Chances are, you’ve heard the term "oil pulling" at least once, even if you aren’t completely familiar with the practice. Also called "oil swishing," this ancient technique is making its rounds in trendy health circles, and as a dentist, I am a strong advocate for oil pulling as an easy and affordable way to improve dental and oral health while rebalancing the oral microbiome.
But the question is: What is oil pulling, exactly? And does it actually work?
History of oil pulling.
In India, the practice of ayurvedic medicine has been the mainstay of health for the last several millennia. This system is based on the theory of three doshas (energies) and how foods, herbs, and other natural remedies balance those doshas. According to ayurvedic tradition, equilibrium among the doshas results in better health, less stress, and more fulfilling relationships.
But regardless of an individual’s dosha or unique constitution, taking care of the teeth and mouth according to ayurvedic principles will always include a prescription to practice oil pulling. Also referred to in texts as Kavala Graha or Gandusha, oil pulling is the habit of swishing an oil throughout the mouth for several minutes, sometimes multiple times a day, to support health. According to one review of the history and uses of oil pulling, "[Oil pulling] is claimed to cure about 30 systemic diseases ranging from headache, migraine to diabetes and asthma. Oil pulling has been used extensively as a traditional Indian folk remedy for many years to prevent decay, oral malodor, bleeding gums, dryness of throat, cracked lips and for strengthening teeth, gums and the jaw."
This review is taken from the Journal of Ayurveda and Integrative Medicine, and while I personally rely more on oil pulling for oral benefits, ayurvedic practitioners have long touted the benefits of oil pulling as preventive, minimizing the need for future medication or surgery due to a lack of disease. In ayurveda, oil pulling is believed to draw out toxins from the teeth and gums, thereby detoxifying the mouth and, if done regularly, the entire body.
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Oil pulling in modern life.
It wasn’t until the 1990s that oil pulling became a modern trend. Dr. F. Karach, a Russian doctor, wrote about oil pulling during that time, and the idea rapidly spread throughout natural health circles.
Today, publications from Cosmopolitan to WebMD have reviewed the practice with varying levels of accolade. Bloggers throughout the world claim their "obsession" with it—while still others express their skepticism. Even researchers at the University of Oxford in Great Britain have reviewed the available research on oil pulling, as its popularity has risen to such high levels. They agree that, while limited, the current evidence suggests that regularly oil pulling "may have beneficial effects on dental hygiene." In this review, they also point out the cost-effectiveness of oil pulling, particularly if it can help to prevent future dental procedures.
What is oil pulling?
Before I answer the all-important question, "Does oil pulling work?" let me first explain the process.
How do you practice oil pulling?
Oil pulling is done by swishing a tablespoon of a vegetable oil around in your mouth for up to 20 minutes while sitting upright. Depending on the source, you may hear that it’s incredibly important to swish for the entire 20 minutes while others claim the length of time is less important and oil pulling multiple times a day is really the best way to achieve the benefits of oil pulling. Ideally, I like to practice oil pulling for about 10 minutes, two to three times a day.
After swishing for at least 10 to 15 minutes, spit the oil out into a trash can (flushing or rinsing it down pipes may result in clogs as the oil rehardens), then rinse your mouth with water for a few minutes. It’s best to brush before oil pulling, because the point of pulling is to recondition your oral biofilm. Brushing aggressively removes the biofilm, so I suggest brushing and cleaning your tongue right before.
If the thought of just swishing oil for several minutes sounds gross, you can try one of the recipes I created for oil pulling chews. My remineralizing chews include arginine, which has been shown to prevent tooth decay, while my microbiome chews contain baobab, a prebiotic that serves as fuel for the beneficial bacteria in the mouth, helping to rebalance the oral microbiome. Both recipes are great, and I like to keep some chews around to pull after a glass of wine or cup of coffee to prevent bad breath or staining.
What type of oil should I use?
In ayurvedic tradition, sesame oil was (and still is) the popular choice. Sunflower oil has been suggested by many, but coconut oil is the most popular oil used today, particularly because of its known antioxidant and anti-inflammatory activity (which are both important for promoting oral health).
According to one review, there have also been reports of oil pulling with olive oil, gooseberry extract, mangos, and even milk. However, these have not been used in research to study oil pulling benefits. I recommend sticking to organic, cold-pressed coconut oil; it offers the most overall benefit.
Are there any risks to oil pulling?
If done correctly, oil pulling is safe and free of side effects for most people. The exception to this rule is if you regularly aspirate, or choke on, the oils you’re using. When fats enter the lungs, a condition known as lipid pneumonia may result. This is also the reason oil pulling is never recommended for children, particularly those under the age of 5.
Other concerns about oil pulling are that it can loosen crowns or fillings. A properly placed crown or filling won’t move because of oil pulling, as the movement would be the same as if you swished water in your mouth for 20 minutes. However, if you have a decayed foundation, oil pulling may break down and remove some of the mucus, pus, or bacteria hidden under a filling. If a filling or crown moves or becomes detached while oil pulling, it’s a sign you have an infected tooth and need to see your dentist right away.
It’s also important to note that oil pulling is not dangerous for pregnant mothers. This was thought to be the case at one point because of the false assumption that oil pulling "draws out toxins from the bloodstream"—which it doesn’t. There is no known reason why oil pulling would affect fetal or maternal health in any negative way.
Now let’s take a look at some of the results you can expect to achieve if you make oil pulling a regular part of your personal care routine.
Photo: Vera Lair
Benefits of oil pulling.
1. Reduces the bacteria that causes cavities.
A few different studies have investigated the impact of oil pulling on harmful bacteria that causes cavity formation. The most notorious of these, and the one tested in the majority of studies, is Streptococcus mutans.
S. mutans is a bacteria closely associated with tooth decay. While not all bacteria are bad, an overgrowth of this one is thought to cause or speed the development of cavities (also called "dental caries"). In nearly every clinical trial (testing either sesame or coconut oil), oil pulling performed as well or almost as well as chlorhexidine, the main ingredient in most mouthwashes, at eliminating overgrown S. mutans bacteria.
These results may not be seen for at least a few weeks, though. A two-week trial (most of the others were three weeks or longer) found that oil pulling had no significant benefit versus fluoride or herbal mouthwashes in eliminating the bacteria.
2. May aid in preventing gingivitis.
Also closely connected to microbial activity in the mouth, gingivitis is another hot topic in oral health. The inflammation, tenderness, and bleeding of gums caused by gingivitis begins with plaque formation, and multiple studies have found that oil pulling with sunflower, sesame, and coconut oil can reduce the amount of plaque that leads to gingivitis. One study even recorded a marginal (i.e., not statistically significant) increase in oil pulling's benefits over chlorhexidine.
Because of the way gingivitis occurs, some researchers believe coconut oil pulling is the best option for prevention because it is known to have major anti-inflammatory and "emollient," or soap-like, effects. There are no studies investigating the practice of oil pulling to prevent or treat actual gingivitis, but these results are certainly promising.
3. Kills bad breath.
Bad breath, or "halitosis," can be an embarrassing occurrence—and, on occasion, speak to a more serious underlying condition. As another symptom treated by conventional mouthwash, bad breath can be eliminated just as effectively by oil pulling. Swishing helps to reduce the bacteria that often causes bad breath.
4. Improves symptoms of oral thrush.
Another oil pulling benefit is a potential improvement of oral thrush. This fungal infection is caused by certain species of Candida growing in the mouth. People at the highest risk are those on microbiome-altering medications, people with dentures, chemotherapy/radiation patients, and those using inhalers for asthmatic conditions. (Babies often have oral thrush, too, but remember—no oil pulling for the kiddos!)
Does oil pulling work for oral thrush? At least one review has found that it does. By removing pathogenic bacteria and killing some yeast that may lead to the condition, oil pulling, especially with antifungal coconut oil, can help to prevent or improve the symptoms of oral thrush.
5. May help remineralize teeth.
Because it helps to correct the microbial dysbiosis in your mouth, oil pulling (particularly with coconut oil) may be a beneficial part of a teeth remineralization routine. The foods you eat all contribute to the biofilm or oral microbiome, and oil pulling helps to support proper equilibrium between good and bad bacteria.
Does oil pulling work?
Now we’ve arrived at the bottom line: Does oil pulling work? The answer is yes—but not necessarily as a miracle cure-all. There are a number of reasons oil pulling may help to improve oral health. For one, the oils used often have antioxidant, antifungal, and anti-inflammatory properties that help to keep processes in check that can eventually have a negative impact in the mouth.
Oil pulling also breaks up some of the bacteria that sticks to your teeth throughout daily life. This "bacterial adhesion" contributes to dysbiosis and can lead to cavities and other dental issues. Since oil pulling helps maintain a healthy balance of bacteria, rather than killing dangerous and healthy microorganisms, I think it’s a much better option than traditional mouthwash. This removal of bacterial adhesions is also why many people report such a significant difference in the appearance of their teeth before and after oil pulling.
Lastly, the swishing of oils creates a "saponizing" or soap-like action within the mouth. For lack of a better comparison, they lather up a bit and help to actually clean your teeth of bacteria. It’s also one way they may help to remove some stains.
Getting started with oil pulling.
To start oil pulling, try beginning with three to five minutes per day and work your way up to 10 to 15 minutes. If you’re feeling really brave, try doing it twice a day. But don’t feel obligated to obsessively swish—I tell my patients to follow an 80/20 rule, so oil pulling four to five days a week will likely accomplish many of the aforementioned dental benefits. Don’t worry too much about the time of day, since there’s no evidence that oil pulling in the morning or at night is better or worse; just don’t forget to brush your teeth beforehand.
Other ways to maximize oil pulling benefits involve following good oral hygiene. Eating calcium-, vitamin D-, vitamin K-, magnesium-, and phosphorus-rich foods aid your mouth in the effort to reverse cavities naturally, as does reducing your consumption of sugar, refined carbohydrates, and acidic foods. (One tip: If you do have something acidic, like coffee, try to rinse your mouth with water immediately afterward to offset the acidity.)
You may also try adding supplements to your diet to support good dental health including calcium, vitamin D3, vitamin K2, magnesium, and a good oral probiotic. It’s also true that the health of your mouth is a mirror to your overall health. Following proper dental hygiene will definitely aid your body in maintaining proper microorganism equilibrium and preventing disease. However, there’s no evidence (as of yet) that oil pulling on its own actually prevents or treats disease.
The good news is that oil pulling comes with no serious side effects when practiced correctly, so it’s still a great habit to develop as part of a healthy lifestyle.