Oral health is ‘a key indicator of overall health, well-being and quality of life. It encompasses a range of diseases and conditions that include dental caries (decay), periodontal (gum) disease, tooth loss, oral cancer, oral manifestations of HIV infection, oro-dental trauma, noma and birth defects such as cleft lip and palate’ as defined by the World Health Organisation (WHO) (1).

Risk factors for oral disease

There are several risk factors for oral disease including poor oral hygiene, an unhealthy diet, smoking, alcohol, stress, hormonal, impaired immune function, chronic disease, genetics (2) and obesity (3).

What is plaque and what are its effects?

Dental plaque starts to form soon after mechanical cleaning i.e. toothbrushing, flossing, interdental brushes, initially as a sticky deposit on the teeth which attracts bacteria to stick to the surface. The bacteria are then able to multiply and grow and attract other bacterial species to the bacterial cells already present in the plaque mass. Over time, if not addressed plaque bacteria can cause dental disease including gum disease which results in symptoms such as bad breath (halitosis), bleeding gums, red and inflamed gums, recession, mobility and tooth loss. Gum disease has also been linked to chronic disease such as heart disease (4) and new onset diabetes (5), so even more reason to keep the mouth healthy.

Coconut Oil Pulling

Good oral hygiene is essential to keep the teeth and gums healthy, but the use of coconut oil as a pulling agent might be a useful adjunct.

Oil pulling has been used as a traditional Indian folk remedy for many years to prevent dental disease and strengthen the teeth and gums. Coconut oil is primarily composed of medium chain fatty acids and contains 92% saturated acids, with 50% of this being composed of the fatty acid, lauric acid. Evidence shows that coconut oil has antimicrobial properties (6). The exact mechanism of coconut oils antimicrobial action is unclear, but it is thought monolaurin and other medium chain fatty acids present in coconut oil have the capacity to alter the bacterial cell wall, penetrate and disrupt the cell membranes which subsequently leads to death of the bacteria. In the oral cavity, coconut oil pulling plays an important role in preventing oral infection by pulling the infection (bacteria along with their toxins and pus) out of the tissues, allowing the body to heal itself and has been shown to significantly improve plaque and bleeding scores in patients with gum disease (7).

Why coconut oil rather than conventional mouthwashes?

There has been some evidence that conventional mouthwashes increase the risk of diabetes. (8). The mechanism proposed is that mouthwashes wipe out the beneficial as well as the disease-causing microbes which are important for health. Beneficial bacteria play an important role in the nitric oxide pathway and that reduced levels of nitric oxide raises the risk of insulin resistance, impaired vascular function and high blood pressure (8).

How to Oil Pull

• Preferably use organic virgin coconut oil (available from health food stores and Supermarkets).
• Take a tablespoon of the oil (or start with a smaller amount and build up to a tablespoon).
• Swish around the mouth for approximately 15-20 minutes and then spit out. As its an oil remember to not spit it down the sink, instead spit into a paper towel and discard.
• Rinse your mouth out with warm water several times.
• Then brush your teeth thoroughly.
Coconut oil can be done at any time of day but some people believe it is best done, first thing on an empty stomach.

Take home message

Be efficient with your oral hygiene routine by brushing, flossing or using interdental brushes. Bleeding gums is a sign of gum disease and needs to be addressed. See a dentist or dental hygienist if concerned who can also advise and remove the hardened deposits (tartar) from your teeth, making it easier for you to keep the teeth and gums healthy. As an adjunct to good oral hygiene consider the use of coconut oil pulling, it’s definitely worth a try!

References

1. World Health Organisation. Oral Health. Accessed: https://www.who.int/health-topics/oral-health/#tab=tab_1. 8th May 2020.
2. Muhammad A N (2017) Prevalence of periodontal disease, its association with systemic diseases and prevention. International Journal of Health Sciences. 11: 72-80. [Online – PubMed]
3. Martinez-Herrera M et al (2017) Association between obesity and periodontal disease. A systemic review of epidemiological studies and controlled clinical trials. Medicina Oral, Patologia Oral, Cirugia Bucal. 22: e708-e715. [Online – PubMed].
4. Chang Y et al., (2020) Improved oral hygiene is associated with decreased risk of new-onset diabetes: a nationwide population-based cohort study. Diabetologia 63 (5): 924-933. [Online – PubMed]
5. Gomes-Filho I S et al (2020) Severe and moderate periodontitis are associated with acute myocardial infarction. Journal of Periodontology [Epub ahead of print]. [Online – PubMed].
6. Oyi J A et al (2010) Formulation and antimicrobial studies of coconut (Cocus nucifera K Linne) Oil. Research Journal of Applied Sciences, Engineering and Technology 2: 133-137. [Online – PubMed].
7. Nagilla J et al (2017) Comparative Evaluation of Antiplaque Efficacy of Coconut Oil Pulling and a Placebo, Among Dental College Students: A Randomized Controlled Trial. Journal of Clinical and Diagnostic Research, 10: ZC08-ZC011. [Online – PubMed].
8. Preshaw P M (2018) Mouthwash use and risk of diabetes. British Dental Journal, 225: 923-926. [Online – PubMed].

 

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