Академический Документы
Профессиональный Документы
Культура Документы
Contact Author
ABSTRACT
Oil pulling is an age-old process mentioned in Charaka Samhita and
Sushrathas Arthashastra. This study was conducted to assess the effect
of oil pulling on Plaque and Gingivitis.
Objectives: (1) To assess the effect of oil pulling on plaque and
gingivitis. (2) To monitor its safety on oral soft and hard tissues.
Methodology: 10 subjects performed Oil Pulling along with their
other oral hygiene measures for 45 days, using Refined Sunflower Oil.
Their Plaque and gingival scores were assessed periodocally by modified
PHP and Gingival indices. The results were subjected to t-test and
Wilcoxon signed rank test.
Results: The reduction in plaque and gingival scores from baseline to
45 days were 0.81+-_0.41 (p<0.01) and 0.39+_0.17 (p<0.01)
respectively. The differences were found to be statistically significant.
Conclusion: Oil pulling is having dental benefits. Hence this holds a
chance to be added to other oral hygiene measures.
Key words: Plaque; Gingivitis; Rinsing; Oil pulling.
Dr. HV Amith
E-mail : amith_hv@yahoo.co.in
Methodology
After screening the entire batch of 50 first year Physiotherapy
students, at the KLESs Physiotherapy College, Belgaum, 10
male students in the age range 19-21 years were recruited for
a 45 days study. The criteria for selection of the subjects were:
Inclusion criteria
! Subjects willing to participate.
! Subjects having at least 20 natural teeth in the permanent
dentition.
! Subjects with mild to moderate gingivitis and plaque
accumulation.
! Subjects willing to refrain from any form of dental
treatments during the study period.
Exclusion criteria
! Subjects having allergy to the oil used.
! Subjects with systemic diseases and using antibiotics.
! Subjects undergoing orthodontic treatment or using intraoral artificial prosthesis.
! Subjects using any other mouth wash / rinse.
Armamentarium
! Refined sunflower oil (Fortune Company)
! Measurement beaker
! Containers and tea spoons
! Mouth mirror
! Probe
! Tweezers
! Cotton
! Kidney tray
! Two tone Disclosing agent (Alpha plac).
Plaque Scoring
Patient Hygiene Performance Index developed by Podshadley
AG and Haley JV (1968) was modified to score the plaque
from both the buccal and lingual / palatal surface of all the
teeth instead of just the Index teeth. For assessment, the plaque
was disclosed using Two tone disclosing agent.(9) The
disclosing agent was applied with cotton and rinsed after 1
minute. Each tooth surface (facial and lingual) was divided
into 5 sections by imaginary lines (Figure 1):
! Mesial third
! Distal third
! Middle third further divided horizontally into gingival,
middle and occlusal sections as shown below.
Pre-study procedures
! The subjects were blinded about the aim of the investigation
in order to avoid any possible bias.
! In order to participate the subjects signed a witnessed
consent form and committed themselves to the study.
! Ethical clearance was obtained from the KLE Society
Ethical committee.
Experimental Protocol
This study was carried out at the Department of Preventive
and Community Dentistry.
Oral prophylaxis was not performed so that the subjects began
the treatment regimen with their normal existing level of plaque
deposits. All subjects were instructed to continue their normal
13
Scores
! 0 Absence of Plaque
! 1 Presence of Plaque
The score was calculated by adding all the values for each
sub-division on both buccal and lingual for each tooth. The
total score was divided by the number of teeth examined to
get a individual score. It was interpreted as follows:
! Excellent = 0
! Good = 0.1-1.7
! Fair = 1.8-3.4
! Poor = 3.5-5.0
Statistical Analysis
Students paired t test and Wilcoxon signed rank test were used
to compare the plaque and gingivitis scores before and after
performing Oil pulling. The validity level was fixed to p<0.05.
Gingivitis Scoring
Gingival index by Loe H and Sillness J (1963) was used to
assess the severity of Gingivitis on the index teeth 16, 12, 24,
36, 32, 44. The tissues surrounding each tooth were divided
into four gingival scoring units, distal-facial papilla, facial
margin, mesial-facial papilla and the entire lingual gingival
margin. A blunt instrument, such as a periodontal pocket probe,
was used to assess the bleeding potential of the tissues.(10)
Scores
! 0 - Absence of inflammation / normal gingival
! 1 Mild inflammation, slight change in color, slight edema,
no bleeding on probing.
! 2 Moderate inflammation, moderate glazing, redness,
edema and hypertrophy, bleeding on probing.
! 3 Severe inflammation, marked redness and hypertrophy,
ulceration, tendency to bleed spontaneously.
Totaling the scores around each tooth gave the gingival index
score for the area. Totaling all the scores and dividing by the
number of teeth examined provided the gingival index score
for that person, which was interpreted as follows:
! Mild gingivitis = 0.1-1.0
Results
The present study was conducted to assess the dental benefits
of Oil pulling. Plaque and Gingival indices were performed
on the subjects at baseline, 15, 30 and 45 days of Oil pulling.
The changes in the index scores during the study period were
compared.
No adverse reactions to any hard and soft tissues of the oral
cavity were noticed during the study. The resultant changes in
the plaque scores have been summarized in Tables 2,
accompanied by Figure 2. There was a net decline in mean
plaque scores from baseline to 45 days amounting to 0.810.41
(p<0.01). The greatest reduction in plaque scores was noted at
the examinations between 15 and 30 days (0.37). Though the
decline in plaque scores at 15 days was not significant, the
rest of the differences were highly significant.
Baseline
15 days
30 days
1.
3.27*0.21#
3.210.21
3.140.17
3.050.08
2.
3.640.79
3.590.75
3.430.58
2.960.46
3.
3.470.38
3.200.25
3.230.21
3.090.17
4.
3.450.79
3.580.50
3.190.42
2.960.25
5.
3.440.46
3.060.33
2.850.25
2.270.17
6.
3.140.79
2.980.71
3.120.63
2.730.42
7.
3.371.04
3.650.88
2.520.75
2.180.50
8.
3.340.63
3.210.54
2.530.46
2.230.29
9.
3.560.88
3.750.75
2.940.58
2.440.38
10.
3.901.21
3.611.0
3.230.75
2.610.54
* The first line in each row indicates plaque index scores of the respective subjects.
#
The second line in each row indicates gingival index scores of the respective subjects.
14
45 days
Mean
Std.Dev.
Base line
3.4580
0.2102
15 days
3.3840
0.2787
Base line
3.4580
0.2102
30 days
3.0180
0.3046
Base line
3.4580
0.2102
45 days
2.6520
0.3558
15 days
3.3840
0.2787
30 days
3.0180
0.3046
15 days
3.3840
0.2787
45 days
2.6520
0.3558
30 days
3.0180
0.3046
45 days
2.6520
0.3558
MeanDiff.
Std.Dv.Diff.
Paired t-value
P-value
Significance
0.0740
0.2177
1.0748
0.3104
NS
0.4400
0.3001
4.6363
0.0012
0.8060
0.4086
6.2378
0.0002
0.3660
0.4010
2.8860
0.0180
0.7320
0.4696
4.9292
0.0008
0.3660
0.1796
6.4428
0.0001
0.72
0.70
0.59
0.60
0.48
0.50
0.40
0.33
0.3
0.27
0.30
0.21
0.16
0.20
0.10
0.00
Base line
15 days
Mean
30 days
45 days
Std.Dev.
Fig. 2:
Mean
Std.Dv.
Base line
0.7180
0.3044
15 days
0.5920
0.2700
Base line
0.7180
0.3044
30 days
0.4800
0.2145
Base line
0.7180
0.3044
45 days
0.3260
0.1571
15 days
0.5920
0.2700
30 days
0.4800
0.2145
15 days
0.5920
0.2700
45 days
0.3260
0.1571
30 days
0.4800
0.2145
45 days
0.3260
0.1571
MeanDiff.
Std.Dv.Diff.
Paired t-value
P-value
Signi.
0.1260
0.0829
4.8068
0.0010
0.2380
0.1199
6.2777
0.0001
0.3920
0.1673
7.4087
0.0000
0.1120
0.0671
5.2758
0.0005
0.2660
0.1190
7.0689
0.0001
0.1540
0.0682
7.1424
0.0001
15
4.00
3.46
3.02
3.50
Mean plaque score
there has been mention of other oils like sesame oil, groundnut
oil, olive oil, mustard oil etc. Liquids from water and milk to
extracts of gooseberries have been used for Oil Pulling. Some
oils are more palatable than others in their raw state. Hence
the author after trying various types of oils, came to a
conclusion to use the most palatable, the refined sunflower oil
for this study.
3.38
2.65
3.00
2.50
2.00
1.50
1.00
0.21
0.28
0.30
0.36
0.50
0.00
Base line
15 days
Mean
30 days
45 days
Std.Dev.
Fig. 2:
Discussion
Since there are no studies till date assessing the dental benefits
of Oil Pulling, our study has been the first in this untrodden
path. When compared to tooth brushes and mouth rinses, Oil
Pulling has also resulted in a significant improvement in oral
hygiene.
Though refined sunflower oil has been used in the present study,
16
Conclusion
Within the limits of the present study, it can be concluded that
Oil Pulling has the ability to reduce plaque and gingivitis. It
emerges from this study that an individual is able to maintain
low levels of plaque and gingivitis even if he is performing
Oil Pulling, just for 45 days.
This study is just the tip of an iceberg and we recommend that
further longitudinal studies with larger sample size should be
conducted. Research comparing the use of different types of
oils for the Oil Pulling procedure, and their effect on oral
hygiene are needed. Also microbiological analysis of saliva
and plaque if considered will add more internal validity to
such studies. Further, studies comparing the effect of various
commonly prescribed mouthwashes and Oil Pulling on the oral
hygiene are warranted.
Acknowledgements
The authors would like to thank all the subjects who
participated this study, without whose kind co-operation, it
would have been impossible to complete the research.
THE AUTHORS
Dr. HV Amith
BDS
Post Graduate Student,
Department of Preventive and Community Dentistry.
KLES Institute of Dental Sciences ,Belgaum, Karnataka.
#29 C, II Main, 6th Cross, Bhaskar diary road,
Sadashivnagar, Belgaum 590010. Karnataka.
Mobile: +919448008007
E-mail: amith_hv@yahoo.co.in
Dr. L Nagesh
MDS
Ex-Professor and Head,
Department of Preventive and Community Dentistry.
KLES Institute of Dental Sciences ,Belgaum, Karnataka.
JOHCD ! www.johcd.org ! January 2007;1(1)
17
REFERENCES
1. http://www.who.int/oral_health (accessed on 02-04-2006)
2. Tritten CB, Armitage GC. Comparison of a sonic and a manual
toothbrush for efficacy in supragingival plaque removal and
reduction of gingivitis. J Clin Periodontol 1996;23:641-8.
3. Killoy WJ, Love JW, Love J, Fedi PF, Jr, Tira DE. The effectiveness
of a counter-rotary Action Powered toothbrush and conventional
toothbrush on Plaque Removal and gingival Bleeding. J
Periodontol 1989; 60(8): 473-7.
4. Putt MS, Kleber CJ, Smith CE. Evaluation of an alum-containing
mouthrinse in children for plaque and gingivitis inhibition during 4
weeks of supervised use. Pediatr Dent 1996;18:139-44.
5. Ram K S. Agnivesas Charakasamhita Vol I(Sutra Sthana).
Varanasi: Chowkhamba Sanskrit Series office; 2002:99-100, 123.
6. Ravi DT. Ashtanga Sangraha (Sutra Sthana) of Srimad
Vrddhavagbhata. Delhi: Chawkhamba Sanskrit Pratishtan;
2003:551-4.
7. http://www.oilpulling.com/ (accessed on 21-12-2005)
8. Dingari LC. The Shalakya Tantra II.1st ed. Hyderabad: Smt D
18