Coconut oil swishing

Yu Feng Lin & Fawziya Twam

Coconut oil swishing, also known as oil pulling, is a traditional Ayurvedic practice that involves swishing a tablespoon of coconut oil in your mouth for about 15-20 minutes and then spitting it out. Ayurveda uses a natural approach to herbs and spices, using holistic remedies to find the root cause of any problem and manage it holistically. Coconut oil is widely available and cost-effective, making it an attractive option for many people seeking to prevent common oral diseases through the practice of oil pulling. Coconut oil has 92% saturated medium-chain fatty acids, most of which are lauric acid, followed by other acids, such as capric acid, caprylic acid, etc., and its glycolipid component is sucrose monolaurate. It can oxidize sucrose on Streptococcus mutans, preventing its regeneration and reattachment of plaque, and has anti-caries properties. Proponents of coconut oil swishing claim various health benefits, but it's essential to evaluate these claims using evidence-based medicine principles.

There is limited scientific evidence to support many of the health claims associated with coconut oil swishing. However, some studies suggest that oil pulling with coconut oil may help reduce plaque and improve oral hygiene by reducing the levels of harmful bacteria in the mouth. However, these effects are generally modest and may not be superior to traditional oral hygiene practices like brushing and flossing. There is also limited evidence to suggest that coconut oil swishing may have a mild positive effect on gum health, including reducing gingivitis and plaque-induced gum inflammation. Some people claim that oil pulling with coconut oil can whiten teeth. While there's anecdotal evidence supporting this claim, there's no strong scientific evidence to confirm its effectiveness. Others suggest that it can detoxify the body, improve skin conditions, and even boost the immune system. However, there's no substantial scientific evidence to back up these claims.

The objective of one study was to assess the effectiveness of oil pulling with coconut oil in improving oral health and dental hygiene. To achieve this objective, the researchers conducted a review that included randomized controlled trials (RCTs) comparing the effects of oil pulling with coconut oil on oral health and dental hygiene. Notably, no meta-analysis was performed due to variations in clinical heterogeneity and differences in data reporting across the included studies. The researchers conducted comprehensive searches across six electronic databases, including PubMed, Medline, EMBASE, AMED, CENTRAL, and CINAHL. Their efforts yielded 42 eligible studies, from which four RCTs involving a total of 182 participants were selected for analysis. These trials ranged in duration from 7 to 14 days.

The results of the selected studies indicated some significant findings. Oil pulling with coconut oil showed promise in reducing salivary bacterial colony counts (p = 0.03) and plaque index scores (p < 0.001). In addition, one of the studies demonstrated a significant difference in staining when compared to the use of Chlorhexidine (p = 0.0002). However, it's important to note that the available data was deemed insufficient for drawing conclusive findings. Furthermore, the quality of the included studies was mixed, and there was a high risk of bias in some cases.

A separate study aimed to compare the microbiological effects of Virgin Coconut Oil (VCO) pulling with Palm Oil (PO) pulling when used as adjunctive oral hygiene care. The study involved 36 volunteers with gingival inflammation who were randomly assigned to two groups: one starting with VCO (test) and the other with PO (control) in a crossover design. Oil pulling was performed for 28 days alongside their regular oral hygiene routines. After a 21-day wash-out period, the participants switched to the other oil type and repeated the protocol. Plaque samples were collected at different points, including baseline, after the first oil pulling period, after the washout, and after the second oil pulling period. The study measured various microbiological parameters, including total, aerobic, and anaerobic bacteria, as well as Mutans streptococci (MS) counts. The mean differences between VCO and PO were compared using paired t-tests.

The results showed that after 28 days of oil pulling, there was no significant difference in the number of total, aerobic, or anaerobic bacteria compared to baseline in both the PO and VCO groups. However, PO pulling demonstrated a significant reduction in MS count compared to baseline (P = 0.010), whereas VCO pulling did not show a significant reduction in MS count. Importantly, there was no statistically significant difference in the mean changes of any microbiological parameters between the two treatments.

The study found that VCO pulling did not demonstrate a statistically significant superior benefit in reducing plaque bacteria compared to PO pulling. However, PO pulling appeared to reduce Mutans streptococci (MS), which are associated with dental caries, significantly. The study concluded that further investigations are needed to better understand the potential oral health benefits of different oil pulling practices and their effects on specific types of oral bacteria.

While coconut oil is generally considered safe for oral use, there can be side effects such as nausea, upset stomach, and an unpleasant taste. Additionally, oil pulling should not be used as a substitute for regular dental care and oral hygiene practices recommended by dental professionals.

The limited evidence from these studies suggests that oil pulling with coconut oil may have a positive impact on oral health and dental hygiene. However, to establish a more robust understanding of its effectiveness, future clinical trials with rigorous designs and execution are needed. Given the universal availability of coconut oil, it holds potential as an adjunct to standard preventative oral health regimens.

References:

Peng TR, Cheng HY, Wu TW, Ng BK. Effectiveness of Oil Pulling for Improving Oral Health: A Meta-Analysis. Healthcare (Basel). 2022;10(10):1991. Published 2022 Oct 11. doi:10.3390/healthcare10101991

Siripaiboonpong N, Matangkasombut O, Pengcharoen H, Boonchaiyapluk B, Rujiraprasert P, Srithanyarat SS. Microbiological Effects of Virgin Coconut Oil Pulling in Comparison with Palm Oil Pulling as an Adjunctive Oral Hygiene Care for Patients with Gingival Inflammation: A Randomized Controlled Clinical Trial. J Indian Soc Periodontol. 2022;26(1):58-63. doi:10.4103/jisp.jisp_768_20

Woolley J, Gibbons T, Patel K, Sacco R. The effect of oil pulling with coconut oil to improve dental hygiene and oral health: A systematic review. Heliyon. 2020;6(8):e04789. Published 2020 Aug 27. doi:10.1016/j.heliyon.2020.e04789