Oral Exam Oral Oil Pulling

Author Comment: A recent segment on “The Dr. Oz Show” contained information on oral oil pulling and provided a demonstration of this procedure scian nebulizer. This daily television show provides health information and disease prevention segments to its viewers. Since oil pulling is not familiar to the dental community, it warrants discussion and information that the dental professional should be aware of when treating patients who may use this practice. Dr. Oz has presented other dental advice to viewers in the past and the program has a large number of followers. This column is not intended to promote oil pulling without high evidenced-based information, but it is meant to provide information on the subject since the reality of treating patients who use this practice is very possible.

Oil pulling oral hygiene therapy
Typical quality oils that are used in oil pulling. These oils were found at Whole Foods, Inc.

Your patient today is a lovely woman from Southern India named Amisha. She is new to your practice and has just been transferred to the United States with her two children due to her husband’s position at a local company. Amisha is 32 years old, in excellent health, and has no dental problems that she reports.
During your oral assessment you inquire about her oral hygiene practices. Amisha tells you that she has used oral oil pulling and swishing followed by brushing and flossing as part of her daily routine. This has been her practice since she was a teenager. Growing up in her community in southern India, this was a common practice that was taught to older children. You ask her to tell you more about this practice since you are not familiar with the use of oil swished orally.

Ayurvedic medicine evolved 3,000 to 5,000 years ago and is one of the world’s oldest whole body healing systems. The concept is based on the connection of the body with mind and spirit dental scaling machine. All three must be in harmony to promote health. The best analogy is that of a tree that is diseased. The roots are nourished so that the tree becomes strong, and able to fight off stress and disease. Oil pulling or oil swishing has been commonly practiced within Ayurvedic medicine communities in India for centuries.

Typically, quality oil is used, such as sesame or sunflower oil, and the oil is pulled throughout the mouth and teeth contacting the oral tissues for approximately 10 minutes (some suggestions are for up to 20 minutes). The liquid is not swallowed but is expectorated. The teeth are brushed and flossed following the swish (see related short article for protocols) and some recommend a saltwater rinse as well.
Sesame oil (Sesamum indicum plant) is a monounsaturated fat and belongs to a family of others rich in these types of fats such as avocados, peanuts, and almonds. These types of fats, when eaten, are part of a healthy diet and should replace the unhealthy fats that are consumed by many individuals. A balance of calories must be considered as well. Sesame oil is high in nutritional benefits with antioxidants of mainly three lignans: sesamol, sesamin, and sesamolin that have antioxidant properties and potentiate vitamin E. Vitamin E is protective against heart disease and strokes (Asokan, 2008).
Since sesame oil is used in cooking within Indian households, the oil has always been readily available and has been the oil of choice. Lignans are a group of chemical compounds found in plants and they are one of the major classes of phytoestrogens. Their chemical action is that of an antioxidant. Ayurvedic medicine and Indian folk remedy utilizes the oil pulling to prevent caries, oral malodor, bleeding gums, cracked lips, sore throat issues, as well as strengthening the teeth.
Asokan suggests that, although the mechanism of the process of oil pulling is not exact, it is believed that the oil, which is a vegetable oil, is acted on by the salivary alkali and a “soap making process” known as saponification is initiated contra angle handpiece. Saponification is defined as a chemical reaction in which an ester is heated with an alkali. An example is the alkaline hydrolysis of a fat or oil to make soap. Emulsification is initiated in which the oil is broken down into minute droplets and the surface area of the oil is increased. It is believed that the “unsaponifiable” components of the sesame oil, sesamin, or sesamolin offer protection to the oral cavity because of the antioxidant properties.
Chlorhexidine mouthwash is often used to control gingivitis in clinical practice. A study by Asokan et al. evaluated the use of chlorhexidine and oil pulling therapy in the treatment of gingivitis. The study was a randomized, controlled, triple-blind study (2009). The study evaluated oil pulling on plaque-induced gingivitis. The effect of chlorhexidine used in the management of gingivitis is known. But in the Asokan study, oil pulling was found to be equally effective in controlling gingivitis.

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