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Oil pulling (Kavala / Gandusha ) for Dental problems

Oil pulling is an ancient procedure mentioned In Ayurveda literature, which involves swishingoil in the mouth. It is practiced even now in India extensively as a traditional Indian remedy for oral health.

Various oils used for swishing are Coconut oil, Corn oil, Rice bran oil, Palm oil, Sesame oil, Sunflower oil and Soya bean oil. They are used for preventive and supportive oral care. Additionally there are many medicated oils like Arimedadi oil which are prescribed for therapeutic use.

Caution: Oil pulling should be done under guidance and prescription of qualified Ayurveda doctor.
Mechanism of action: The mechanisms of oil-pulling action are currently being researched. It is possible that the viscosity of the oil would inhibit bacterial adhesion and plaque co-aggregation. The other possible mechanism might be the saponification process that occurs as a result of alkali hydrolysis of oil by bicarbonates in saliva. There are antimicrobial properties in some of these oils which have been researched scientifically.

This local application therapy is advised along with diet and lifestyle modifications, treatment of causative factors and systemic treatment for various oral/dental problems like caries prevention, gingival bleeding, oral malodor, pain and burning in the mouth, xerostomia, generalized teeth sensitivity, and prevention and treatment of periodontal diseases.

As dental practitioners we have a choice now to avoid side effects of mouthwashes and other local applications for various oral conditions and a substitute in the form of oil pulling which has been practiced for more than 2000 years.

Step 1: Pour one tablespoon of oil prescribed by Ayurveda doctor into your mouth empty stomach in the morning.

Step 2: Swish the oil around in your mouth through your teeth without swallowing it. (Don’t tilt your head back to gargle or swallow). The oil becomes watery as your saliva mixes with it. Relax your jaw muscles and use your tongue to help move the liquid around the mouth.

Step 3: When the oil/saliva mixture becomes thicker, spit out the oil into the toilet. At this time it may look yellowish.

Step 4: Rinse out your mouth a couple of times with water. Initially it should be done for 5 minutes and gradually increase it to 10-15 minutes. Continue with brushing after oil pulling. 
Scientific evidence: Scientific evidence shows that the oil-pulling therapy could reduce the plaque index, modify gingival scores and the total oral bacteria count in gingivitis patients. There are many studies in vitro and in vivo on oil pulling and oral health, dental caries, periodontal conditions, and properties of oils used for this therapy. I am listing few of them below for your reference.

1. Priyanka Selvam, Nandan N, Sunil Raj. Oil Pulling - A Blessing in Disguise. J Ayurveda Integr Med Sci 2016;4:8-13.

2. Sooryavanshi, S; Mardikar, B. R. (1994). "Prevention and treatment of diseases of mouth by gandoosha and kavala". Ancient Science of Life. 13 (3–4): 266–70.

3. C. Hannig, C. Wagenschwanz, S. Pötschke, K. Kümmerer, A. Kensche, W. Hoth-Hannig, M. Hannig. Effect of Safflower Oil on the Protective Properties of the in situ Formed Salivary Pellicle. Caries Research. 2012; 46(5): 496

4. Lakshmi, T; Rajendran, R; Krishnan, Vidya (2013). "Perspectives of oil pulling therapy in dental practice". Dental Hypotheses. 4 (4): 131–4.

5. Hebbar A, Keluskar V, Shetti A. Oil pulling – Unraveling the path to mystic cure. J Int Oral health 2010;2:10-3.

6. Asokan S, Rathinasamy TK, Inbamani N, Menon T, Kumar SS, Emmadi P, et.al. Mechanism of oil-pulling therapy – In vitro study. Indian J Dent Res 2011;22:347.

7. Asokan S, Rathan J, Muthu MS, Rathna PV, Emmadi P; Raghuraman; Chamundeswari. Effect of oil pulling on Streptococcus mutans count in plaque and saliva using Dentocult SM Strip mutans test: A randomized, controlled, triple-blind study. J Indian SocPedodPrev Dent 2008;26:12-7.

8. Thaweboon S, Nakaparksin J, Thaweboon B. Effect of oilpulling on oral microorganisms in biofilm models. Asia J Public Health 2011;2:62-6.

9. Faizal C. Peedikayil, Prathima Sreenivasan and Arun Narayanan. Effect of coconut oil in plaque related gingivitis — A preliminary report. Niger Med J. 2015 Mar-Apr; 56(2): 143–147.

10. Amith HV, Ankola AV, Nagesh L. Effects of oil pulling on plaque and gingivitis. J Oral Health Community Dent 2007;1:12-8.

11. Asokan S, Emmadi P, Chamundeswari R. Effect of oil pulling on plaque induced gingivitis: A randomized, controlled, triple-blind study. Indian J Dent Res 2009;20:47-51

12. Asokan S, Kumar RS, Emmadi P, Raghuraman R, Sivakumar N. Effect of oil pulling on halitosis and microorganisms causing halitosis: A randomized controlled pilot trial. J Indian SocPedodPrev Dent 2011;29:90-4

13. AIT researchers show coconut oil could combat tooth decay (Press release). Athlone Institute of Technology. 3 September 2012. Retrieved April 30, 2015.

14. Tomar P, Hongal S, Jain M, Rana K, Saxena V. Oil Pulling and Oral Health: A Review. IJSS Case Report & Reviews 2014;1(3):33-37.

15. Kensche, A.; Reich, M.; Kümmerer, K.; Hannig, M.; Hannig, C. (2012). "Lipids in preventive dentistry". Clinical Oral Investigations. 17 (3): 669–85.

16. Rowena Anne Mathew, M. Sankari. Oil Pulling and its Role in Oral and Systemic Diseases- A Review Article. International Journal of PharmTech Research. Vol.6, No.2, pp 701-703, April-June 2014.

17. Fife B. Evidence that oil pulling eradicates harmful bacteria. Dental health with oil swishing. Well Being J 2008;Nov-Dec:39-42.

18. Asokan S. Oil pulling therapy. Indian J Dent Res 2008;19:169.

19. Effect of oil-pulling on dental caries causing bacteria. Afr J Microbiol Res 2008;2:063-06.

20. Singh A, Purohit B. Tooth brushing, oil pulling and tissue regeneration: A review of holistic approaches to oral health. J Ayurveda Integr Med 2011;2:64-8.

21. Kato MJ, Chu A, Davin LB, Lewis NG. Biosynthesis of antioxidant lignans in Sesamum indicum seeds. Phytochemistry 1998;47:583-91.

22. Ogbolu DO, Oni AA, Daini OA, Oloko AP. In vitro antimicrobial properties of coconut oil on Candida species in Ibadan, Nigeria. J Med Food 2007;10:384-7.

23. Sechi LA, Lezcano I, Nunez N, Espim M, Duprè I, Pinna A, et al. Antibacterial activity of ozonized sunflower oil (Oleozon). J Appl Microbiol 2001;90:279-84. 
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