Oil pulling
Oil pulling is an ancient Ayurvedic dental technique originating from India, involving the swishing of edible oil, such as sesame or coconut oil, in the mouth for 15–20 minutes to purportedly improve oral hygiene and reduce harmful bacteria.[1][2] Documented in classical texts like the Charaka Samhita and Sushruta Samhita as kavala or gandoosha, it has been practiced for centuries as a holistic remedy believed to detoxify the body and treat various ailments, though modern interest surged in the 1990s through advocacy by Ukrainian physician F. Karach.[1] Proponents claim oil pulling reduces plaque, gingivitis, bad breath, and salivary bacterial counts like Streptococcus mutans, while also whitening teeth and alleviating dry mouth, positioning it as a natural adjunct to conventional oral care.[2][3] Systematic reviews and meta-analyses indicate low-quality evidence for modest oral health benefits, particularly in reducing gingivitis, with mixed results for plaque and bacterial counts. A 2022 meta-analysis of nine RCTs (344 participants) found significant reductions in salivary bacterial colony counts versus controls (mean difference: 17.55 CFU/mL; 95% CI: 2.56–32.55), but no notable effects on plaque index (mean difference: -0.10; 95% CI: -0.33–0.14) or gingival index (mean difference: -0.05; 95% CI: -0.12–0.02).[2] However, a 2023 meta-analysis of 25 RCTs (1,184 participants) reported no significant bacterial reductions and chlorhexidine superiority for plaque, with probable benefits for gingival health versus non-chlorhexidine mouthwashes; a 2025 meta-analysis of nine RCTs similarly showed significant gingival improvements versus chlorhexidine but nonsignificant plaque effects.[4][5] Earlier reviews noted comparable short-term plaque reductions to chlorhexidine (up to 50% with coconut oil over 30 days in some trials), emphasizing oil pulling's supplementary role.[1] Overall evidence remains low due to small sample sizes, short durations (1–45 days), high risk of bias, and inconsistent protocols, with calls for larger, longer-term RCTs.[2][3][4] Despite these findings, potential risks include aspiration-induced lipoid pneumonia, and the practice is generally safe for adults but not recommended for children under five due to swallowing risks.[6][1] Oils like sesame (rich in antimicrobial sesamol) and coconut (containing lauric acid) are most studied, with no superior oil identified.[6][1]History
Origins in traditional medicine
Oil pulling, referred to as kavala graha or gandusha in ancient Ayurvedic literature, originates from traditional Indian medicine and is detailed in foundational texts such as the Charaka Samhita and Sushruta Samhita, which date from approximately the 4th century BCE to the 2nd century CE. These practices involve retaining or swishing medicated oils or decoctions in the mouth to address oral and systemic imbalances, forming a core component of Ayurvedic oral hygiene rituals.[7] In these texts, oil pulling is prescribed specifically for oral detoxification by drawing out accumulated toxins (ama) from the oral cavity and deeper channels, thereby purifying the mouth and preventing the buildup of harmful substances.[8] It is also described as a method to strengthen teeth and gums, enhance jaw firmness, and avert oral diseases such as pyorrhea (periodontitis), bleeding gums, and dental decay by promoting tissue resilience and reducing inflammation.[9][10] Within Ayurveda, oil pulling evolved as a recommended daily ritual, particularly for balancing the vata dosha, which governs movement and dryness in the body; imbalanced vata is believed to contribute to oral dryness, tooth sensitivity, and degenerative conditions, and the practice's lubricating effects help mitigate these by nourishing oral tissues and stabilizing doshic harmony.[11] Over time, it became integrated into broader Ayurvedic dinacharya (daily routines) to support preventive health, emphasizing its role in maintaining oral vitality as part of holistic well-being.[12]Modern adoption and popularization
The modern revival of oil pulling in the late 20th century is credited to Ukrainian physician Dr. F. Karach, who introduced the practice to a broader audience during a 1992 presentation at the conference of the All-Ukrainian Union of Oncologists and Bacteriologists. Karach described oil pulling as a simple detoxification method using edible oils like sunflower or sesame, claiming it could address over 30 systemic illnesses by drawing toxins from the bloodstream through the oral mucosa. His advocacy, based on personal observations and patient outcomes, sparked initial interest among alternative health practitioners in Eastern Europe, though it remained niche outside traditional Ayurvedic circles until the 2000s.[13] The practice gained significant momentum in the West during the early 2000s, propelled by publications that framed it as an accessible wellness ritual. A key milestone was the 2008 release of Oil Pulling Therapy: Detoxifying and Healing the Body Through Oral Cleansing by naturopath and nutritionist Bruce Fife, which detailed the technique's purported benefits and encouraged its daily use for oral and overall health improvement.[14] By the 2010s, oil pulling surged as a trend in wellness blogs and early social media, with sites like Goop and natural health forums promoting it as a natural alternative to conventional oral care, leading to widespread adoption among health-conscious consumers.[15] Integration into holistic dentistry and alternative medicine accelerated in the 2010s, as practitioners began incorporating oil pulling into preventive regimens for its supposed antibacterial properties and support for gingival health.[16] Endorsements from celebrities amplified this shift; for instance, actresses Gwyneth Paltrow and Shailene Woodley discussed its benefits in interviews in 2014, crediting it for brighter teeth and fresher breath.[17][18] By the 2020s, influencers on platforms like TikTok and Instagram, including wellness advocates with millions of followers, further popularized it through viral challenges and testimonials, sustaining its status as a go-to ritual in contemporary self-care up to 2025.[19]Practice
Procedure and technique
Oil pulling, akin to the Ayurvedic practice of kavala graha (swishing a smaller amount of oil to draw out toxins), though related to gandusha (holding a full mouth of oil without swishing to strengthen tissues), involves swishing a measured amount of edible oil in the mouth to cleanse the oral cavity.[8][12] The modern technique, following kavala, is performed by gently pulling and pushing the oil through the teeth and around the gums without gargling or swallowing.[20] The standard procedure follows these steps:- Begin on an empty stomach, ideally in the morning, by taking approximately 1 tablespoon (10-15 ml) of oil into the mouth.[12]
- Swish the oil vigorously but gently between the teeth and throughout the oral cavity for 10-20 minutes, or until the oil becomes thin and milky in consistency.[22]
- Spit the oil into a trash receptacle to avoid clogging drains, taking care not to swallow it as it may contain bacteria and toxins.[20]
- Rinse the mouth thoroughly with warm water, followed by brushing the teeth and flossing as part of regular oral hygiene.[12]