Comparison of the Effects of Oil Pulling Therapy With Different Oils
Condition: Gingivitis
MeSH terms: Gingivitis
Study type: Interventional

Summary: 
      Oil pulling" or "oil swishing" originates from ancient Ayurvedic medicine in India and now
      practiced in other parts of the world as a form of complementary and alternative medicine. It
      has been described as Kavalagraha or Gandhoosha in the ayurvedic texts of Charaka Samhita and
      Sushruta Samhita. It is a procedure that involves swishing oil in the mouth a period of 15
      min, before spitting it out.

      In addition to its systemic benefits, oil pulling therapy has also benefits on oral health.

      The oil pulling therapy can be performed by using edible oils like sesame oil, sunflower oil
      and coconut oil. However, there is only one study in the literature comparing the effect of
      oil pulling therapy using coconut oil versus sesame oil on plaque-induced gingivitis and the
      results were in favor of coconut oil.

      In order to clarify the gap in the literature on this field, this study was designed to
      compare the plaque-inhibiting effects of oil pulling therapy with sesame oil or coconut oil
      using 4- day plaque regrowth study model.
    

Detailed description: 
      The study is conducted as an observer masked, cross over design with a single-center where
      the participants were randomly allocated to groups. Before the initiation of the study period
      all participants underwent thorough scaling and polishing of the teeth by both hand and
      ultrasonic instruments to remove all plaque, calculus and stain and were instructed in how to
      maintain oral hygiene. This phase considered as a preparatory period by the end of this
      period all participants obtained healthy gingiva clinically.

      The randomization of the participants were provided by closed envelop system (BM). The
      conductors of the study were blinded to the mouthrinses received by participants. The tested
      products and regimens of use are shown in Table 1. Identical coded bottles were used to fill
      the mouthrinses. The bottles also had stickers on explaining the usage instructions. On the
      first day of each study period, to confirm all patients to have plaque score of 0 at the
      baseline, erythrosine was applied to all teeth and then scaling and polishing to remove
      plaque and extrinsic stain and disclosing of the teeth was performed. All tooth cleaning
      applications (other rinse, chewing gum or toothbrushing / toothpaste) were forbidden for 4
      days of study protocol and rinsing regimen was performed. The tested agents included the
      following: 1) Sesame oil (10 ml, twice daily 15-20 minute) 2) Coconut oil (10 ml, twice daily
      15-20 minute). Participants were instructed to perform the mouthrinsing after breakfast and
      dinner and to avoid rinsing, eating and drinking following hour after rinsing. Even though
      the mouthrinses were in provided identical bottles and patients were not informed about the
      products however due to the taste and color differences of the products total subject
      blindness could not be achieved.

      On day 5 (Friday), each subject was scored for staining using Lobene stain index following an
      oral soft tissue examination. Following the satin scoring erythrosine disclosing was
      performed and Turesky et al. modification of the Quigley and Hein index was used for plaque
      scoring. All buccal and lingual surfaces of all fully erupted permanent teeth, with the
      exception of the third molars were scored for stain and plaque. Six sites of each teeth were
      also used to score Gingival Index (GI) and bleeding on probing (BOP). All clinical
      examinations were performed by a single trained and calibrated clinician (YS) who was masked
      to the study.

      Following the recording of clinical parameters, all plaque and tooth stain (if present) were
      removed by polishing and washout period of 14 days was awaited after the second phase of the
      study. For the washout period, the subjects were instructed to go on to their routine oral
      hygiene habits. Following this period the procedures explained before were repeated until
      each participant used each of the rinses for the second phase of the study.

      Standardized questionnaire were filled by the participants in order to evaluate their
      attitudes and occurrence of adverse effects with regard to the product used at the end of
      each phase. The questions evaluated the flavor of the mouthrinse, the alteration in the taste
      of food and drinks, the perception of the plaque reduction, the staining that the mouthrinse
      created, the feeling to create nausea. Five point Likert type scale was used to collect the
      responses to the questions which ranged from 1- "very negative" to 5- "very positive"
      excluding the question about the preference of the product. At the end of each phase
      participants were asked to bring the bottles to control the remaining mouthrinses in order to
      control the compliance of the participants.
    

Intervention name(s): oil pulling with coconut oil; oil pulling with sesame oil
Intervention type(s): Other; Other
Intervention description(s): using oil pulling therapy with coconut oil; using oil pulling therapy with sesame oil
Allocation: Randomized
Intervention model: Crossover Assignment
Masking: Double (Participant, Investigator)
Primary purpose: Prevention
Keywords: oil pulling; gingivitis