Chennai resident Radhika Meghanathan started swishing coconut oil in her mouth about a year and half ago after seeing advertisements promoting the technique of oil pulling. She had a cavity in one tooth and experienced sensitivity every now and then, but was dead against the root canal treatment recommended by her dentist. Looking for another way out, she decided to give oil pulling a try.

The ancient Ayurvedic therapy involves gargling a tablespoon of oil in the mouth for anywhere between two minutes and 20 minutes before spitting it out – a practice that is said to help keep plaque away and control the hundreds of thousands of micro-organisms in the oral cavity, some of which cause ill-health.

Meghanathan first tried gingelly oil but did not like its taste, and switched to coconut oil. After a year of the routine, she feels it has helped her. “I still have the cavity, but it has not created any further trouble and I haven’t had any issue of sensitivity or pain,” she said. “I have not felt the need to assess whether [the cavity] has become bigger.”

Instead of her regular dental appointment every six months, Meghanathan now feels she can afford to put off her next visit till the time the affected tooth starts hurting again.

Inspired by Ayurveda

Oil pulling is mentioned in the ancient Indian medicinal texts Charaka Samhita and Sushruta Samhita, dating back to the period between the 4th century BC and the 2nd century AD. “Oil pulling is an age-old therapy, known to us as Kavala Graha or Gandoosha,” said Ayurvedic doctor L Mahadevan of the Sri Sarada Ayurveda Clinic in Chennai. “It may be done by gargling or by completely filling the mouth with oil. In Ayurveda, primarily gingelly oil and coconut oil is prescribed for oil pulling.”

Mahadevan recommends performing oil pulling before brushing one’s teeth. “Swish warm oil for about two to five minutes in the mouth and then rinse with warm water thoroughly,” he said, adding that this practice has been used traditionally to treat gum disease, tooth decay and mouth ulcers.

In theory, oil pulling works by creating a protective layer around the tooth. Moving the oil around the mouth emulsifies it, increasing its surface area. The oil film thus formed on the tooth surface reduces collection of plaque and bacteria. The alkalis in saliva react with the oil, leading to saponification, or the formation of a soap-like substance, which leads to reduction in plaque adhesion. Scientific studies describe how coconut oil has a high saponification value, which promotes the removal of plaque, surface debris and micro-organisms.

Ad of an oil company promoting oil pulling

“Oil pulling is very effective as a preventive method, it dislodges surface debris and it makes tooth-brushing more effective,” said Dr Sharath Asokan, professor and head of the KSR Institute of Dental Science and Research at Tiruchengode in Tamil Nadu, who studied the effectiveness of sesame oil pulling for his doctorate. “It reduces bacterial colony count, reducing caries [tooth decay] and gingivitis-causing microorganisms, and definitely works well against bad breath, halitosis.”

In recent years, the technique has generated interest beyond Ayurvedic practitioners and their followers. Attempts to test the theory continue among dental researchers.

In 1992, Ukranian doctor Fedor Karach presented a paper on oil pulling at a conference of oncologists and bacteriologists in his country. He claimed that such a treatment could cure a variety of illnesses, ranging from heart disease and digestive troubles to hormonal disorders. He claimed it had cured him of a chronic blood disorder he had suffered for 15 long years, and had within three days rid him of his arthritis, which at times had left him bed-ridden and in extreme pain.

Karach did not have the evidence to support his claims, but the idea piqued the interest of dental researchers around the world, who turned their attention to studying whether there was any merit in putting some oil and moving it around in the mouth.

Testing the theory

Doctors at Kannur Dental College in Kerala tested the anti-bacterial efficacy of coconut oil on streptococcus mutans, the most common bacteria causing dental caries. They compared the oil to chlorhexidine, the common anti-bacterial chemical used in mouthwash that is recognised as the gold standard against which other anti-plaque and gingivitis agents are measured. Fifty five girl children were divided into two groups and each group assigned the use of mouthwash or coconut oil exclusively for a period of one month. The presence of the micro-organism in saliva and plaque was measured on the first, fifteenth and thirtieth days. The results of the study, published in the October issue of the Journal of International Society of Community and Preventive Dentistry, showed that the doctors found no significant variations between the two groups and concluded that coconut oil was as effective in preventing the growth of micro-organisms as the chemical mouthwash.

“Coconut oil pulling, even though used in traditional medicine systems in coconut growing countries, has not been studied in detail and, hence, we decided to use this oil for our study,” said the lead author, Dr CP Faizal.“Also, coconut oil is known to contain key fatty acids, like lauric acid that has known anti-bacterial properties, making it an ideal choice for our study.”

Faizal also compared the effects of chlorhexidine, ketaconazole, which is an anti-fungal agent, probiotics, which are effective against gum disease, and coconut oil on fungal microbes in children with caries – which are usually a result of the presence of high levels of microorganisms. The results, published in Scientifica International Journal in March, show that the anti-fungal activity of coconut oil is similar to chlorhexidine and higher than that of probiotics. The researchers, however, cautioned that more studies were needed to validate these findings.

Another study by doctors at the Army College of Dental Sciences in Secunderabad, Telangana, demonstrated a statistically significant reduction in the presence of the streptococcus mutans bacteria among those who used coconut oil as well as chlorhexidine, even though there were fewer pathogens in the mouths of those who used the mouthwash as compared to coconut oil users.

While studies are on to ascertain the effectiveness of oil pulling to fight gum disease, reports indicate there is a risk associated with the practice – if the oil enters the lungs, it can cause lipoid pneumonia. Proponents of the technique also caution that oil pulling cannot be a substitute for medicines or therapeutic mouthwashes.

However, with indications that oil pulling might indeed have a scientific basis, some researchers say it is a safe and cost-effective supplement to other dental care practices. “Oil pulling is a traditional remedy that is now being backed by some scientific proof,” said Dr Sharath Asokan of the KSR Institute of Dental Science and Research. “It is not a chemical or medicament with therapeutic effects. It is a preventive home remedy and cannot replace conventional brushing or the therapeutic mouthwash.”