Year : 2013 | Volume
: 4 | Issue : 4 | Page : 131--134
Perspectives of oil pulling therapy in dental practice
T Lakshmi1, R Rajendran2, Vidya Krishnan3,
1 Department of Pharmacology, Saveetha Dental College and Hospitals, Chennai, Tamil Nadu, India
2 Green Chem Herbal Extracts and Formulations, Bangalore, Karnataka, India
3 Department of Oral Medicine, SRM Kattankulathur Dental College, Chennai, Tamil Nadu, India
Department of Pharmacology, Saveetha Dental College and Hospitals, Chennai, Tamil Nadu
Oil pulling has its origin in Ayurvedic medicine, is a natural remedy to improve oral health. Its antibacterial properties help to eradicate the bacteria and other debris from adhering to the oral cavity. It reduces the accumulation of plaque, prevents halitosis, cavities, gingivitis. It is used to heal the bleeding gums and mouth ulcers. Oil pulling with sesame oil improves overall health. Other than oral health, oil pulling also helps in reducing asthma, allergies, chronic fatigue, diabetes, migraine headaches and chronic skin problems. It works by detoxifying or cleansing the body. The aim of this article is to highlight the benefits of oil pulling in management of oral health.
|How to cite this article:|
Lakshmi T, Rajendran R, Krishnan V. Perspectives of oil pulling therapy in dental practice.Dent Hypotheses 2013;4:131-134
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Lakshmi T, Rajendran R, Krishnan V. Perspectives of oil pulling therapy in dental practice. Dent Hypotheses [serial online] 2013 [cited 2020 Jul 14 ];4:131-134
Available from: http://www.dentalhypotheses.com/text.asp?2013/4/4/131/122675
Oil pulling is an ancient Ayurvedic remedy for oral health and detoxification. It involves the use of pure oils as antibacterial agents for inhibiting harmful bacteria, fungus and other organisms of the mouth, teeth, gums and throat.  It involves rinsing the mouth with 1 tablespoon (10 ml) of oil for 15-20 min and spitting it out. Swishing activates the enzymes and the enzymes draw toxins out of the blood. Either sunflower oil or sesame oil, both of which are usually used for cooking and readily available at home. 
Oil pulling is also a traditional home remedy to prevent teeth decay, oral malodor, bleeding gums, dryness of throat and cracked lips and for strengthening the teeth, gums and jaws.  The concept of oil pulling was familiarized by Dr. Karach in the 1990s in Russia. It is claimed to cure about 30 systemic diseases ranging from headache, migraine to diabetes and asthma. ,, Oil pulling therapy can be performed using edible oils such as sunflower or sesame oil. Oil pulling is a powerful detoxifying Ayurvedic technique that has recently become very popular as a complementary and alternative medicine remedy for many different health ailments.
Dental caries also known as tooth decay or a cavity in which bacterial processes change carbohydrates present in food left on the teeth to an acid that demineralizes hard tooth structure. If demineralization exceeds saliva then it can lead to hard tissues break down resulting in the dental caries. , Two groups of bacteria are mainly found to be generally responsible for dental caries Streptococcus mutans and Lactobacillus. Chlorhexidine is considered to be a gold standard, acts as an antiplaque, anticaries and antigingivitis agent. , It may discourage compliance because of its unpleasant taste and undesirable side effects such as tooth staining and alterations in taste sensations.
Sesame oil has various advantages over chlorhexidine such as no staining, no lingering after taste and no allergy. Sesame oil is cost-effective than chlorhexidine and is readily available in the household. There are no disadvantages for oil pulling therapy except for the extended duration of the procedure compared with chlorhexidine. Hence oil pulling carried out with sesame oil or sunflower oil plays a vital role in treating plaque, gingivitis and eradicating dental caries. Various scientific literatures support the use of these edible oils as a household remedy to maintain the oral health.
Methodology for Oil Pulling Therapy
For oil pulling therapy, a tablespoon (teaspoon for young children above 5 years of age) of sesame oil is taken in the mouth, sipped, sucked and pulled between the teeth for 10 and 15 min. The viscous oil turns thin and milky white. The oil should not be swallowed as it may contain bacteria. Oil pulling therapy should be followed by tooth brushing and is preferably performed on an empty stomach in the morning. 
It is important to understand that during the oil pulling/oil swishing process one's metabolism is intensified. This leads to improved health. One of the most striking results of this process is the fastening of loose teeth, the elimination of bleeding gums and the visible whitening of the teeth.
The oil pulling/swishing is carried out best before breakfast. To accelerate the healing process, it can be repeated 3 times a day, but always before meals on an empty stomach.
Mechanism of Action
Asokan et al. conducted a study to evaluate the antibacterial activity of sesame oil and lignans isolated from sesame oil on oral microorganisms and to check whether saponification or emulsification occurs during oil-pulling therapy.  Sesame oil and lignans did not show antibacterial activity, whereas emulsification of sesame oil occurs during oil pulling therapy and Increased consumption of NaOH in titration is a definite indication of a possible saponification process, which enhances the cleansing action of the sesame oil during oil pulling therapy.
Antibacterial Activity of Sesame Oil
The efficacy of oil pulling on dental caries causing S. mutans and Lactobacillus acidophilus was determined by Anand et al. The study shows remarkable decrease in the total count of bacteria and the process of oil pulling reduced the susceptibility of a host to dental caries. Sesame oil showed a significant antibacterial activity by inhibiting the growth of S. mutans and L. acidophilus. 
Oil pulling therapy of sesame oil
Asokan et al. conducted randomized controlled triple blind clinical trial study to evaluate the efficacy of oil pulling therapy by sesame oil on dental caries causing S. mutans count in plaque and saliva, plaque induced gingivitis. Study group was given sesame oil to suck and pull in the morning 10 min before tooth brushing whereas the control group was asked to swish with 0.2% chlorhexidine mouthwash 30 min before tooth brushing. Study showed a significant reduction in colony count of S. mutans in plaque sample and decrease in plaque, gingival index score in the study and control group. Clinical study hence reported the use of sesame oil (idhayam oil) pulling therapy is an effective home remedy than chlorhexidine mouth wash and recommended in improving oral health in India. 
Role of coconut oil in "pulling" therapy
A study, as reported by the British Dental Association, shows that "pulling" with coconut oil can reduce cavities.  They found that that "coconut oil strongly inhibited the growth of most strains of Streptococcus bacteria including S. mutans - a causative organism of dental caries." However, the coconut oil may need to be "pre-digested" with an enzyme to make it most effective. 
Impact of oil pulling on plaque and gingivitis
Amith et al. conducted a study on the effect of oil pulling on plaque and gingivitis. Study showed swishing with refined sunflower oil in the mouth reduces gingivitis and plaque. There was a net decline in mean plaque scores from baseline to 45 days amounting to 0.81 ± 0.41. Hence, plaque scores have reduced by 18-30% and gingivitis has reduced by 52-60%. 
The effect of oil pulling using coconut oil, corn oil, rice bran oil, palm oil, sesame oil, sunflower oil and soy bean oil was evaluated by Thaweboon et al. on the biofilm models formed by S. mutans, Candida albicans, Lactobacillus casei. It was found that coconut oil exhibited antimicrobial activity against S. mutans and C. albicans. Sesame oil had antibacterial activity against S. mutans, whereas sunflower oil had antifungal activity against C. albicans. L. casei found to be resistant to the oils tested. The evidence based research suggest the use of edible oils for oil pulling as a home remedy to treat dental caries. 
Oil pulling therapy for halitosis
Asokan et al.  conducted a study to evaluate the effect of oil pulling with sesame oil on halitosis and the microorganisms that is responsible for it and to compare its efficacy with chlorhexidine mouthwash.
Group I (oil pulling) and Group II (chlorhexidine) included 10 adolescents each. The following parameters were assessed: Marginal gingival index, plaque index, organoleptic (ORG) breath assessment (ORG 1), self-assessment of breath (ORG 2) and benzoyl-DL-arginine-naphthylamide (BANA) test from tongue coating samples on days 0 and 14 of the experimental period.
The result showed comparisons of the pre- and post-therapy values of plaque and modified gingival index score showed a statistically significant difference (P = 0.005 and 0.007, respectively) in Groups I and II. There was a definite reduction in the ORG 1, ORG 2, Scores and BANA test Score in both Groups I and II. It can be concluded that oil pulling therapy has been equally effective like chlorhexidine on halitosis and organisms, associated with halitosis.
Oil pulling is considered as to have beneficial effects on systemic health also and has been claimed to cure diabetes, eczema, thrombosis, intestinal infection, respiratory diseases.
A study was conducted to assess the effect of oil pulling on plaque and gingivitis and to monitor its safety on oral soft- and hard tissues. A total of 10 subjects performed oil pulling along with their other oral hygiene measures for 45 days, using refined sunflower oil. Their plaque and gingival scores were assessed periodically. 
They found a statistically significant reduction in plaque and gingival scores from baseline to 45 days. They concluded that oil pulling could be used for oral hygiene.
The proponents of oil pulling would agree and would add that oil pulling could have positive systemic effects on other, more serious conditions. They feel that toxins and bacteria from the body might be expelled through the tongue and trapped in the oil and removed from the body. 
Oil pulling therapy with edible oils cannot be used as a treatment adjunct as of now, it promises to be a better preventive home therapy in developing countries like India. Extensive studies with larger samples, varying time periods and longtime follow-up should be carried out to establish the efficacy of oil pulling therapy in prevention of halitosis. The exact mechanism of action of oil pulling therapy is still not clear hence further research studies with sesame oil will lead to wonderful approach in the field of dentistry for maintenance of oral health.
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