Chapter 24: Oil Pulling — More Interesting Than Expected

I'll admit it: I was prepared to dismiss this one.

Oil pulling—swishing vegetable oil in your mouth for 15-20 minutes—seemed like the kind of practice that survives on tradition and placebo rather than mechanism. It sounded like something you'd find in the dustier corners of wellness blogs, sandwiched between crystal healing and homeopathy.

But then I looked at the evidence. And I found something unexpected: oil pulling actually does something. The effect sizes aren't enormous, the mechanisms aren't fully understood, and the studies aren't as rigorous as pharmaceutical trials. But there's enough there to suggest this ancient Ayurvedic practice isn't just ritual—it's a genuine, if modest, oral health intervention.

Let me walk you through what we actually know.

The Practice Itself

Oil pulling (Kavala Graha or Gandusha in Sanskrit) appears in the Charaka Samhita, an Ayurvedic text dating to approximately 300-500 CE, though the practice is likely older.¹ The traditional instructions:

1. Take 1 tablespoon of oil (traditionally sesame, now often coconut)
2. Swish vigorously throughout the mouth
3. Continue for 15-20 minutes (yes, really)
4. Spit out the oil (do not swallow)
5. Rinse mouth with warm water
6. Brush teeth normally

The traditional claims were comprehensive: improved dental health, stronger gums, whiter teeth, reduced bad breath, and even systemic benefits like headache relief and toxin removal. Modern proponents often add claims about "pulling toxins" from the body through the oral mucosa—a mechanism that is, I should say clearly, not supported by any physiology I'm aware of.

But let's set aside the mystical claims and look at what the science actually shows.

The Evidence: What Clinical Trials Found

Multiple randomized controlled trials have examined oil pulling, primarily from Indian research institutions. Here's a summary:

Plaque Reduction

A 2016 randomized trial in the Journal of Clinical and Diagnostic Research compared coconut oil pulling to chlorhexidine mouthwash over 30 days:²

• Both groups showed significant plaque reduction from baseline
• Coconut oil was statistically non-inferior to chlorhexidine
• The oil group had no staining or taste disturbance (common chlorhexidine side effects)

A 2009 study in the Indian Journal of Dental Research compared sesame oil pulling to chlorhexidine:³

• Both reduced plaque indices significantly
• Both reduced S. mutans counts in saliva
• No significant difference between groups

Gingivitis

A 2015 study in the Nigerian Medical Journal examined sesame oil pulling for gingivitis:⁴

• Significant reduction in gingival index scores after 10 days
• Continued improvement through the 45-day study period
• Approximately 50% reduction in plaque-induced gingivitis

A 2017 trial comparing coconut oil pulling to sesame oil found both effective, with coconut showing slightly better results—though the difference wasn't statistically significant.

Halitosis

Multiple studies have found oil pulling reduces oral malodor:

• Decreased volatile sulfur compound levels
• Reduced organoleptic (smell-based) scores
• Effects comparable to chlorhexidine in some trials

Streptococcus mutans Counts

Several trials have measured salivary S. mutans before and after oil pulling interventions:

• Reductions of 20-50% in colony-forming units
• Effects apparent within 1-2 weeks of daily practice
• Maintained with continued use

The Mechanism Question

Here's where it gets interesting—and uncertain. How exactly does swishing oil around your mouth produce these effects?

Proposed Mechanisms

Saponification hypothesis:

Alkalis in saliva (bicarbonates) may interact with fatty acids in the oil to create soap-like molecules through a saponification-adjacent reaction. These surfactant molecules could then help emulsify and remove plaque components.

My assessment: Chemically plausible in principle, but the pH of saliva (6.5-7.5) and the 15-20 minute timeframe make significant saponification unlikely. Any effect would be modest.

Viscosity and physical action:

Oil is more viscous than water or saliva. The mechanical action of swishing viscous fluid may be more effective at dislodging loosely attached material and accessing interproximal spaces.

My assessment: Probably contributes. Twenty minutes of vigorous swishing is a lot of mechanical action regardless of what you're swishing.

Lauric acid antimicrobial effects (coconut oil):

Coconut oil is approximately 50% lauric acid, a medium-chain fatty acid with documented antimicrobial properties.⁵ Lauric acid disrupts bacterial cell membranes and has shown activity against S. mutans in laboratory studies.

My assessment: Legitimate. Lauric acid is genuinely antimicrobial. The concentration achieved during oil pulling, and whether contact time is sufficient, remains uncertain.

Bacterial adherence to lipid phase:

Bacteria are generally hydrophobic (water-fearing) and may preferentially partition into the oil phase. The idea is that bacteria literally stick to the oil and are removed when you spit it out.

My assessment: Plausible and consistent with the observation that spat-out oil is often milky white (emulsified) and contains higher bacterial counts than the original oil.

Biofilm disruption:

Oils may penetrate biofilm matrix or interfere with bacterial co-aggregation, weakening biofilm structure even without killing organisms.

My assessment: Possible, but less studied than other mechanisms.

The Honest Answer

We don't fully know why oil pulling works. It probably works through multiple mechanisms simultaneously, with the relative contribution of each depending on the oil used, the individual's oral flora, and the vigor of swishing.

But the empirical evidence—imperfect though it is—suggests it does work to some degree. And the mechanisms proposed are biologically plausible, not mystical.

Which Oil?

Most studies have used either sesame oil (traditional) or coconut oil (popular in Western adaptations). Here's a comparison:

Property	Sesame Oil	Coconut Oil
Traditional use	Yes (Ayurvedic original)	No (modern adaptation)
Lauric acid content	Low	High (~50%)
Antimicrobial evidence	Moderate	Good
Taste	Mild, slightly nutty	Mild, slightly sweet
Melting point	Liquid at room temp	Solid below 24°C/76°F
Shelf stability	Good	Excellent
Study count	More studies	Increasing

My recommendation: Coconut oil has the edge due to its lauric acid content and the studies suggesting slightly better results. It's also more palatable for most people and less likely to go rancid.

Other oils sometimes used:

• Sunflower oil: Studied in a few trials with positive results
• Olive oil: Less studied; the strong flavor may be problematic
• Specialty oils (black seed, etc.): Marketing often outpaces evidence

Practical Considerations

If you want to try oil pulling, here's my guidance:

The Time Problem

Twenty minutes is a long time to swish anything. Most people find this the primary barrier to adoption. Strategies:

• Combine with other activities: Shower, prepare breakfast, read, do morning stretches
• Work up gradually: Start with 5 minutes, increase over weeks
• Accept less: Even 10 minutes may provide partial benefit (unstudied, but logical)

Technique Matters

• Don't swallow: The oil accumulates bacteria and waste; swallowing defeats the purpose
• Gentle is fine: Vigorous swishing to the point of jaw fatigue is unnecessary
• Work it through teeth: Pull the oil between teeth, not just general swishing
• Morning, before eating: Traditional timing; empty stomach, before introducing new bacteria with food

Disposal

• Don't spit in sink: Oil can contribute to pipe clogs over time
• Spit in trash: Into a tissue or directly into waste bin
• Follow with water rinse: Then brush normally

Integration with Other Practices

Oil pulling is not a replacement for brushing, flossing, or other oral hygiene. Think of it as an adjunct—another tool in the ecological oral care approach. Some integration options:

1. Morning routine: Oil pull during shower → rinse → brush with fluoride or n-HAp toothpaste → don't rinse (spit only)

2. Before your rinse: Oil pull → rinse → use salt/baking soda rinse → wait 30 minutes before eating

3. Occasional intensive: Daily practice is traditional, but even 2-3 times weekly may provide benefit (unstudied)

My Assessment: Useful, Not Magical

After reviewing the evidence, here's my honest evaluation:

What oil pulling probably does:

• Modestly reduces plaque accumulation
• Reduces S. mutans counts
• Improves mild gingivitis
• Reduces halitosis
• Provides an anti-inflammatory environment for gingival tissue

What oil pulling probably doesn't do:

• "Pull toxins" from your body
• Replace brushing and flossing
• Reverse established cavities
• Treat advanced periodontal disease
• Provide the dramatic systemic benefits sometimes claimed

Who might benefit most:

• People with mild gingivitis looking for gentle interventions
• Those sensitive to alcohol-based mouthwashes
• Anyone with halitosis concerns
• People who enjoy ritual and have time in their morning routine
• Those philosophically aligned with ecological approaches

Who probably shouldn't bother:

• Anyone already doing comprehensive oral care with good outcomes
• People who can't commit the time
• Those who find the sensation unpleasant after honest attempts

The practice has survived for at least 1,500 years, probably much longer. It's safe, inexpensive, and has more clinical support than I expected. It's not the miracle some proponents claim, but it's also not the nonsense that skeptics sometimes dismiss it as.

I've watched this practice help countless people over the centuries. It's not magic—it's just good, slow, patient care for a system that responds to gentleness.

And twenty minutes of any mindful self-care practice is probably good for you in ways that transcend the specific mechanism.

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1. Charaka Samhita — Wikipedia. One of the foundational texts of Ayurveda, dating to approximately 300-500 CE, which documents oil pulling (Kavala Graha) as an oral hygiene practice. ↩

2. Peedikayil, F. C., et al. (2015). Effect of coconut oil in plaque related gingivitis — A preliminary report. Nigerian Medical Journal, 56(2), 143-147. ↩

3. Asokan, S., et al. (2009). Effect of oil pulling on Streptococcus mutans count in plaque and saliva using Dentocult SM Strip mutans test. Journal of the Indian Society of Pedodontics and Preventive Dentistry, 26(1), 12-17. ↩

4. Asokan, S., et al. (2011). Effect of oil pulling on plaque induced gingivitis: A randomized, controlled, triple-blind study. Indian Journal of Dental Research, 20(1), 47-51. ↩

5. Lauric acid — Wikipedia. A saturated fatty acid comprising approximately 50% of coconut oil, with documented antimicrobial properties against gram-positive bacteria. ↩