Title	Strategies Utilizing Oil Pulling Are as Effective as Chlorhexidine Therapies for Maintaining Oral Hygiene
Clinical Question	For maintaining oral hygiene, are strategies utilizing oil pulling more effective than therapies utilizing chlorhexidine mouthrinse?
Clinical Bottom Line	Oil pulling and chlorhexidine (mouthwash or gel) therapies are equally effective in maintaining oral hygiene as demonstrated by their equal efficacy in reducing the bacteria counts, plaque and gingival indices scores. Thus oil pulling has the potential as a reliable method for routine oral hygiene measures.
Best Evidence
PubMed ID Author / Year Patient Group Study type (level of evidence) 19336860 Asokan/2009 20 age-matched adolescent boys with plaque-induced gingivitis Randomized Controlled Trial Key results Effects of two interventions, oil pulling with sesame oil and 0.12% chlorhexidine mouthwash, on plaque-induced gingivitis were compared. Comparing the pre- and post-treatment plaque (PI) and modified gingival (MGI) indices scores, both treatments significantly (P < 0.001) reduced the scores of both indices after 10 days of intervention. When the two treatments were compared based on the post-treatment PI and MGI scores as well as the total colony count of the aerobic microorganisms, there was no significant difference between the two interventions. Thus, oil pulling with sesame oil and 0.12% chlorhexidine mouthwash have comparable effects as oral hygiene methods, as measured by their effects on the bacteria counts, plaque and gingival indices scores. 25210256 Singla /2014 Adults between the ages of 18 and 55 Randomized Controlled Trial Key results Four treatment groups, chlorhexidine gel (Group A), and oil pulling groups using sesame oil (Group B), coconut oil (Group C), and olive oil (Group D), were compared based on their effects on bacteria counts, plaque and gingival indices scores. All treatments significantly reduced bacteria counts (Streptococcus mutans & Lactobacillus), plaque and gingival scores after 3 weeks of intervention. There was no significant difference in percent reduction of the above variables among the four treatments. Thus, oil pulling and chlorhexidine gel have comparable effects as oral hygiene methods, as measured by their effects on the level of bacteria counts, plaque and gingival scores.
Evidence Search	oil pulling AND chlorhexidine AND plaque AND gingivitis
Comments on The Evidence	Validity: The research utilized groups within a close age range and the subject size was similar for each of the variables being evaluated. All of the groups were given the same conditions. There were no competing interests for the research. The research should be considered acceptable. Perspective: Oil pulling is a safe and more affordable method of maintaining oral hygiene, and it is as effective as the therapy (chlorhexidine treatment) considered as the ‘gold standard’. Oil pulling is more accessible and can be used in conjunction with other effective oral hygiene methods.
Applicability	Oil pulling is safe and natural with no side effects. At-home preventive therapy for maintaining oral hygiene is great for patients who cannot afford more expensive mouth rinse. In countries with limited resources oil pulling has been very effective in maintaining oral hygiene. However, it may be advisable to always complement oil pulling with fluoridated oral hygiene products to enable adequate expose to fluoride.
Specialty	(Public Health) (General Dentistry) (Periodontics)
Keywords	Oil pulling, chlorhexidine, oral hygiene, plaque induced gingivitis, coconut oil, sesame oil, olive oil
ID#	3226
Date of submission	04/13/2017
E-mail	nnaji@livemail.uthscsa.edu
Author	Chiamaka Nnaji
Co-author(s)
Co-author(s) e-mail
Faculty mentor	Bennett T. Amaechi, BDS, MSc, PhD
Faculty mentor e-mail	amaechi@uthscsa.edu
Basic Science Rationale (Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?) None available
Comments and Evidence-Based Updates on the CAT (FOR PRACTICING DENTISTS', FACULTY, RESIDENTS and/or STUDENTS COMMENTS ON PUBLISHED CATs) None available