Does Oil Pulling Work?

Starting the day off at the beach with your skin smelling of tropical-scented sunscreen can be one of life's greatest pleasures. Smelling coconut oil as you swish it around in your mouth before work -- well, that's another story. 

What is Oil Pulling?

Oil pulling, or placing oil in the mouth to kill harmful bacteria, seems to have caught on recently. It's a controversial practice that takes dedication and time, though fortunately not the 10 or 20 minutes of marathon swishing some sources suggest. Oil pulling, an ancient Ayurvedic folk practice, dates back 3,000 to 5,000 years to traditional Indian medical remedies. Advocates claim swishing any type of oil in your mouth every day will whiten your teeth, reduce bacteria, strengthen your gums and jaw, improve your skin, clear your sinuses, prevent ​bad breath and even protect against heart disease and Alzheimer’s disease. 

Two sessions of four minutes, as recommended by Dr. Amala Guha, assistant professor of immunology and medicine at the University of Connecticut Health Center and the founding president of The International Society for Ayurveda and Health, were sufficient for my first attempt at oil pulling. The taste itself isn't so bad on the surface, but putting chunky coconut oil in your mouth before being fully awake can trigger a gag reflex.

"People are saying that their breath is better, their gums don’t bleed anymore and their teeth look a little whiter," says Jeffrey Dalin​, a dentist based in St. Louis. "I haven’t had the guts to do it, but I think it’s something at least worth looking into." 

What does research say?

But what's the scope (and scoop) on this mouth rinse practice? Does it work?

"It's not given proper credit," said Guha, who was trained in Ayurveda, a traditional form of medicine that relies on natural healing, in India. She explains that using liquids in the mouth for health purposes is mentioned in two ancient Indian Ayurvedic texts (one written in 800 B.C. and the other in 700 B.C.), and the practice is part of one of the oldest health systems in the world.

Oil pulling for oral hygiene is common. But before you go racing out to the store for oil, the American Dental Association cautions that because of a lack of evidence, they do not recommend oil pulling as a replacement for standard oral health care such as flossing and teeth brushing.

The texts also claim that about 30 systemic diseases, including headaches and diabetes, can be cured. Yet there is a lack of knowledge on the science and side effects behind the practice, according to Guha.

A small study published in 2009 involving sesame oil and 20 adolescent boys with plaque-induced gingivitis found that oil pulling reduced plaque and the bacterium Streptococcus mutans. This bacterium is cited as being a major cause of tooth decay and overgrowth of bacteria in mouth can also lead to gum disease.

A larger study published in 2013, also using sesame oil, found similar results, summarizing that oil pulling had a significant effect on plaque and gingivitis.

For coconut oil users, lauric acid found in the oil can be a benefit. It is known for its antimicrobial properties, such as the ability to fight off viruses, bacteria and yeasts.

Another study from 2011 says, "Oil pulling therapy has been equally effective like chlorhexidine [mouthwash] on halitosis and organisms."

How it works

Guha says there are two oil pulling techniques: kavala and gandusa.

Kavala: fill your mouth with liquid and hold it there for a couple of minutes before swirling it around the mouth and spitting it out. The process shouldn't exceed more than three or four minutes; it's repeated at least two or three times.

Gandusa: the technique of holding the liquid still in the mouth for three to five minutes. The liquid is then spit out and the process is repeated.

In Ayurveda, many different liquids can be used depending on the condition being treated and the physiology of the person. Milk, honey and hot water containing herbs are just some of the other mediums, explains Guha.

For daily oral hygiene, she recommends using coconut or sesame oil, which she says have mild abrasive powers and more healing benefits than other oils (and are less harmful).

Where to dispose the oil?

Jennifer Beckinsale, who tried oil pulling for 10 days, spit hers into a disposable cup and threw it away, but didn't like how wasteful that felt. Still, she says she would try oil pulling again. Remember, your sink is out, because the oil may harden and clog your pipes.

When to expect results?

Results can be expected in a few months with benefits such as reduced plaque, cavity prevention and stronger gums for individuals who already have a healthy mouth. For the person with plaque buildup, we recommend a teeth cleaning first for faster results.

How it doesn't work

Mark Wolff, professor and chair at the New York University College of Dentistry, expresses skepticism about oil pulling's effects on oral health. "I am not sure there is any harm, but I have never seen it have any positive effect on my patients who have been using oil pulling or in clinical research that has been published."

Limited research, mostly dating back to 2008 and 2009, suggests oil pulling – particularly with coconut oil – can stop plaque from forming. But evidence is lacking, and experts caution that you shouldn’t expect any greater benefits. "There’s absolutely no data whatsoever that shows diabetes can be treated or prevented, or that heart disease can be," says Lyla Blake-Gumbs, a physician with the Cleveland Clinic’s Center for Integrative Medicine. "It’s not a new practice – it’s been done thousands of years – but there were no real records kept​. So I can’t go to any objective, well-run clinical trials to look into the other claims." 

There is also little research available on the effectiveness of these treatments to cure other diseases.

Negative Side Effects

Guha warns that there can be negative side effects if improper technique is used, including dry mouth, excessive thirst, muscular stiffness, exhaustion and loss of sensation or taste in the mouth. Oil pulling likely won’t cause any adverse effects – so long as you don’t swallow the oil. Doing so could cause diarrhea or an upset stomach, Blake-Gumbs says. And the swooshing itself isn’t going to taste good. Oil, be it olive, sesame or coconut, is often difficult to tolerate – and some types are solid at room temperature, until they begin to melt in your mouth. "I had one patient tell me she did it with sesame oil first, and she couldn’t hold it in her mouth because it was too strong a flavor," Blake-Gumbs says. "Then she tried olive oil, and that was more agreeable to her."

Are You Interested?

Individuals who are interested in trying kavala or gandusa to treat health conditions need to review all credentials of Ayruvedic practitioners before starting any treatment. Guha says that there are very few trained professionals in the United States as none of the Ayurveda schools here are accredited; only schools in India provide the proper certifications.

Bottom line? 

Oil pulling is relatively simple and inexpensive – coconut oil runs around $10 ​or less​ ​​​​– and it’s not invasive. But there’s still no solid evidence that it actually works, and experts agree that if you’re concerned about your teeth, it’s best to brush at least twice a day for two minutes each time.

If you're just looking for a natural way to boost your oral health, you can oil away without supervision and get about the same benefits as commercial mouthwash.

Just don't forget to floss.

Article published on CNN.

US News article.

Dentin Decay

Detect decay by inspecting the color and hardness
Usually, dental decay is fairly easy to detect. When a cavity is just beginning, it is typically identified by a brown or white color or a change in the translucency of the enamel of the tooth. The dentist or dental hygienist uses a special dental instrument called an explorer to feel the suspect area and check its hardness. If the area is hard, in other words, if no break in the enamel layer is detected, we feel there is not a cavity present. If, however, the surface feels soft and the explorer "sticks" in the suspect site, we feel a cavity is present.

Fluoride makes our enamel stronger, but dentin decay is harder to detect Because of the widespread use and availability of fluoride in our drinking water, foods, and oral care products, we are seeing a different decay pattern. The appearance is different from the typical pattern of decay and more difficult to detect. As the outer surface of the enamel absorbs fluoride (from toothpaste, for example), the enamel becomes very resistant to demineralization and eventual decay. If there is a small break in the integrity of the enamel, a pit or groove where decay-causing bacteria can live, the bacteria can dissolve the enamel in such a way that the hole in the enamel cannot be detected. Once the decay-causing bacteria reach the underlying dentin, the acids eat away at that substance and quickly make a large cavity - but one that still cannot be easily seen or detected. In this way the enamel becomes undermined. A dentist looking at such a small cavity would think it very easy to restore. However, once the decayed portion of the enamel is removed and the dentin becomes visible, the true extent of the damage becomes obvious. The small cavity becomes a big cavity.

One of the major problems with decay that appears to occur only in the dentin is in the detection. If a radiograph is taken a part of the periodic examination process, we may be able to see dentin decay if it is moderate to extensive. Decay seen on radiographs is typically two to seven times greater in the tooth. Modern high-speed radiographic film and reduced x-ray exposure makes it more difficult to detect early decay on radiographs.

You can prevent decay by using fluoride
The conscientious application of a source of topical fluoride, through either an over-the-counter dentifrice or a prescription fluoride product, and thorough plaque removal are essential. Bonded sealants are also an effective protection against dentin decay. We strongly advice these procedures. Periodic examinations at intervals recommended by the dentist catch decay at the earliest possible time. This is the only way to keep small problems from developing into larger problems.

Click here to check out our blog post on foods that cause decay. 
Click here for our post on how to prevent decay.

If you have any questions about dentin decay, please feel free to ask us. 

Give Yourself A 60-Second Dental Check-Up

Regular visits to your dentists are absolutely essential to prevent serious dental problems. But it is also important to give yourself an oral check-up from time to time. This simple process just takes a minute, but it can yield valuable clues to the health of your mouth, teeth, and gums.

Stand before a well-lit mirror and open your mouth wide.

1. Check your gum line and the lines between your teeth
Good: There should be no brown lines here
Bad: If you see brown lines, that is a sign of tartar build-up
What to do: Time to go to the dentist. Once the brown lines are cleaned up at the clinic, regular flossing will keep tartar away.

2. Stick out your tongue. What does the surface look like? 
Good: A healthy tongue should be pink
Bad: If it is coated with white, it can be an indication of poor digestion. This coating also results in bad breath.
What to do: Use a stainless steel scraper to clean your tongue every morning. 

3. Are there ridges along your tongue? 
Bad: This is often a sign of tooth grinding. People may not be aware they grind their teeth, but it can happen when they are stressed. 
What to do: If you wake up with an aching jaw, you should see a dentist.

4. Take a look at the inside of your cheeks. 
Bad: Do you see white patches? These can occur if you chew the inside of your mouth when you bite and chew your food. 
What to do: These should be checked by your dentist because a wound inside the cheek can not only get infected, but may also be a sign of pre-cancerous changes, especially in smokers. An ulcer that does not heal within three weeks should also be investigated.

5. How do your gums look?
Good: If they are pink and rosy, your gums are in good health. 
Bad: But if they are red, it is a signal that gingivitis or gum inflammation has turned into gum disease. Another clue: gums that bleed when you brush your teeth. 
What to do: Your dentist can help you with a course of antibiotics and dental hygiene guidance on how to rebuild gum health. 

Bad: Pale gums can indicate iron deficiency - a warning sign of anemia. 
What to do: Up your intake of green vegetables, tofu, chickpeas, lentils, and dried fruits such as raisins and prunes.