Oil reduces cavities or improves oral health (ADA, 2017).

Oil Pulling

“The
whole purpose of oil pulling is to get rid of the oil-soluble toxins in the
body,” said by a creator of GuruNanda Pulling Oil (Bradford, 2015).

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Oil
pulling is a long process in which oil is held and swished in the mouth to
produce benefits to oral health (Poonam, Sudhee, Manish, Kuldeep, and Vrinda,
2014). It is a traditional Indian remedy without any solid scientific proof to
prevent decay, oral malodor and for strengthening teeth and gums (Poonam et al,
2014). People who use oil pulling claim that holding and swishing oil in the mouth
for a certain time can “pull” out toxins and bacteria in the mouth (Poonam et
al, 2014).

The oil,
just like mouthwash, acts as a cleanser. People need to swish approximately 1
tablespoon of oil around in their mouths for 20 to 30 minutes (Shanbhag, 2016,
p. 106). When people put it in mouth and work it around the teeth and gums, it is
supposed to “pull” out bacteria and other debris (Shanbhag, 2016, p. 107). When
the time is up, the oil is spit out. The purpose of this practice is to kill
harmful cariogenic bacteria and improve oral health (Poonam et al, 2014).

However,
currently, there are no reliable scientific studies to prove that oil pulling effectively
reduces cavities or improves oral health (ADA, 2017). Due to the lack of
scientific evidence, the American Dental Association (ADA) does not recommend
oil pulling as a regular dental hygiene practice (ADA, 2017). The public is
recommended to maintain good oral health by brushing twice a day for two
minutes with fluoridated toothpaste and floss between teeth twice a day without
oil pulling (ADA, 2017).

The
thesis is that oil pulling is not effective in decreasing bacteria, preventing
cavities or reducing halitosis no matter what type of oil is used.

Bacteria
Colonization

Oil pulling cannot effectively reduce bacteria
colonization on enamel and reduce cavities. A study was conducted to measure the
count of adherent bacteria on teeth before and after use of oil pulling on
adults (Hannig, Kirsch, Al-Ahmad, Kensche, Hannig and Kümmerer, 2012, p. 649-658). A test group and two control groups were
present. 0.2% Chlorhexidine mouthrinse was used as a positive control group;
the negative control group did not use any mouthrinse (Hannig et al,
2012). Safflower oil, olive oil and
linseed oil were used to rinse for 10 minutes after pellicle was formed on
teeth surfaces (Hannig et al, 2012). Then, the subjects were carried for 8 hours and adherent bacteria were
measured (Hannig et al, 2012). The
results of the study show that oil pulling has no significant antibacterial
effects on teeth compared to the negative control group (Hannig et al,
2012). However, more than 85% bacteria
were reduced with the use of chlorohexidine mouthrinse (Hannig et al,
2012). Therefore, oil pulling with safflower
oil, olive oil and linseed oil are not recommended for the purpose of
decreasing bacteria counts on tooth surfaces.

Another randomized
double blinded controlled study from PubMed compared the effect of different mouthrinses
and oil pulling on bacteria count for children 6-12 years old (Jauhari,
Srivastava, Rana & Chandna, 2015). 4 groups of mouthrinses (fluoride
mouthrinse with 200 ppm sodium fluoride, herbal mouthrinse containing Salvadora
Persica, sesame oil and distilled water) were used in this test (Jauhari et al,
2015). Bacteria count was measured prior to the use of mouthrinses twice a day
for 2 weeks (Jauhari et al, 2015). The effectiveness of fluoride and herbal
mouthrinses was found to be significant while sesame oil pulling was not in reducing
the bacterial colonization of an individual (Jauhari et al, 2015). Results of
the test are shown in Table 1: Comparison of Pre- and Post-Treatment Mean Values
of S. mutans Count in the Study and Control Groups Using the Paired ‘t’ Test

Based on the results of
the study, oil pulling with sesame oil should not be used for children to replace
daily dental care with toothbrushes and floss.

In 2015, another study done by Thomas, Thakur and
Mhambrey compared the antimicrobial efficacy of several different mouthrinses.
The results of the in vitro study indicate that even when fluoride is added to
oil, oil pulling is still not as effective as 0.2% chlorohexidine or other mouthrinses
in reducing cariogenic bacteria.

Therefore, oil pulling is not recommended as an effective
antibacterial agent to reduce oral biofilm formation due to lack of solid scientific evidence.
Regular tooth brushing and flossing for twice a day are recommended to continue.

Halitosis

Oral malodor, also called halitosis, is negatively affecting
many people. It is believed that the release of volatile sulphur compounds from
breathes is the major cause of oral malodor. Various treatments are available
for the public and many individuals are wondering about the effect of oil
pulling on halitosis.

In order to understand the effect of oil pulling, 2 journal
articles were found from US National Library of Medicine. The study done by Sheikh
and Iyer in 2016 stated that oil pulling with rice bran oil is effective in
reducing halitosis; however, no control group was present to compare the
results, the study participants are not representative and the rinsing time for
the 3 groups were different. In this study, rice bran oil, sesame oil, and
0.02% chlorhexidine mouthrinse were tested on 30 pregnant women for a 2-week period (Sheikh & Iyer,
2016). Halitosis was measured by TANITA breath checker HC-212M-BL, a sulfide
monitor used for detection of volatile sulfides in breathes. Breathes were
measured at a 1 cm distance from the sensor for a particularly time period. However,
30 pregnant women are not representative to all adult population. Therefore,
the results may not be accurate and are not generalizable.

A similar randomized controlled study done by Sood,
Devi M, Narang and Makkar in 2014 is also questionable. The study participants
are teenagers; so, the results cannot be generalized to other age groups. The reduction
of organoleptic scores could possibly due to the smell of the sesame oil itself
and the rinsing action.

Conclusion

Based on
data collected above, oil pulling has low efficacy in reducing bacteria and no
strong conclusion was made on the effect of oil pulling on oral malodor. Further
studies with larger sample size that includes all applicable age groups should
be done. At present, adults and
children are not recommended to use oil pulling to improve dental health until
further studies prove its statistically and clinically significant benefits to
individual’s oral health.

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