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Title Strategies Utilizing Oil Pulling Are Not as Effective in Preventing caries Activity as Fluoride and Herbal Mouthrinses
Clinical Question Are strategies utilizing oil pulling effective in preventing caries compared to other caries prevention strategies?
Clinical Bottom Line For reducing caries activities in patients, oil pulling is less effective than fluoride. This conclusion is based on a single trial with 52 children, which measured a surrogate outcome, bacterial metabolic activity, as well as S. mutans levels.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 26379378Jauhari/ 201552 healthy children aged 6 to 12 yearsRandomized Controlled Trial
Key resultscaries activity in the study subjects was measured using surrogate outcomes by measuring the metabolic activity of the oral bacteria using the Oratest and the Dentocult SM kit. On comparison of the effects of fluoride mouthrinse (200 ppm NaF), herbal mouthrinse (containing 5 mg Salvadora Persica) and oil pulling (10 ml sesame oil) on the caries activity of the subjects, fluoride and herbal mouthrinses showed a significant effect in the reduction of caries activity, while oil pulling and distilled water (control) made no significant change in caries activity of the subjects.
Evidence Search oil pulling and caries
Comments on
The Evidence
Validity: The study design is a randomized controlled trial. Initially the patient groups started with no significant difference in their S. mutans counts when tested with Dentocult. There is no evidence showing whether or not all 52 children completed the trial. Patient groups were reevaluated after 2 weeks of the trial. This trial period seems adequate to accurately measure the bacterial activity changes. Although the authors claimed that the study was double-blinded, it would be impossible to blind the patients to the intervention due to the obvious difference in taste and nature (oil vs. water) of the products; no mention was made of blinding of the investigators when using the Oratest and Dentocult tests. Perspective: Most studies on oil pulling have investigated its effect on oral hygiene and periodontal disease using surrogate measures of effects on oral bacteria levels, plaque and gingival indices. In this study, caries activity was measured by a surrogate outcome (bacteria metabolic activity) and not by a disease outcome. Disease outcome (incident caries lesions) would be a more accurate outcome measure. Thus the strength of the evidence for the effect of oil pulling on caries activity and caries prevention is very low. The Oratest is based on the assumption that metabolically active bacteria produce acid that causes demineralization (caries formation). Thus any conclusions on the effect of the oil pulling on caries activity would be based mainly on its antimicrobacterial activity.
Applicability The subjects, children aged 6-12 years, who participated in the study are representative of my perspective patients. Considering that oil pulling was found to have no significant effect on the caries activities of the subjects as measured in this study, oil pulling may have no clinical application in dental practice. If the patient is looking for a measure to prevent caries effectively, oil pulling will not be a good option. However, the study demonstrated that fluoride (200 ppm NaF) and herbal (containing 5 mg Salvadora Persica) mouthrinses have significant antimicrobial effects and reduced the caries activity of the subjects, and as such may be useful clinically in caries prevention.
Specialty/Discipline (Public Health) (General Dentistry) (Pediatric Dentistry)
Keywords oil pulling, caries prevention, caries activity, oral health, Oratest, Salvadora persica, Streptococcus mutans, mouthrinses
ID# 3205
Date of submission: 04/10/2017spacer
E-mail parksh@livemail.uthscsa.edu
Author So Hyeon Park
Co-author(s) e-mail
Faculty mentor/Co-author Bennett T. Amaechi, BDS, MSc, PhD
Faculty mentor/Co-author e-mail Amaechi@uthscsa.edu
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