Oil pulling is an ancient Ayurvedic practice that involves swishing a tablespoon of edible oil, such as coconut or sesame oil, in the mouth for an extended period. Proponents suggest this practice can draw out bacteria and toxins, leading to improved oral hygiene. The primary question is whether this traditional technique can effectively help prevent or manage the development of dental cavities.
Understanding How Cavities Develop
Dental cavities begin when specific types of bacteria in the mouth consume sugars and starches left on the teeth. These bacteria, primarily Streptococcus mutans, produce acids as a byproduct of their metabolic process. This acidic environment lowers the pH in the mouth, which attacks the hard, mineral-rich enamel surface of the tooth.
Continuous acid exposure causes demineralization, a process where minerals are leached out of the enamel structure. Bacteria, food debris, and acid combine to form a sticky, colorless film called plaque. If this cycle continues, the enamel weakens, and a permanent hole, or cavity, eventually forms.
Proposed Mechanisms of Oil Pulling
The theoretical effectiveness of oil pulling against cavity formation is based on several proposed biological and chemical actions. Primary is the mechanical action of swishing the viscous oil vigorously around the mouth and between the teeth. This physical movement helps loosen and disrupt the sticky bacterial biofilm, or plaque, from the tooth surfaces.
Another key theory centers on lipid binding, where the oil attracts the bacteria and their surrounding structures. Bacterial cell walls and plaque biofilm are hydrophobic, meaning they readily mix with oil. As the oil is swished, it effectively attracts and dissolves the lipid layers of the bacteria, pulling them out of the mouth when the oil is expelled.
A chemical component called saponification is also suggested. This proposes that the fatty acids in the oil react with alkaline substances in saliva, generating a soap-like substance. This substance can further aid in emulsifying the plaque and cleansing the oral cavity.
Scientific Findings on Cavity Prevention
Scientific research has primarily focused on whether oil pulling reduces the two factors that lead to cavities: plaque amount and acid-producing bacteria count. Multiple clinical studies, often using coconut or sesame oil, indicate that oil pulling significantly reduces the number of cariogenic bacteria, specifically Streptococcus mutans.
In short-term comparisons, the reduction in S. mutans counts achieved through oil pulling has been found to be comparable to traditional chlorhexidine mouthwash. Research also demonstrates that oil pulling leads to a measurable reduction in the Plaque Index, a clinical score quantifying bacterial film on teeth. The antimicrobial properties of coconut oil, specifically lauric acid, contribute to this reduction in harmful bacterial load.
Oil pulling shows promise in reducing the cause of cavities (plaque and bacteria), but it is not a treatment for existing decay. Once a cavity has formed, oil pulling cannot reverse structural damage or regrow enamel. Furthermore, oil pulling does not contain fluoride, which is the gold standard for promoting remineralization and strengthening weakened enamel. Therefore, oil pulling is best considered an adjunct therapy to support a healthy mouth, but it must not replace conventional, evidence-based practices for cavity prevention.
Safe Practice and Limitations
Oil pulling involves placing about one tablespoon of edible oil, typically unrefined coconut or sesame oil, into the mouth. The oil should be swished through the teeth for approximately 10 to 20 minutes before being spat out. It is important to spit the used oil into a trash receptacle, not down a sink drain, as the oil can solidify and cause plumbing blockages.
The limitations of oil pulling must be recognized, and it should never replace a comprehensive oral hygiene routine. This routine includes brushing twice daily with fluoride toothpaste, flossing, and attending regular professional dental check-ups. Swishing the oil for a prolonged time can sometimes lead to jaw fatigue or soreness, especially when first starting.
A serious, though rare, risk is the accidental aspiration of the oil into the lungs, which can cause lipoid pneumonia. Individuals who may struggle with swishing control, such as children or those with certain medical conditions, should avoid the practice.