Does oil pulling (rinsing your mouth with oil) actually work?

Oil pulling has a modest effect on gum health and plaque. A review of 25 studies involving more than 1,100 participants in total shows that oil pulling improves gum inflammation compared with regular mouthwashes, but scores worse on plaque reduction than chlorhexidine (the standard antiseptic mouthwash). The quality of the evidence was rated by the researchers themselves as 'very low', so the precise figures are uncertain.

For bad breath, the picture is mixed. A small study in young people with braces found that after 20 days of oil pulling there were even fewer anaerobic bacteria than with chlorhexidine use. However, a systematic review of 26 studies concluded that there is insufficient evidence that oil pulling genuinely tackles bad breath. Both findings come from studies with a high risk of bias, so no firm conclusions should be drawn from them yet.

Sesame oil appears to be the best-studied option within oral health. In a study of 120 patients with gum disease, sesame oil pulling was just as effective as chlorhexidine for plaque reduction. In patients with type 2 diabetes, an inflammatory marker (CRP) and blood triglycerides also fell -- something chlorhexidine did not achieve. This is a single 30-day study, so its relevance over the longer term is unknown.

Coconut oil is popular for oil pulling, but the evidence supporting it for oral health is too sparse for conclusions. An important distinction: eating coconut oil demonstrably raises LDL cholesterol and total cholesterol. That risk does not apply to rinsing and spitting it out, but it does show that coconut oil is not simply 'healthy'.

Most dentists and dental students are sceptical about oil pulling due to the lack of strong evidence, although many acknowledge that it has some potential for gum health and breath. A laboratory study of a special oil pulling product containing essential oils showed promising results for bacterial growth on braces, but the lead researcher has a commercial interest in that product and the study did not test real patients.