Efficacy of Oil Pulling Therapy on Supragingival Plaque Growth
Condition: Gingivitis
MeSH terms: Gingivitis
Study type: Interventional

Summary: 
      Oil pulling is a method based on Ayurvedic medicine which aims to obtain local and systemic
      benefits by swirling oils in the oral cavity for a period of 15 minutes, before spitting it
      out.12 Although the exact mechanism of action is not clear, there are some proposed theories.
      One proposed theory is the saponification or "soap making" process which occurs as a result
      of alkali hydrolysis of fat.9 Second theory speculates the inhibition of plaque formation and
      adhesion of bacteria due to the viscous nature of the oil. 13 According to the third theory,
      presence of antioxidants in oil prevent lipid peroxidation and thus help to the destruction
      of microorganisms and potentiating the action of Vitamin E in the oral cavity.14 The effect
      of oil pulling on halitosis and the use of oil pulling in addition to conventional oral
      hygiene practices was investigated in some studies13,15,16 but to the best knowledge of the
      authors, no study has evaluated the plaque-inhibiting effects of oil pulling. Therefore this
      study was conducted to evaluate the plaque-inhibiting effects of oil pulling using 4- day
      plaque regrowth study model17,18 compared to 0.2% CHX-containing mouthrinse. The tested
      hypothesis was that oil pulling would perform plaque regrowth inhibition as well as the
      CHX-containing mouthrinse.
    

Detailed description: 
      The study was a single-center, observer masked, cross-over design with subjects randomly
      allocated to treatment sequences. During a 2-week preparatory period, participants rendered
      plaque, calculus and stain free by a thorough scaling and polishing of the teeth by both hand
      and ultrasonic instruments and were instructed in self-performed plaque control. At the end
      of the preparatory period, all subjects had clinically healthy gingiva.

      Participants were randomly allocated to two groups by closed envelop system (BM) and masked
      to the mouthrinse received. The tested products and regimens of use are shown in Table 1.
      Mouthrinses were filled in identical but coded bottles. Instructions for usage was written on
      the bottles. On day 1 (Monday) of each study periods, after disclosing the teeth with
      erythrosine all subjects received scaling and polishing to remove plaque and extrinsic stain
      and disclosing of the teeth was repeated. By this way it was confirmed that all participants
      had a plaque score of 0 at baseline. Subjects were then asked to refrain from all forms of
      tooth cleaning and to apply the rinsing regimen. The tested agents included the following: 1)
      0.2 % chlorhexidine mouthrinse ( 10 mL, twice daily for 30 seconds) 2) Coconut oil (10 Ml,
      twice daily 15-20 minute) All agents were to be used after breakfast and dinner and the
      subjects should be avoided rinsing, eating and drinking during the first hour after rinsing.
      During the 4- day period, the use of any other rinse, chewing gum or toothpaste was not
      allowed. The mouthrinses were in identical bottles but total subject blindness cannot be
      possible due to the taste, color, consistency, rinsing time differences.

      On day 5 (Friday), subjects received an oral soft tissue examination and were asked to
      complete a standardized questionnaire to evaluate their attitudes with regard to the product
      used. The patients were asked about 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. After the completion of the questionnaire, each
      subject was scored for staining using Lobene stain index.19 After that, disclosing was
      performed with erythrosine and plaque scoring was performed using the Turesky et al. 20
      modification of the Quigley and Hein index.21 Stain and plaque indices were recorded from the
      buccal and lingual surfaces of all fully erupted permanent teeth, with the exception of the
      third molars. In addition, Gingival Index (GI) and bleeding on probing (bop) were recorded
      from six sites of each teeth. All clinical examinations were performed by a single clinician
      (YS) who was masked to the study.

      After recording the clinical parameters, subjects received a polishing to remove all plaque
      and tooth stain if present and 14 days of washout periods were allowed after 4- day period.
      22 During the wash out period, the subjects returned to normal oral hygiene methods with a
      standard toothbrush* and a fluoride containing tooth paste**. These procedures were repeated
      until each participant used each of the rinses.
    

Intervention name(s): chlorhexidine; oil pulling
Intervention type(s): Other; Other
Intervention description(s): patients used chx moutrinses for four days; patients used oil pulling for four days
Intervention MeSH terms: Chlorhexidine
Allocation: Randomized
Intervention model: Crossover Assignment
Masking: Double (Participant, Investigator)
Primary purpose: Prevention
Keywords: gingivitis; oil pulling