Abstract
Introduction
Oil pulling is an ancient Ayurvedic practice believed to offer oral and systemic health benefits. This study aimed to assess the knowledge and awareness of the effects of oil pulling among dentists and dental students, exploring their familiarity with the practice and perceived effectiveness.
Methods
A cross-sectional study was conducted with 495 participants, including dental interns, general dentists, and specialist dentists. A structured online questionnaire was distributed, consisting of 17 questions to evaluate participants’ knowledge, attitudes, and awareness of oil impacts. Statistical analyses were performed using chi-square tests to identify significant differences among groups.
Results
The findings revealed significant differences in the familiarity with oil pulling between dental interns and more experienced professionals. While 85% of the interns demonstrated limited knowledge, specialist dentists reported greater awareness. Nevertheless, most participants expressed some degree of skepticism about recommending oil pulling due to insufficient clinical evidence. Despite this, many acknowledged its potential benefits in improving gum health and reducing halitosis.
Conclusion
This study highlights a knowledge gap in dental education regarding alternative oral health practices, such as oil pulling. Oil pulling has been suggested to offer certain oral health benefits, though current clinical evidence remains limited. The results suggest that dental education should incorporate discussions on complementary therapies to equip professionals with a balanced understanding. Further well-designed studies are warranted to verify its clinical efficacy as an adjunct to conventional oral hygiene methods.
Supplementary Information
The online version contains supplementary material available at 10.1186/s12906-025-05209-x.
Keywords: Oil pulling, Oil pulling therapy, Coconut oil, Sesame oil, Oral health
Introduction
The mouth is known as the mirror of the human body. Several systemic diseases and conditions are related to oral health and vice versa [1]. Early development and the establishment of oral hygiene habits help prevent periodontal disease and dental caries. Mechanical plaque removal techniques such as brushing and flossing are the most reliable and commonly recognized methods; nevertheless, mouthwash usage has long been used as an adjuvant strategy to preserve dental hygiene and oral health [2].
Oil pulling is an ancient Ayurvedic practice that was first used to maintain oral health in India. According to Ayurveda, there are connections between the tongue and the kidneys, heart, lungs, small intestine, spine, and other organs [3]. It is thought that oil transport aids in the excretion of harmful heavy metals through saliva [4]. According to traditional Ayurvedic medicine, oil pulling is believed to stimulate the production of salivary enzymes and facilitate the removal of toxins from the body through the tongue, thereby contributing to detoxification and purification [3, 5–7]. These cultural beliefs have been passed down historically, although they currently lack robust scientific validation and should be interpreted with caution. In addition to these traditional claims, some studies suggest possible oral health benefits, such as improving gingival health, reducing gum bleeding, relieving symptoms of dry mouth, and contributing to fresher breath and whiter teeth [5, 8, 9]. Furthermore, a limited number of clinical reports have indicated that oil pulling may reduce bacterial load and support oral hygiene, yet these findings require further validation through well-designed randomized controlled trials [5, 10–12]. Nevertheless, these effects require further confirmation through well-designed clinical trials, and oil pulling should currently be regarded as a complementary rather than evidence-based approach.
Oil pulling is a technique that entails swishing a spoonful of oil around the mouth, forced in between all the teeth and into the mouth. It is traditionally recommended to perform oil pulling early in the morning, before breakfast, for at least five minutes on an empty stomach [5]. Sunflower oil, sesame oil, and coconut oil are a few types of organic oils that are utilized [13]. The viscous oil turns milky white and becomes thinner at the end if the process is followed appropriately. After spitting it out, the mouth is cleaned with water or saline. It is not recommended to swallow the oil due to its bacterial and toxin content [14]. After oil pulling, it is recommended that the teeth be cleaned manually or brushed as part of the regular oral hygiene routine. Oil pulling is contraindicated in children under 5 years of age because of aspiration risk [15].
Oil pulling is not a widely emphasized topic that is frequently covered in traditional dentistry schools, despite its potential benefits. Conventional dental education primarily emphasizes evidence-based treatments and conventional oral care techniques, often overlooking alternative or traditional practices such as oil pulling. Because of their involvement in scientific research and practical experience, dental professionals and students may have varied ideas on the efficacy of this approach and differing levels of familiarity. Interpreting these variations is important for assessing the extent to which oil pulling is incorporated into modern dentistry and whether it is considered as a practical supplementary oral health practice.
The aim of this study was to evaluate the knowledge and awareness of oil pulling, its importance, and effects on oral and systemic health among dentists and dental students, while also considering how dental education influences attitudes and perceptions toward the technique.
Methods
Study population
This descriptive cross-sectional study was conducted at Lokman Hekim University, Faculty of Dentistry. The study was approved by the Ethics Committee of Lokman Hekim University (No: 2024/139, on 29.05.2024). The null hypothesis stated that there would be no statistically significant differences in knowledge, awareness, and attitudes regarding oil pulling among dental interns, general dentists, and specialty dentists. A cross-sectional survey was chosen as the best design for assessing knowledge and awareness at a single moment in time among various professional groups. A prevalidated questionnaire confirmed the reliability of responses, and chi-square tests were used as the correct statistical method for categorical data, allowing comparison across interns, general dentists, and specialists.
Informed consent was obtained with the survey forms explaining the purpose of the study, and the information from the surveys will be used for publication however all the surveys were filled anonymously. A total of 495 individuals were recruited into the study. The sample consisted of three groups: 201 dental interns (fourth- and fifth-year students in clinical internship), 164 general dentists, and 130 specialist dentists. The sample size included all the participants who met the inclusion criteria. Inclusion criteria were based on dentists and dental students who volunteered to participate in the study. The dental students were from fourth- and fifth-year dentistry students who started their internships and thus treat patients under supervision. A questionnaire including 17 questions- 16 single choice and 1 multiple choice- was administered, and the questions were obtained from a prevalidated questionnaire (Suppl. File 1). The questionnaire demonstrated adequate validity and reliability, with a reliability coefficient of 0.79 determined through a pilot study involving 10 dental interns, 10 specialist dentists and 10 general dentists. The questions were short and easy to understand and were administered online via Google Forms. Communication methods such as e-mail and WhatsApp were used to send the questionnaire to the participants. The questionnaire was prepared to test the knowledge, awareness and attitudes toward oil pulling.
Statistical analyses
All the statistical analyses were conducted using chi-square tests to assess associations between categorical variables. Post-hoc comparisons with Bonferroni corrections were applied to identify pairwise group differences with significant results. Statistical significance was defined as a p-value < 0.05.
Descriptive statistics were used to summarize the distribution of responses among dental interns, general dentists, and specialist dentists. Chi-square tests were used to examine the relationship between professional groups and their familiarity with oil pulling, perceived mechanisms, systemic health effects, daily use, and other beliefs.
Exploratory Factor Analysis (EFA) was applied to examine the underlying structural dimensions of the 17 items in the survey. The Kaiser–Meyer–Olkin (KMO) sample adequacy value was found to be acceptable (KMO = 0.71), and Bartlett’s sphericity test yielded a significant result (χ²(136) = 1078.42, p < 0.001). These findings indicate that the data are suitable for factor analysis.
Three factors with eigenvalues above 1 were obtained, and the scree plot analysis supported this structure. However, the resulting factors did not fully correspond to the initially predicted domains of knowledge, awareness, and attitude. Partial confusion in construct validity was observed due to some items showing significant loadings under multiple factors and some items having low factor loadings. It is noteworthy that some items designed to measure the “attitude” dimension also showed significant loadings on factors related to knowledge or belief.
Taking this into account, analyses were conducted at the item level to maintain the validity of the responses. The overall internal consistency of the 17-item scale was found to be acceptable (Cronbach’s α = 0.78).
Results
This study is the first questionnaire study performed among specialist dentists, dentists and dental interns, regarding knowledge and awareness of oil pulling. In this study 495 individuals had participated, including 130 specialist dentists, 164 dentists and 201 dental interns. To identify significant differences between the groups, statistical analyses were conducted, and the results were organized according to the main study topics. The results demonstrated differences in attitudes, beliefs, and familiarity with oil pulling, as well as opinions on its effectiveness in oral and systemic health.
Chi-square analysis and post-hoc comparisons were conducted to identify significant correlations. The results indicated significant differences between groups in several aspects, including daily use, suggested mechanism, possible systemic effects and familiarity with oil pulling.
Familiarity with oil pulling
A significant association was found between the respondents’ level of education and their experience with oil pulling (p < 0.001). A statistically significant difference between dental interns and specialist dentists was revealed (p = 0.026). Additionally, there was a noticeable knowledge gap between dentists and interns, and the difference was significant (p < 0.001). Interns presented lower level of knowledge than others (shown in Fig. 1).
Fig. 1.
Familiarity with oil pulling among groups
Mechanism of oil pulling
A significant difference was observed in the mechanism through which oil pulling exerts its effects (p < 0.05). A total of 85.1% of the dental interns, 74.4% of the general dentists, and 82.3% of the specialist dentists’ knowledge of the mechanism of oil pulling was not clear. Compared with the other groups, general dentists (18.9%) correctly identified emulsification with a higher number, as the process compared to others (shown in Table 1).
Table 1.
Responses to question ‘Under which mechanism does oil pulling work?’
| Under which mechanism does oil pulling work? | Dental intern | Dentist | Specialist dentist | Total |
|---|---|---|---|---|
| Emulsification | 21 | 31 | 16 | 68 |
| Sapnofication | 7 | 5 | 7 | 19 |
| None of the above | 2 | 6 | 0 | 8 |
| Not sure | 171 | 122 | 107 | 400 |
| p < 0,05 |
Effect on systemic health issues
A significant difference was observed among the groups regarding their beliefs about whether oil pulling could influence conditions such as GERD, peptic ulcers, diabetes, and migraines (p < 0.05). Intern dentists composed the most uncertain group (66.2%), followed by specialist dentists (66.9%) and general dentists (56.7%). Compared with interns (6%) and specialists (8.5%), general dentists were more likely to disagree (18.3%) (shown in Fig. 2).
Fig. 2.
Responses to question ’Do you think chronic use of oil pulling has an effect on systemic issues?’
Swallowing oil instead of spitting
A significant difference was found regarding the acceptability of swallowing the oil instead of spitting it out (p < 0.05). Most respondents disagreed with swallowing oil (Interns: 51.7%, General Dentists: 55.5%, Specialists: 42.3%). However, specialist dentists had the highest uncertainty rate (48.5%) (shown in Table 2).
Table 2.
Responses to question ‘Swallowed oil used for oil pulling instead of spitting it out is acceptable.’
| Swallowed oil used for oil pulling instead of spitting it out is acceptable. | Dental intern | Dentist | Specialist dentist | Total |
|---|---|---|---|---|
| Disagree | 104 | 91 | 55 | 250 |
| Agree | 8 | 18 | 12 | 38 |
| Not sure | 89 | 55 | 63 | 207 |
| p < 0,05 |
Chronic use of oil pulling causing stains on teeth
A significant difference was observed regarding the belief that chronic use of oil pulling may cause stains on teeth (p < 0.05). Most respondents were unsure (Interns: 67.2%, General Dentists: 62.8%, Specialists: 60.8%). Compared with the other groups, specialists were the most likely to disagree (32.3%) compared to other groups (shown in Table 3).
Table 3.
Responses to question ‘Chronic use of oil pulling causes stains on teeth.’
| Chronic use of oil pulling causes stains on teeth. | Dental intern | Dentist | Specialist dentist | Total |
|---|---|---|---|---|
| Disagree | 35 | 47 | 42 | 124 |
| Agree | 31 | 14 | 9 | 54 |
| Not sure | 135 | 103 | 79 | 317 |
| p < 0,05 |
Daily use of oil pulling
A highly significant difference was observed in the belief that oil pulling should be practiced daily (p < 0.001). Compared with general dentists (29.9%) and interns (12.4%), specialist dentists had the highest agreement rate (33.8%). Intern dentists composed the most uncertain group (61.7%) (shown in Fig. 3).
Fig. 3.
Perception of daily oil pulling among different groups
Reasons for recommending oil pulling
The participants were asked why they might recommend oil pulling to patients. Some respondents selected more than one reason, and the responses indicated variability. The most frequently cited reasons included the following:
General oral health benefits (n = 57)
Reduction in bacterial load (n = 34)
Prevention of oral diseases (n = 21)
Treatment of halitosis (n = 17)
However, the majority of the participants (n = 219) stated that they would not recommend oil pulling at all. The results indicated that while some professionals recognize possible advantages, a majority are still skeptical about the efficacy of the technique (shown in Fig. 4).
Fig. 4.
Reasons for recommending oil pulling by group
Oil pulling as an alternative to brushing
No statistically significant difference was found (p > 0.05). Most participants across all groups did not view oil pulling as an alternative to brushing. Agreement with this idea was very low, especially among specialists and general dentists.
Best time of practice
No significant difference emerged regarding the perceived best time to perform oil pulling. All groups showed similar preferences, with “morning before breakfast” being the most common response.
Appropriateness for children
There was no significant variation across groups about whether oil pulling is suitable for children. Most respondents were either uncertain or disagreed. Specialists were slightly more cautious in recommending it for pediatric use.
Minimum recommended age
Responses varies widely and no statistical significance was found. Most participants considered six years to be the minimum appropriate age, whereas others preferred older ages such as 10 or 12.
Source of knowledge about oil pulling
No significant difference was found in the sources from which respondents learned about oil pulling. The most common source was social media and informal online resources for all groups.
Recommended frequency per week
No group showed a clear consensus. Most commonly recommended frequency was “2–3 times per week,” but statistical differences were not significant.
Recommended duration per session
No significant difference was detected. The majority selected “5–10 minutes” or “10–15 minutes” regardless of professional group.
Preferred oil type
While coconut oil was the most frequently chosen type across all groups, the differences were not statistically significant (p > 0.05). Sesame and olive oil were also cited.
Belief about microbiota modulation
No significant difference was found among groups regarding the belief that oil pulling modulates oral microbiota. Uncertainty remained high across all respondents.
Concern about allergic reactions
Most participants showed a neutral stance or disagreed that oil pulling could cause allergies. There was no statistically significant variation between groups.
Discussion
This study provides valuable information regarding the knowledge and awareness of oil pulling among dental interns, specialist dentists, and general dentists. Although many respondents were familiar with the method, there was a general lack of detailed knowledge and considerable skepticism regarding its efficacy. The results of our study are consistent with previous investigations showing that dental professionals generally remain cautious about alternative oral health care techniques like oil pulling, mainly due to the scarcity of strong clinical evidence [1, 11, 12].
Recent randomized controlled trials have evaluated the clinical efficacy of oil pulling. For instance, Zürcher et al. (2025) reported modest plaque reduction with sesame oil, whereas Monika et al. (2025) found reductions in microbial load with coconut oil among periodontitis patients. However, findings remain inconsistent, emphasizing the need for more robust clinical evidence.
The relationship between education level and familiarity with oil pulling was a remarkable finding. Specialist dentists and general practitioners indicated higher knowledge compared to dental interns; however, they also exhibited higher levels of skepticism regarding the efficacy of intervention. These findings indicate that dental education has an important role in forming professional viewpoints on complementary and alternative medicine [1, 11]. Dental education primarily focuses on evidence-based dentistry, which may explain the hesitation among experienced professionals to integrate oil pulling into clinical recommendations [1, 4].
The results also indicated that despite some perceived benefits, a significant proportion of respondents would not recommend oil pulling to their patients. While some acknowledged its potential for reducing bacterial load and improving oral health, most participants expressed uncertainty regarding its long-term effects. These concerns are consistent with prior studies that highlight the need for controlled clinical trials to establish oil pulling as a credible adjunct to oral hygiene practices [10, 15–17].
Interestingly, while oil pulling has been widely practiced in certain cultures for centuries, its recognition in general dentistry remains limited. This observations highlights a broader issue regarding the integration of traditional oral health practices into modern evidence-based dental care. As alternative therapies continue to gain popularity among the public, it is crucial that dental professionals possess accurate, evidence- based knowledge to guide patients education and clinical recommendations [5, 9, 13].
Given the gaps in knowledge and skepticism observed in this study, future research should explore how educational interventions can influence awareness and acceptance of alternative oral health practices among dental professionals. Integrating discussions on oil pulling and similar practices into dental school curricula could provide students with a more comprehensive understanding of both conventional and complementary oral health approaches. Additionally, clinical studies are needed to assess the efficacy, safety, and potential benefits of oil pulling compared with conventional oral hygiene procedures [6–8].
The study has several limitations. First, the survey was only carried out through one institution, which might have limited how broadly the results could be applied to other populations. Secondly, the data based on self-reported responses, which are susceptible to recall bias and social desirability bias. Third, the cross-sectional design prevents any evaluation of causal correlations between educational background and knowledge or attitudes regarding oil pulling. Ultimately, despite the prevalidation of the questionnaire, a structured survey cannot entirely reflect the depth and complexity of participants’ opinions and experiences. Future multicenter and longitudinal studies, preferably including clinical validation, are necessary to enhance the evidence basis.
Conclusion
This study emphasizes the importance of interactions between traditional oral care methods and modern evidence-based dentistry. While oil pulling may offer certain benefits, its role in professional dental care remains uncertain. These conclusions should be interpreted with caution due to the limited clinical evidence currently available. Our findings demonstrated significant differences in knowledge and awareness across groups; however considering the methodological limitations of the study, they should be regarded cautiously. The findings highlight the necessity of more research, clinical validation, and better dental education to help professionals and patients make evidence-based decisions about oral health. By integrating scientifically balanced discussions on such practices, dental professionals can make more informed, evidence-based recommendations to their patients.
Supplementary Information
Authors’ contributions
S.M.A. and B.M.Ö. designed the study and developed the questionnaire. S.M.A. conducted data collection and S.M.A. and B.M.Ö. conducted statistical analysis. S.M.A. wrote the initial draft of the manuscript. Both authors contributed to the interpretation of results, revised the manuscript critically for important intellectual content, and approved the final version.
Funding
This study was not supported by any sponsor or funder.
Data availability
The data that support the findings of this study are available from the corresponding author upon reasonable request.
Declarations
Ethics approval and consent to participate
Study approval statement: This study was approved by the Ethics Committee of Lokman Hekim University with approval number 2024/139, dated 29.05.2024.
Consent to participate statement: Participation in this study was voluntary. All participants provided informed consent prior to completing the survey. The survey was anonymous and participants were informed that their data would be used for research and publication purposes.
This study was conducted in accordance with the ethical principles of the Declaration of Helsinki (2013 revision). Ethical approval was obtained from [Insert name of ethics committee or institutional review board, with approval number if available]. Written informed consent was obtained from all participants prior to their inclusion in the study.
Competing interests
The authors declare no competing interests.
Footnotes
Publisher’s Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
References
- 1.Krishnapriya V, Vikneshan M, Senthil M. Knowledge and awareness about effects of Sesame oil pulling and its health benefits among dental students of Igids, puducherry: a cross sectional study. J Sci Dentistry. 2018;8(2):2–7.
- 2.Krishnamurthy S, Vijayasarathy S. Chap. 9 - Role of nanomaterials in clinical dentistry A2 - Grumezescu, Alexandru Mihai BT - Nanobiomaterials in dentistry. Elsevier Inc.; 2016.
- 3.Singh A, Purohit B. Tooth brushing, oil pulling and tissue regeneration: a review of holistic approaches to oral health. J Ayurveda Integr Med. 2011;2:64–8. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 4.Kensche A, Reich M, Kümmerer K, Hannig M, Hannig C. Lipids in preventive dentistry. Clin Oral Investig. 2013;17:669–85. [DOI] [PubMed] [Google Scholar]
- 5.Gosavi HS, Tandon S, Rai TS, Mathur R, Rathore AS, Krishnan V. To evaluate the efficacy of oil pulling on caries activity of Streptococcus mutans: an in vivo study. Int J Clin Pediatr Dent. 2024;17(5):580–4. 10.5005/jp-journals-10005-2852. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 6.Yollar ET. Oil pulling in dentistry. Dicle Dent J. 2024;25(3):92–5. [Google Scholar]
- 7.Mythri H. Oil pulling: A traditional method on the edge of evidence. Dent Hypotheses. 8(3):57–60.
- 8.Asokan S. Folk remedy. Br Dent J. 2009;207:568. [DOI] [PubMed] [Google Scholar]
- 9.Zürcher C, Nagl M, Vukoje K, Heller I, Eick S, Kapferer-Seebacher I. Efficacy of sesame-based oil pulling in plaque reduction: a randomized controlled trial. Healthcare. 2025;13(14):1634. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 10.Monika M, Rudhra K, Vennila K, Elanchezhiyan PSH, Shakeron S. Evaluating the effect of virgin coconut oil pulling on viral load, bacterial load and inflammatory mediator levels in chronic periodontitis - A clinical study. J Oral Biol Craniofac Res. 2025;15(1):153–8. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 11.Priya R, Kaur N, Rawat A, Sharma V, Bhalla M, Gupta R. Effect of coconut oil pulling on plaque-induced gingivitis: a prospective clinical study. J Indian Assoc Public Health Dent. 2023;21(3):238–41. [Google Scholar]
- 12.Raja BK, Devi K. Oral health effects of oil pulling: a systematic review of randomized controlled trials. J Indian Assoc Public Health Dent. 2021;19(3):170–9. [Google Scholar]
- 13.Shanbhag VKL. Oil pulling for maintaining oral hygiene–a review. J Tradit Complement Med. 2017;7:106–9. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 14.Asokan S, Rathan J, Muthu MS, et al. Effect of oil pulling on Streptococcus mutans count in plaque and saliva using. Dentocult SM strip mutans test: a randomized, controlled, triple-blind study. J Indian Soc Pedod Prev Dent. 2008;26:12–7. [DOI] [PubMed] [Google Scholar]
- 15.Hebbar A, Keluskar V, Shetti A. Oil pulling-unraveling the path to mystic cure. J Int Oral Health. 2010;2:11–4. [Google Scholar]
- 16.Sirisha K, Devi PK. Oil pulling-a comprehensive cost-effective domiciliary remedy. Int J Res Dent. 2014;4:1–5. [Google Scholar]
- 17.Jong FJ, Ooi DJ, Teoh SL. The effect of oil pulling in comparison with chlorhexidine and other mouthwash interventions in promoting oral health: a systematic review and meta-analysis. Int J Dent Hyg. 2024;22(1):78–94. [DOI] [PubMed] [Google Scholar]
Associated Data
This section collects any data citations, data availability statements, or supplementary materials included in this article.
Supplementary Materials
Data Availability Statement
The data that support the findings of this study are available from the corresponding author upon reasonable request.