Oil pulling versus chlorhexidine mouth rinse: Is one better than the other?

What is oil pulling?

Oil pulling is an ancient holistic and herbal remedy that originated in Ayurvedic medicine in India.¹ It’s been used for centuries, dating back to 3000 BC.² It is believed that oil pulling is beneficial in reducing the chances of gingivitis, dental caries, xerostomia, oral malodor, and to help with tooth whitening.³

It is also believed that oil pulling helps reduce inflammation in the body, which can help improve a variety of systemic diseases. This is likely due to the antimicrobial activity in edible oils, such as the medium-chain fatty acids and phenolic compounds.

There are several different kinds of edible oils that can be used for oil pulling, including sunflower oil, coconut oil, sesame seed oil, and olive oil.⁴ Recommendations are to pull the oil in the morning before eating any food, and to sip and swish one tablespoon of the oil for about 15 to 20 minutes and then dispose of it.¹

What is chlorhexidine?

Chlorhexidine is a mouth rinse used in traditional dental medicine. It is a bisbiguanide, a compound that has both bacteriostatic and bactericidal properties, making it antifungal and antimicrobial. It was first developed in the 1940s in the UK and was marketed as a disinfectant. Then in the 1970s, it was found to have antiplaque properties.⁵

By 1976, it was available as a mouth rinse. Chlorhexidine is used both prophylactically and therapeutically in dental treatment. It has been found to influence anaerobic and aerobic bacteria and can destroy RNA and DNA of viruses such as flu, Hepatitis, HSV, and others. It is used to help treat dental caries, aid in oral hygiene, and in presurgical and postoperative care. Recommendations are to swish between 18 to 20 mg of chlorhexidine for 30 to 60 seconds once or twice a day, depending on the treatment.⁵

Oil pulling versus chlorhexidine

There’s not much research on oil pulling that compares it to chlorhexidine, but I analyzed seven studies on this topic to figure out whether one is better than the other. These studies used the measurements of gingival index, plaque index, and S. mutans count to determine their benefits. Five out of the seven studies found that there was no significant difference in the measurements between the groups of people who used oil pulling and those who used chlorhexidine for oral health.

One of the studies concluded that oil pulling has the same amount of effectiveness as chlorhexidine against halitosis.⁶ Another found oil pulling to be as beneficial as chlorhexidine, without the adverse effects that comes with using chlorhexidine, such as tooth and tongue staining, taste alteration, and enhanced supragingival calculus.⁷

Is one better than the other?

There is a lack of sufficient evidence to conclude that oil pulling is better than chlorhexidine or that chlorhexidine is better than oil pulling. Evidence shows that there are some major differences between oil pulling and chlorhexidine. Oil pulling does not require a prescription, it is cost-effective, it has no associated side effects, and it is a natural option. Chlorhexidine, however, does require a prescription, can be costly, does have some associated side effects, and is not a natural product.

More research is needed to definitively answer if one is better than the other. It is important to consult with a dental professional before implementing new products into one’s oral hygiene routine. It is our job as dental professionals to provide patients with all the information available about a product, such as benefits, risks, and side effects.

References

1. Peng T-R, Cheng H-Y, Wu T-W, Ng B-K. Effectiveness of oil pulling for improving oral health: a meta-analysis. Healthcare. 2022;10(10):1991. doi:10.3390/healthcare10101991

2. Saher F, Hosein M, Ahmed J. (2018). Role of coconut oil pulling on oral health – an overview. J Pakistan Dent Assn. 2018;27(03):94-99. doi:10.25301/jpda.273.94

3. Menaka V, Kavya G, Bhuvaneshwari R, Azali AS, Aparna S, Kumar PD. Effectiveness of coconut oil pulling as an adjuvant to oral hygiene procedure on plaque-induced gingivitis among middle-aged adults – an interventional study. J Global Oral Health. 2020;2(2):102-107. doi:10.25259/jgoh_6_2020

4. Jong FJ, Ooi DJ, Teoh SL. The effect of oil pulling in comparison with chlorhexidine and other mouthwash interventions in promoting oral health: a systematic review and meta‐analysis. Int J Dent Hyg. 2023;22(1):78-94. doi:10.1111/idh.12725

5. Deus FP, Ouanounou A. Chlorhexidine in dentistry: pharmacology, uses, and adverse effects. Int Dent J. 2022;72(3):269-277. doi:10.1016/j.identj.2022.01.005

6. Naseem M, Khiyani MF, Nauman H, Zafar MS, Shah AH, Khalil HS. Oil pulling and importance of traditional medicine in oral health maintenance. Int J Health Sci (Qassim). 2017;11(4):65-70. https://pmc.ncbi.nlm.nih.gov/articles/PMC5654187/

7. Raja BK, Devi K. Oral health effects of oil pulling. J Indian Assn Public Health Dentistry. 2021;19(3):170-179. doi:10.4103/jiaphd.jiaphd_8_21