One of the newer health trends that has people talking is a practice called “oil-pulling”. Of course it’s not a “new” practice at all, but comes from the ancient practices of Āyurveda, a 4000 year old medical system that originated in India. Although I have been familiar with the practice for more than two decades, I first started to hear the term “oil-pulling” after the publication of a book written by Bruce Fife called Oil Pulling Therapy: Detoxifying and Healing the Body Through Oral Cleansing. Although I haven’t read the book and probably never will, I have heard that it and others were making the claim that oil-pulling could resolve all kinds of health issues including high blood pressure, arthritis, liver disease and cancer. But is this true?
Oil-pulling is part of the daily regimen in Āyurveda, called dinācaryā (di-naa-char-yaa), performed during the morning ablutions to cleanse and purify the body. To cleanse the mouth specifically, Āyurveda suggests a number of techniques that can be used on a daily basis, including “tongue-scraping” (jihvānirlekhana) and “cleaning the teeth” (dañtadhāvana): oil-pulling is one among several techniques. But the term “oil-pulling” invented by proponents doesn’t actually represent the entire scope of practice. Called gaṇḍūṣa (gan-doo-sha) and kavalagraha (kavala-graha), the practice of oil-pulling is comprised of filling the mouth with oil (gaṇḍūṣa) and swishing it through the teeth (kavalagraha). For gaṇḍūṣa the mouth is completely filled with a prescribed medication, and then held without expectoration for some time. According to the 6th century physician Vāgbhaṭa, there are four categories of gaṇḍūṣa based upon the clinical manifestations of the bodily humors or doṣaḥ:
- snigdha (‘lubricating’, to reduce dryness and deficiency)
- śamśana (‘pacifying’, to reduce inflammation)
- śodhana (‘purifying’, to reduce congestion and mucus)
- ropaṇa (‘healing’, for ulceration and wounds) (Sū 22:2-3).
Although oil is often used, a large number of medications can be used in gaṇḍūṣa depending on the indications, including warm water, fats and oils, milk, fermented gruels (śukta, dhānyāmla), wines, meat soup, herbal decoctions, honey, and alkalis (kṣāra) diluted with water. For daily application, the most commonly used medication is unrefined, cured sesame oil (taila), but other oils such as ghee (ghṛta) or coconut can be used as well. The effects of each oil differ slightly:
- sesame oil: reduces dryness and mucus
- coconut oil: reduces dryness and inflammation
- ghee: reduces dryness and inflammation
To perform gaṇḍūṣa, approximately 2-3 tablespoons or more of the medication is held the mouth for several minutes, until saliva is produced or the nose or eyes become secretory, after which time the medication is spit out. Usually this only takes 3-5 minutes at most. Sesame oil is naturally antimicrobial, and given its lipid-soluble nature, it penetrates into the gums and below the gum line to inhibit the growth of oral bacteria. Sesame oil needs to be cured before use, however, which can be done by heating the oil in pan at a low-medium heat, and sprinkling a few drops of water on top. Once the drops of water have evaporated, the oil is ready to use and can be stored for a month or so at time. In this way, only small batches of sesame oil are cured at a time. Although I don’t generally recommend that oils such as sesame, which are rich in polyunsaturated fatty acids be heated, sesame oil is unique in that it contains a heat-activated antioxidant called sesamol that protects and improves the quality and stability of the oil after heating.
Apart from its antimicrobial effects, gaṇḍūṣa with sesame oil also lubricates the mouth and the jaw, and is effective for problems such as gingivitis, periodontitis, receding gums, dry mouth (xerostomia), temporomandibular joint (TMJ) pain, earache, headache, coryza, pharyngitis and narcolepsy. Likewise, there are similar benefits for coconut oil and ghee, although these oils are more nutritive and pacifying, rather than purifying. Coconut oil also contains a short chain fatty acid called caprylic acid (octanoic acid) that has specific anti-fungal properties, making it useful for oral thrush (candidiasis).
Similar to gaṇḍūṣa is kavalagraha, in which a smaller amount of medication such as sesame oil is taken and then moved about the mouth, pulling it through the teeth and gargling in the back of the throat. This is what people are mostly referring to when discussing “oil-pulling”. Performing kavalagraha with warm water is said to alleviate mucus congestion, promote digestion, and eliminate ‘toxins’ (āma). For hoarseness or sore throat, a variety of preparations can be used, including Indian herbs such as the fresh juice of Brāhmī or a decoction of Bibhītaka fruit. Western herbs such as Sage (Salvia officinalis), Myrrh (Commiphora myrrha), Purple Coneflower (Echinacea angustifolia) or Toothache flower (Acmella oleracea) can also be helpful, used as the diluted tinctures. I frequently use these diluted tinctures in the treatment of problems such as gum disease, throat infection, tonsillitis, and tonsiliths (tonsil stones).
I frequently recommend both gaṇḍūṣa and kavalagraha in my practice, changing up the ingredients as required. Sometimes I recommend the use of an oil, sometimes not. This is why the term “oil-pulling” does not do justice to the original scope of practice. As well, the abundant claims made for the benefit of oil-pulling border on the absurd. This is a technique used primarily for cleaning the oral cavity, and while it does have some systemic benefit, the claim that oil-pulling can resolve serious diseases such as cancer or heart disease is irresponsible. As a practitioner of Āyurveda it is my duty to support and uphold its practices, but at the same time, it’s important to address what are clearly exaggerated claims to protect the integrity of its practices. In a similar fashion, I frequently hear that one should perform oil-pulling for 20 minutes or more at a time. Quite frankly, this is another silly statement, and is not reflective of traditional practices. Swishing oil around in your mouth for too long could cause you to accidentally aspirate (breathe in) some of the oil, and that isn’t so good for your lungs. For most purposes, 3-10 minutes should be enough.