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Oil Pulling Revisited: Where The Danger Lies

by Eric Hall

March 8, 2014

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Donate This week my social media feed exploded with one particular link to the trend of " oil pulling." While Mike Rothschild already did a great job of debunking some of the miracle claims on a Skeptoid blog last year, and Orac poked fun at it as early as 2007, I wanted to point out a few of the details both from the comment section of Mike's post, as well as the pseudoscience claims in the link I saw this week which are both misleading and possibly dangerous.

If you don't feel like following the links, here's the basics of oil pulling: Put a teaspoon or so of coconut oil in your mouth (most sites of course say unrefined and organic because we don't want any "chemicals" in our chemicals). Swish the oil around for 20 minutes. Spit out all of the "toxins" (I guess coconut oil is toxic?). Then rinse with salt water. Finally do your normal oral hygiene routine. Watch miracles happen - well at least by their claims.

Here's what I pointed out - of course rinsing your mouth for an extended amount of time is going to improve your oral hygiene. The focus on taking care of your teeth, plus extended mechanical action will of course loosen plaque and bacteria from your teeth. Mechanical action is an important component for removing bacteria. This is why surgeons don't just run soap over their hands or why we don't just rinse but instead brush our teeth. Most study on soaps and alcohol-based rubs I looked at conclude that the addition of mechanical action increases the effectiveness of those products. Though just a hypothesis, it would be reasonable to conclude the same effect takes place in oil pulling.

The fad of oil pulling has even caught the attention of local news stations. Most reporters went to local dentists, and most had similar conclusions as I did. The practice itself is pretty safe and not likely to cause harm. It probably does have some effect because it both provides for removing of bacteria and other material from the mouth. It also makes people think about their oral health, so it has a side effect of improved oral health because there is less skipped teeth brushing sessions.

There isn't any scientific studies proving any of the claims, even the ones with plausibility. The only "studies" are the ones reviewing the Ayurveda literature or small studies from India done under that premise - and they are not very good quality. Basically, this is a classic case of the argument from antiquity, where because someone did it in the past, it must be good. This is also how we know small rocks float. (Update: 8/24/2015 - I wrote a post to address this flippant comment.)

So what's the harm? Likely, not alot in the practice itself. Though, there are reports of lipid pneumonia being associated with oil pulling. While this isn't solid evidence of harm, when a certain activity continues to be a source of a certain health issue, it means we should more closely monitor that activity. It will be interesting to see if more reports continue.

There is also harm in the claims and how they relate to inaction. When I point out the excessive claims made by oil pulling proponents, the question usually is "what's the harm?" There is an entire website dedicated to showing examples of harm in things, including inaction, being harmful. The link on my feed this week is from a website called "Fashion Lush," making many claims which I find disturbing.
Helps get rid of acne/ eczema/ psoriasis/ & other skin care issues.
While many of these issues are usually pretty harmless and common, it is important to check with your doctor if you suddenly develop these issues because it can be a sign of a more serious issue. Each of these issues have different causes, and there is no plausible mechanism proposed for how cleaning your teeth helps cure these issues. The harm here is thinking oil pulling will cure this, and maybe not finding out there is a more serious issue underlying the condition.
General body detox.

Cures a hangover (hallelujah!!!) & a migraine.
Any time one sees the term "body detox" you should raise your doubt shields. What does this even mean? If your body truly contained toxic levels of anything, you should seek immediate medical help. Other than that, your body does a pretty good job of maintaining the proper levels of things. Some proponents claim the consistency when the oil is spit out is "proof" of toxins coming out. If this is true, it should be easy to test the oil and measure what's in it. Yet, for some reason these "naturopathic" "doctors" haven't done these tests.

And even more strange is the idea of curing a hangover. A hangover is a set of symptoms with varying causes. I'm not sure how oil pulling is supposed to attack all of these problems (including dehydration which is one part of it). In reality, the only cure is time.

If you have migraines, I again would see your doctor. Migraines could be a sign of another condition, and even if not can be serious. Just don't rely on clean teeth to cure it.
Helps with general pain issues.

Manages any weird hormonal imbalances.
If coconut oil contains any hormones, I wouldn't recommend using it. Use of hormones without monitoring by a doctor can be very dangerous for your health. If it is pulling hormones out of your body, that could be just as dangerous. However, there is a low probability of either happening.

My concern here is again people will replace this with traditional care think oil pulling is a replacement for legitimate, evidence-based medical care. Imagine someone with a thyroid condition, or some other hormonal imbalance for which they are being treated: they start oil pulling and they "feel better," so they stop taking their medication under the assumption the oil will "keep them balanced." Now what?
Prevents cavities & gingivitis. Some people even reported it HEALED their cavities?! Not sure about that one... but who knows?!
Actually, science knows. A cavity is damage to the tooth structure, and there is no evidence or method known to regenerate the structure once it has been destroyed. Certainly better oral hygiene could slow or stop the progression of a cavity, and when a tooth is damaged the root structure pulls back from the tooth, thus reducing the pain. So it might feel "healed," but it really is just being maintained. The concern is because of the damage and without being repaired, the tooth could be weakened and further damaged by use. This could lead to intense pain - and could even lead to serious infections if not properly treated.

My concern is not with the practice of oil pulling. It is with the claims that go with it. There is a possibility there is some direct harm (the pneumonia). It is also likely it is a waste of money as a simple salt water rinse along with the brushing and flossing would have the same effect. I also am concerned with the continued peddling of pseudoscience, which only hurts the overall scientific literacy. I would say there isn't much harm in doing this, but please don't believe it is the next miracle cure either. I will just keep brushing and flossing.

Update: A couple of medical professionals have weighed in as well. Dr. Steven Novella reached much the same conclusion in his SBM post on the topic. Dr. Mary Berk-Mooney also weighed in via the comments here. Her Facebook post should be visible, provided you have a Facebook login.

It seems those within the fields of medicine and dentistry reached similar conclusions. One commenter on Mike's post noted, as a hygienist, that those who do oil pulling on a regular basis have plaque that is harder to clean than those with normal oral hygiene routines. While just anecdotal - I don't think ticking off your hygienist is a good idea considering the sharp tools they put in your mouth!


by Eric Hall

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