Comparison and Evaluation of the Efficacy of Sesame Oil, Coconut Oil, and Sunflower Oil Pulling on Gingival Health—A Triple-Blind Randomized Clinical Trial

ABSTRACT

Objective:

Compare and evaluate the efficacy of sesame oil, coconut oil, and sunflower oil pulling on gingival health.

Methodology:

Triple-blind randomized clinical trial was conducted by using three different oils in three groups.

Results:

All three oils were found to be effective on gingival health but coconut oil is found to be more effective.

Conclusion:

This study concluded that all three oils were effective in improving gingival health.

INTRODUCTION

In recent years, various studies have shown that strong relationship exists between oral and systemic diseases. It also considers that oral health is an indicator of the general well-being.[1]

Chronic gingivitis has one of the highest prevalence among other diseases occurring in the oral cavity ranging from 56% to 94% among the Indian adult population.[2]

The most cost-effective method for the prevention of plaque in the supra gingival area is mechanical cleaning of the tooth, however, due to inadequate knowledge and the technical skill required to perform has reduced its effectiveness.[3]

Dr. F. Karach who is of Russian origin is credited for popularizing the process of oil pulling during the period of 1990s. The technique of oil pulling or oil swishing is also found to be quoted in the Ayurvedic literature Charaka Samhita which is called Kavala Gandoosha/Kavala Graha.[4,5,6]

The process of oil pulling therapy involves using a tablespoon of oil to be applied in the gingiva for a time period of 10 to 15 minutes.[6]

The absence of an easily available material which can help in the prevention of plaque caused by oral diseases, necessitated the need for this study to be carried out for evaluating the effectiveness of three different types of oil pulling on the health of the gingiva.

METHODOLOGY

The study design was triple-blind randomized clinical trial with three parallel groups. Ethical clearance was obtained from the institutional ethical review board. The study was carried out in the Department of Public Health Dentistry, Coorg Institute of Dental Sciences. The study involved using oil of three different types, namely sesame oil, coconut oil, and sunflower oil.

Inclusion criteria

1. Participants included the age group of 18–25 year.

2. Subjects who were willing to participate and give informed consent.

A sample size of 60 participants was calculated using the Software G Power. The written consent was obtained from the participants included in the study. A total of 80 healthy subjects were selected out of which 60 subjects were included that matched the inclusion criteria.

The subjects were divided into three groups (Groups A, B, and C) each containing 20 participants by simple random sampling. Lottery method was used to assign oil to each group. The patient was advised to take a tablespoon of oil and massage in the gingiva for 10 to 15 minutes two times a day in the morning and night after brushing.

Group allocation

Group A: subjects were allocated sesame oil.

Group B: subjects were allocated coconut oil.

Group C: subjects were allocated sunflower oil.

The study participants were given toothbrushes and toothpastes of the same quality and brand to overcome the effect of confounding bias. The participants were informed to stop using the oil in the event of any adverse effects and report it to the chief investigator.

The study participants were instructed to report to the Department of Public Health Dentistry on the 7^th day, 14^th day, and 21^st Day for recording the gingival index (GI) given by Loe and Silness in 1963 for assessing the gingival health status. The chief investigator carried out the clinical examination of all the subjects.

Statistical analysis

ANOVA was used for comparison.

RESULTS

The mean GI scores at baseline 7^th day, 14^th day, and 21^st day after using sesame oil were 1.69±0.13, 1.40±0.20.,93±.27.,46±.18, respectively. The mean GI scores at baseline 7^th day, 14^th day, and 21^st day after using coconut oil were 1.70±.18, 1.37±.20.,99±.20.,48±.18, respectively. The mean GI scores at baseline 7^th day, 14^th day, and 21^st day after using sunflower oil were 1.71±.13, 1.37±,18.,98±.23.,51±.22, respectively [Table 1]. The results were statistically significant [Table 1]. But there was no significant difference in their effectiveness in all the intervals [Table 2].

Table 1.

Intragroup comparison of mean values of variables between baseline, day 7, day 14, day 21

Oil	Interval	Mean	Standard Deviation	F	Significance
Sesame oil	Baseline	1.69	0.13	265.745a	0.00(HS)
	7th	1.40	0.20	265.745a	0.00(HS)
	14th	0.93	0.27	265.745a	0.00(HS)
	21st	0.46	0.18	265.745a	0.00(HS)
Coconut oil	Baseline	1.70	0.18	118.638a	0.00(HS)
	7th	1.37	0.20	118.638a	0.00(HS)
	14th	0.99	0.20	118.638a	0.00(HS)
	21st	0.48	0.18	118.638a	0.00(HS)
Sunflower oil	Baseline	1.71	0.13	195.077a	0.00(HS)
	7th	1.37	0.18	195.077a	0.00(HS)
	14th	0.98	0.23	195.077a	0.00(HS)
	21st	0.51	0.22	195.077a	0.00(HS)

HS-Highly Significant, NS-Non-Significant

Table 2.

Comparison of the mean values of variables (gingival index score) between three groups-intergroup

Interval	Oil	Mean	Standard deviation	F	Significance
Baseline	Sesame	1.69	0.13	0.14	0.866(NS)
	Coconut	1.70	0.18
	Sunflower	1.71	0.13
7th day	Sesame	1.40	0.20	0.20	0.817(NS)
	Coconut	1.37	0.20
	Sunflower	1.37	0.18
14th day	Sesame	0.93	0.27	0.40	0.671(NS)
	Coconut	0.99	0.20
	Sunflower	0.98	0.23
21st day	Sesame	0.46	0.18	0.45	0.638(NS)
	Coconut	0.48	0.18
	Sunflower	0.51	0.22

HS-Highly Significant, NS-Non-Significant

DISCUSSION

Oil pulling has been found to be effective in the prevention and treatment of systemic diseases of different varieties. Raja BK and Devi in their systemic review found that the technique of oil pulling may prove to be effective in conjugation to toothbrushing in maintaining good oral hygiene.[5,6]

This study showed that of the three types of oil used, coconut oil was found to be effective in controlling the gingivitis, which was in accordance with the study done by Peedikayil et al. The effectiveness of the coconut oil might be related to the presence of Lauric acid in the coconut oil which reacts with salivary sodium hydroxide to form sodium laureate, which is the active agent for the cleaning action and reduced accumulation of plaque.[3,6,7]

Our findings where similar to the previous studies carried out by Saravanan et al. and Asokan et al. where use of sesame oil showed a significant decrease in the gingival score and gingivitis. Similar to this present study conducted by Amith VH et al. also revealed that oil pulling therapy with sunflower oil plays an important role in the reduction of plaque scores.[7,8,9]

Limitations

Drawback of this research study involved small sample, host response bias, and limited duration of follow-up sequence.

CONCLUSION AND CLINICAL IMPLICATION

The present study concluded that all three oils were effective in improving gingival health. All dental practitioners should promote awareness among people of oil pulling.

Conflicts of interest

There are no conflicts of interest.

Funding Statement

Nil.