MD, PhD, FMedSci, FRSB, FRCP, FRCPEd.

Yesterday, I was interviewed and filmed by a Canadian TV-journalist. Even though the subject was osteopathy (apparently, in Canada, osteopathy is strong and full of woo), we found ourselves talking about ‘oil pulling’. I knew next to nothing about this alternative therapy, but learnt that it was big in North America. When the TV-crew had left my home, I therefore read up about it. I must admit, I was more than a little sceptical about the therapy – not least because I soon found articles by fellow sceptics that were less than complimentary – but, as I studied the original research on oil pulling, my scepticism somewhat waned.

So, what is oil pulling? It is the use of oil for swishing it around your mouth for alleged health benefits. Here are several short points that might explain it more fully:

  • Oil pulling is said to have roots that reach back to ancient Hindu texts. Coconut or sesame oils are usually employed for this therapy.
  • The mechanism of action (if there is one at all) is poorly understood, and several theories have been put forward:

Alkali hydrolysis of fat results in saponification or “soap making” process. Since the oils used for oil pulling contain fat, the alkali hydrolysis process emulsifies the fat into bicarbonate ions, normally found in the saliva. Soaps then blend in the oil, increase the surface area of the oil, and thus cleanse the teeth and gums.

A second theory suggests that the viscous nature of the oil inhibits plaque accumulation and adhesion of bacteria.

A third theory holds that the antioxidants present in the oil prevent lipid peroxidation, resulting in an antibiotic-like effect helping in the destruction of microorganisms.

  • Oil pulling is recommended to be carried out in the morning on an empty stomach. About 10 ml of oil is swished between the teeth for a duration of approximately 15-20 min and spat out. This ritual should be followed by rinsing and tooth brushing. The practice should be repeated regularly, even three times daily for acute diseases.
  • To my surprise, oil pulling has been tested in clinical trials. Some of these investigations seem reasonably sound and suggest that coconut oil pulling reduces potentially harmful bacteria in the mouth.[1] This effect has been shown to lead to a reduction in dental plaque formation[2] , halitosis (bad breath) [3] and gingivitis. [4]
  • The evidence for these oral effects is by no means strong, but I have not found studies that show negative results.
  • Dentists – even the bizarre species of ‘holistic dentists‘ – do not seem to be balled over by oil pulling (some malicious minds might speculate that this is so because they cannot earn much money with it).
  • The claimed benefits of oil pulling are, however, not limited to the oral cavity. It is advocated also for the prevention and treatment of conditions such as headaches, migraines, thrombosis, eczema, diabetes and asthma.[5] Some proponents also claim that oil pulling is a detox therapy. Unsurprisingly, none of these claims are supported by good evidence.
  • As long as you don’t swallow the oil, there are no serious risks associated with oil pulling.

So, what is the conclusion? To me, the evidence looks promising as far as oral health is concerned. For all other indication, oil pulling is neither plausible nor evidence-based.

[1] https://www.ncbi.nlm.nih.gov/pubmed/27891311

[2] https://www.ncbi.nlm.nih.gov/pubmed/18408265

[3] https://www.ncbi.nlm.nih.gov/pubmed/21911944

[4] https://www.ncbi.nlm.nih.gov/pubmed/19336860

[5] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5654187/

8 Responses to Oil pulling, a promising alternative therapy – no, I am not pulling your leg!

  • I welcome criticism of my own miserly response to the very occasional sore throat: I gargle salted water.

    Oil pulling sounds like a silent gargle. As with all such routines, products have been pushed as beneficial. I recall that around the early 90s Listerine was rebuked for making bold claims of itself but took the chastisement onboard and modified its marketing.

    Trying to apply what I’m learning from
    “More Harm Than Good” (or 256, as I think of it, 4x4x4x4 letters – equal to the number of squares on a chess board) oil pulling seems to pass the plausibility test.

  • In the boy scouts I learned to use the end of a wooden stick for a toothbrush. If I came to live in a world without access to better toothbrushes, then I could keep my dental and perhaps overall health in better shape with the end of a wooden stick. Pulling lard or some other sebaceous substance for a quqrter of an hour is probably better than not using anything and perhaps it can supplement the wooden stick when that time comes. But it is not better than what we have today.
    We have a good water supply, good toothbrushes and toothpaste. We have mouth rinse that is already chemically suitable without 15 minutes of swishing it in your mouth and perhaps most important, we have dental floss.

    This is yet another example of an ancient method that has been made into a silly, unnecessary fad.

  • This ritual should be followed by rinsing and tooth brushing…

    That’s not fair. That’s like A+B…unless I am missing something, that is…
    In this manner, even water might show an effect..

  • I have a few patients, which practice oil pulling for years. I think, there are positive aspects for the gum. The quantity of bacteria might be reduced because some species have a lipophilic surface. The requirement for pulling is a “free space” between the teeth – the interdental space. The recommondation 10 ml for 15-20 minutes is absolutely nonsense (huaalp!!).

    If patients ask me, i recommend one soup spoon for 3 minutes. But don´t use olive oil, because some of them have a low pH-value. You can use every other oil for this. There are local effects – but the often claimed generalic effects are hogwash.

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