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. This effect has been shown to lead to a reduction in dental plaque formation , halitosis (bad breath)  and gingivitis. 
- 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. 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.