Oil pulling is an ancient Ayurvedic practice involving swishing an edible oil around the mouth for an extended period. Proponents suggest this technique can significantly benefit oral hygiene, including the reduction or removal of dental plaque. Due to its resurgence in popularity, it is necessary to evaluate whether scientific evidence supports the claim that oil pulling effectively reduces the sticky bacterial film known as plaque.
What is Oil Pulling and How Does Plaque Form?
Oil pulling is a traditional folk remedy involving placing about a tablespoon of edible oil—such as coconut, sesame, or sunflower oil—in the mouth and gently swishing it for up to 20 minutes. Coconut oil is now popular due to its lauric acid content and known antimicrobial properties. Traditionally, the oil was thought to act like a solvent, absorbing toxins and lipid-soluble bacteria from the oral cavity during the swishing action.
Dental plaque is a microbial biofilm that constantly accumulates on tooth surfaces. This sticky substance is composed of a structured community of over 500 species of bacteria embedded in a matrix derived from bacteria and saliva. Plaque formation begins when salivary proteins form an acquired pellicle on the tooth surface. Bacteria then adhere to this pellicle, colonize the surface, and create the resilient biofilm that causes tooth decay and gum disease. If not physically removed, this soft plaque can mineralize into a hardened deposit called calculus or tartar, which requires professional scaling.
The Scientific Evidence on Plaque Reduction
Clinical trials often focus on oil pulling’s effect on the overall plaque index and the count of bacteria associated with decay. Some studies show that oil pulling with coconut or sesame oil can lead to a modest reduction in both plaque scores and indicators of gingivitis. This reduction is sometimes comparable to the effects seen when using a placebo or a standard mouthwash, suggesting a measurable, though limited, benefit.
Research consistently shows a reduction of Streptococcus mutans, a primary bacterium responsible for tooth decay. Multiple studies demonstrate that oil pulling significantly lowers the salivary count of S. mutans, sometimes achieving results similar to a conventional chlorhexidine mouthwash. This supports the idea that the oil exhibits an antibacterial effect that decreases the bacterial load. The reduction in these harmful bacteria contributes to less plaque accumulation over time.
While oil pulling may reduce harmful microorganisms, it is not shown to be superior to mechanical cleaning. Evidence suggests it can help manage the initial, soft plaque biofilm. However, there is no reliable scientific proof that oil pulling alone can effectively remove established, mineralized calculus, which requires physical scraping by a dental professional. The current scientific consensus positions oil pulling as a practice that reduces the microbial population rather than a physical plaque remover.
Oil Pulling as Part of an Oral Hygiene Routine
Oil pulling is generally viewed as an adjunct therapy; it supports but does not replace established oral care methods. Standard oral hygiene relies on the physical, mechanical removal of plaque through brushing and flossing. Toothbrush bristles and floss physically disrupt the bacterial biofilm, which is the most effective way to eliminate plaque.
In a daily routine, oil pulling may be performed before brushing, serving as a pre-cleanse to reduce the overall microbial count. It can complement chemical mouth rinses for reducing bacteria and improving gum health. However, relying solely on oil pulling while neglecting to brush and floss can lead to severe dental problems, as the oil cannot reach all surfaces, particularly between the teeth where plaque thrives.
Major dental organizations, such as the American Dental Association, do not endorse oil pulling as a primary method of oral hygiene. This position is based on the lack of large-scale, high-quality clinical studies confirming its long-term benefits or proving efficacy over traditional cleaning. The consistent recommendation remains brushing twice daily with a fluoride toothpaste and flossing daily to ensure the physical removal of plaque.
Safe Practices and Potential Side Effects
Proper technique is necessary for those incorporating oil pulling into their routine. The practice involves using about one tablespoon of oil and swishing it gently for 5 to 20 minutes. After swishing, the oil must be spit into a trash receptacle, not down the sink or toilet, to prevent plumbing clogs and because it contains bacteria and debris.
Avoid swallowing the oil after swishing, as it is saturated with oral bacteria and debris, which can cause digestive upset, nausea, or diarrhea. Jaw soreness or muscle fatigue can occur, especially when new to the practice or swishing vigorously for a long duration. Individuals with existing temporomandibular joint issues should approach the practice with caution or consider shorter durations.
A rare but serious concern is lipoid pneumonia, which can occur if oil is accidentally inhaled into the lungs. This risk is minimized by swishing gently and avoiding deep breaths through the mouth during the process. Oil pulling should be immediately discontinued if any negative symptoms arise, and it should never be used as the only method for maintaining oral health.