Evaluation of the Effect of Oil Pulling on Dental and Gingival Health
Phase: NA
Conditions: Oral Hygiene, Dental Plaque
Sponsor: Ataturk University

The objectives of this study were to evaluate the inhibitory effect on plaque and the 
tooth discoloration associated with agents used in the chemical plaque control of oil pulling in 
comparison with chlorhexidine-containing mouthwash and water in a four-day plaque regrowth 
model.  
Study Design  
At the beginning of a two-week preparation period, plaque, calculus and dental stains 
will be thoroughly removed, both hand and by ultrasonic scaling and polishing, and oral hygiene 
instruction will be provided for self-administered plaque control (Fig. 1). At the end of the 
preparation period, all participants are expected to have clinically healthy gingivae. The 
participants will randomly divided into five groups, and the coded allocated product will be 
provided. The instructions for use of the allocated products will be given to the individuals with 
a printed program by a dentist who will not involved in the study. On day 1 of the study, after 
the plaque has been stained with a plaque disclosure tablet (Curaprox, Kriens, Switzerland), all 
participants will undergo scaling and polishing to remove plaque and tooth staining, and teeth 
will be redisclose with a tablet to ensure that all the participants will be provided with a zero 
plaque score at the start of the trial. Then, the tooth color will be determined with a digital 
spectrophotometer (VITA Easyshade® V; VITA Zahnfabrik, Bad Säckingen, Germany). 
Afterwards, individuals will asked to avoid all types of dental cleaning and to follow the study 
protocol. The participants will be instructed to avoid other mouthwashes, chewing gum, or the 
use of toothpaste during the four-day period. They will be instructed to control the application 
time with a timer and will be reminded twice a day to use the allocated products for a four-day 
period by the dentist who assigned the product. At the end of the fourth day, tooth color will be 
redetermined with the VITA Easyshade® V. The teeth will then disclosed with a Curaprox® 
plaque staining tablet, and plaque scores will record using the Quigley-Hein and Turesky plaque 
index (Q–H) (Quigley & Hein, 1962; Turesky et al., 1970). Finally, the gingival index (GI) will 
be recorded. All clinical examinations will be performed by a blinded observer. After the 
clinical parameters will be recorded, the teeth will polish to remove all plaque and any tooth 
staining.  
          Clinical Examinations     
         The Quigley-Hein and Turesky plaque indexes (Quigley & Hein, 1962; Turesky et al., 
1970) will be used to measure dental plaque formation and the degree of deposition, and 
gingival index (Loe & Silness, 1963) to evaluate gingival inflammation. To assess tooth color 
change, tooth color determination will be performed at the beginning and end of the study with 
the VITA Easyshade® V digital spectrophotometer and will record as a CIE L* a* b* value. 
Measurements will make under D65 standard lighting conditions corresponding to daylight, 
and the device will be calibrated before each measurement. Color measurements will make 
from the middle third of each participant's right maxillary central incisor tooth. The color of the 
tooth will be determined three times, and the average CIE L* a* b* value will be obtained.  
          The color difference (∆E) values of the teeth at the beginning (L0, a0, b0) and the end 
(L*, a*, b*) of the study will be calculated by using the following CIELAB color difference 
formula: 
∆E=[(∆L)2+(∆a)2+(∆b)2] ½,  

(∆L= L*-L0, ∆a=a*- a0 ve ∆b=b*-b0)  
         The L*, a* and b* values represent the color values measured at the end of four days, 
while the L0, a0 and b0 values represent the color values measured at the beginning of the 
study. 
         Statistical Analysis 
The data obtained as a result of the measurements made by the participants after using 
different products will be analyzed using a statistical software program (IBM SPSS Statistics, 
v23.0®; IBM Corp., Chicago, IL, USA). Because the group number is more than three, (CHX, 
DW, coconut oil, turmeric oil, black cumin oil) the parametric method (ANOVA) will be used 
in the analysis of normally distributed data. Also, homogeneity of variance, another assumption 
of the ANOVA test, will also tested during the analysis. For the multiple comparison tests, the 
Tukey method will be used in homogeneous groups, and the Games-Howell method will be 
used in non-homogeneous groups, depending on the number of samples in the groups 
(Tabachnick et al., 2007). Analyses will be performed at a 95% reliance interval (α=0.05).  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

Figure 1 Flow chart of the study.