Oil pulling (OP) involves swishing edible oil in the mouth for an extended period to promote oral hygiene. Periodontal disease (PD) is a chronic inflammatory condition affecting the tissues that support the teeth, ranging from reversible gingivitis to severe, irreversible bone loss. Proponents suggest oil pulling can manage or even treat periodontal disease by reducing the harmful bacterial load in the mouth. This article examines the scientific evidence behind this traditional claim, clarifying the practice’s role as a supplement to standard dental care.
Understanding Periodontal Disease
Periodontal disease begins with the accumulation of dental plaque, a sticky film of bacteria and food debris that forms on the teeth. If not removed, plaque hardens into calculus (tartar), which cannot be removed by home care. Plaque and calculus cause inflammation of the gums, a condition called gingivitis, characterized by redness, swelling, and easy bleeding.
Gingivitis is reversible with professional cleaning and improved oral hygiene practices. If left untreated, the inflammation progresses into periodontitis. Periodontitis involves the destruction of the soft tissue and the underlying bone that anchors the teeth. This leads to the formation of periodontal pockets, deep spaces between the tooth and the gum line where bacteria thrive, eventually causing the teeth to loosen or be lost.
The Proposed Mechanism of Oil Pulling
Oil pulling’s effectiveness against oral pathogens is rooted in the lipid nature of the oils used. Many oral microorganisms, particularly bacteria, possess fatty outer membranes. When the oil is swished through the mouth, its lipid molecules attract and bind to the lipid components in the bacterial cell walls.
This binding action physically draws microbes and debris out of the oral cavity when the oil is expectorated. Oils, particularly coconut oil, contain medium-chain fatty acids, such as lauric acid, which exhibit natural antimicrobial properties. The mechanical action of swishing also physically disrupts the bacterial biofilm.
The process may also involve saponification, where the vegetable oil reacts with alkaline substances in the saliva. This reaction forms a soap-like substance that acts as an emulsifying agent, increasing the oil’s surface area and enhancing its cleansing ability. This combination of physical removal, chemical binding, and antimicrobial action reduces the overall bacterial load, lowering inflammation and plaque formation.
Clinical Evidence for Efficacy Against Periodontitis
Clinical trials investigating oil pulling typically measure its impact on Plaque Index (PI) and Gingival Index (GI) scores. Numerous studies have demonstrated that daily oil pulling can significantly reduce both plaque and gingivitis scores. In some instances, the reduction in these markers has been shown to be comparable to the effects seen with standard antiseptic mouthwashes, such as chlorhexidine.
For established periodontitis, however, the evidence is less conclusive, and the practice has not been shown to reverse the disease. Periodontitis is specifically defined by the loss of bone and the presence of deep periodontal pockets. Rinsing with any liquid, including oil, has a limited ability to penetrate these deep pockets and effectively remove the subgingival biofilm and calculus.
A randomized clinical trial involving patients with periodontitis found that oil pulling, when used as an adjunct to professional non-surgical periodontal treatment, provided clinical benefits similar to a chlorhexidine rinse. This suggests that while oil pulling may help manage gingivitis symptoms and reduce the overall bacterial population, it does not replace professional treatment necessary to address the bone destruction and deep pocket infection characteristic of periodontitis.
Practical Application and Safety Considerations
The procedure involves placing about one tablespoon of oil in the mouth. This is gently swished, sucked, and pulled between the teeth for 10 to 20 minutes. The oil will change from viscous to a thin, milky-white consistency when thoroughly mixed with saliva.
Spit the used oil into a trash receptacle, as the oil can solidify and cause plumbing clogs. The oil should never be swallowed, as it contains bacteria and toxins drawn out of the mouth. Although rare, there is a theoretical risk of lipoid pneumonia if the oil is accidentally inhaled into the lungs, which is a concern for those with swallowing difficulties.
Oil pulling should be viewed as a complementary practice. Regular brushing with fluoride toothpaste, daily flossing, and professional dental check-ups are the foundation for preventing and managing periodontal disease. If you have active periodontitis, consult with a dentist before incorporating oil pulling, as professional intervention is necessary to address the disease’s progression.