Oil pulling - Ayurvedic oral hygienic technique

It is a common belief that oral health serves as a gateway to general health. This implies that oral health significantly impacts the general health and wellbeing of an individual. In recent years, various studies have provided unequivocal evidence on the strong relationship between systemic and oral diseases. It is believed that this relationship is due to common risk factors shared between various diseases. Periodontal diseases (such as gingivitis and periodontitis), and dental caries are the most common forms of oral diseases. The incidence of periodontal disease is found to be greatest in diabetic patients and those with heart diseases, as compared to the healthy population. In fact, various studies have identified periodontal disease as a risk factor for the etiology of coronary heart disease. Similarly, a thorough examination of the gingival tissue can point toward a significant deficiency of Vitamin C and other nutritional deficiencies.5 Dental caries, which is also one of the most common forms of infectious diseases globally, has been found to significantly affect the systemic health, and quality of life of individuals. The oral cavity serves as a focal point of entry for pathogens into the systemic circulation. While the host immune system of a healthy individual prevents the body from virulent microorganisms, a breach in the physical barriers in the oral cavity may provide access to into the systemic circulation. Similarly, a lack of oral hygiene allows an increase in virulent microbial colonization of the oral biofilm. Therefore, mechanical and chemical means of controlling the quantity and quality (virulence) of the oral biofilm is important in preventing systemic diseases and particularly periodontal diseases such as gingivitis and periodontitis. An emphasis on preventing oral diseases can lead to a reduction in the incidence of various systemic diseases as well. Similarly, routine screening and oral examinations may help in identifying early manifestations of systemic diseases in the oral cavity and help in preventing disease progression. The fields of medicine and dentistry have witnessed major technological advancements in recent years. Despite this fact, on a larger public health scale basic protocols of patient care continue to focus on and highlight the importance of simple, preventive and behavioral modification strategies. Recently, various forms of alternative or traditional medicinal treatments, such as Ayurveda have started to gain popularity, due to their natural origin, cost effectiveness, negligible side effects, and improved patient compliance. Ayurveda is a form of traditional holistic medicinal system originating in the Indian subcontinent region. Its advent and practice in the region reportedly date back about 3000-5000 years. Recently, it has gained popularity as complementary medicine in other parts of the world. The aim of this review is to identify the potential uses of oil pulling therapy in the prevention of various oral diseases and to pinpoint its use as an adjunct to conventional oral hygiene aids. What is Oil Pulling? Oil pulling or oil swishing, as the name suggests involves vigorous swishing of oil in the oral cavity to achieve local and systemic benefits, similar to the modern day use of mouthwashes and oral rinses. It has been used for centuries for the treatment and prevention of various oral and systemic diseases, using edible oils derived from either sunflower, sesame, and coconut. The process of oil swishing is believed to cure or control 30 different types of systemic diseases including headaches, migraine, and chronic diseases such as asthma and diabetes mellitus. The effects of oil pulling on oral health, as an adjunct to conventional oral hygiene measures have been exemplary. Scientific evidence suggests that oil pulling therapy may reduce the total oral bacterial count and reduce plaque and gingival scores. Furthermore, it has also shown to diminish the susceptibility to dental caries from marked to slight or moderate level. The Procedure Oil pulling is performed preferably in the morning on an empty stomach. One tablespoon (approximately 10 ml), of sesame oil, being the recommended dose for adults is sipped, and swished between the teeth for a duration of approximately 15-20 min and spat out. Swishing the oil for the recommended duration in the oral cavity changes the viscosity of the oil, which turns milky white with a thin consistency. Swallowing the oil should be avoided as it may have toxins and bacteria, which are harmful to general health. This should be followed by rinsing, conventional tooth brushing and flossing. The practice should preferably be performed 3 times daily for acute diseases. While there are no suggested contraindications, it is not advisable for children below the age of 5 years to perform oil pulling.