Unlike chlorhexidine, oil pulling is free of chemicals and alcohol, as well as lower in cost, and it appears to be similarly effective as the antiseptic against plaque and gingivitis.

This article discusses the second video in a four-part series on oil pulling. If you missed the first video, see Does Oil Pulling Help with Cancer?.

Oil Pulling for Teeth Whitening and Bad Breath Tested is the third in the series.

I do not recommend oil pulling and explain why in the final video of the series, The Risks of Oil Pulling.

For other tips on oral and dental health, see:

In health,

Michael Greger, M.D.

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