Evaluation of Efficacy of Coconut Oil Pulling Therapy as an adjunct to Scaling in Diabetic patients with Chronic Gingivitis – A Randomised Controlled Clinical Study.

INTRODUCTION:

Gingivitis is one of the most commonly found oral diseases. It is the initial stage of periodontal disease that occurs due to the colonization of plaque microorganisms on the tooth. Antibacterial mouthrinses like Chlorhexidine are used as an adjunct to mechanical plaque control. Chlorhexidine is considered as the “gold standard†but there are a few disadvantages associated with the long term use like altered taste sensation and staining of the teeth1. There is a requirement for a long term, home based remedy which is also economical.

Oil pulling or oil swishing, is a traditional Indian folk remedy that involves swishing oil in the mouth for oral and systemic health benefits. Oil pulling has been used extensively as part of alternative medicine for many years to prevent decay, oral malodour, bleeding gums, dryness of the throat, cracked lips and for strengthening teeth, gums, and the jaw.1 Oil pulling therapy can be done using edible oils like sunflower or sesame oil.

The modern version of oil pulling was coined by Ukranian physician Dr. Karach during 1990’s in Union of Soviet Socialist Republics (USSR), after he experimented swishing oil in the above-mentioned method and cured himself from a blood disease. He further studied it, systematized it and propagated it across the world. Dr. Karach says: “With the oil therapy, I healed my chronic blood disease of 15 years. With the use of this therapy; I healed within 3 days of an acute arthrosis that had forced me to lie in bed.â€2

 Various oils used for swishing 3-7

1. Coconut oil

2. Corn oil

3. Rice bran oil

4. Palm oil

5. Sesame oil

6. Sunflower oil

7. Soya bean oil.

Coconut oil has a unique role in the diet as an important physically functional food. What makes coconut oil different from most other dietary oils are the basic building blocks, or fatty acids, making up the oil. The predominant composition of coconut oil is a medium chain fatty acid, whereas the majority of common edible fats in our diet are composed almost entirely of long chain fatty acids. This influences the physical and chemical properties of the oil.

Coconut oil contains 92% saturated acids, approximately 50% of which is lauric acid Recently, results from many studies revealed that the monolaurin, the monoglycerides of lauric acid from coconut oil had antimicrobial activity against various Gram-positive and Gram-negative organisms, including Escherichia vulneris, Enterobcater spp.8  *Helicobacter pylori,*9  Staphylococcus *aureus,*10  Candida spp., including Candida albicans, Candida glabrata, Candida tropicali, Candida parapsilosis, Candida stellatoidea and *Candida krusei,*11  as well as enveloped viruses though the exact antibacterial mechanism of the action of coconut oil is still unclear, it was hypothesized that monolaurin and other medium chain monoglycerides had the capacity to alter bacterial cell walls, penetrate and disrupt cell membranes, inhibit enzymes involved in energy production and nutrient transfer, leading to the death of the bacteria.7

Mechanism of action

The oil acts as a cleanser. When you put it in your mouth and work it around your teeth and gums it “pulls†out bacteria and other debris. Oil pulling has a very powerful detoxifying effect. Toxins are pulled from the body the very first time you try it.

Swishing process makes oil thoroughly mixed with saliva. Swishing activates the enzymes and the enzymes draw toxins out of the blood. The oil must not be swallowed, for it has become toxic. As the process continues, the oil gets thinner and white. If the oil is still yellow, it has not been pulled long enough. It is then spit from the mouth, the oral cavity must be thoroughly rinsed and mouth must be washed thoroughly.12

The mechanisms of oil-pulling action are not known. It has been proposed, however, that the viscosity of the oil can inhibit bacterial adhesion and plaque coaggregation.13 The other possible mechanism might be the saponification process that occurs as a result of alkali hydrolysis of oil by bicarbonates in saliva.14

Limited literature or scientific proof is available to accept oil pulling therapy as a preventive adjunct to scaling and root planing. Therefore, the aim of the present, clinical study was to clinically evaluate the anti-plaque effect of coconut oil pulling and its influence on chronic gingivitis as compared to chlorhexidine mouth wash in diabetic patients.

AIM OF STUDY:

To introduce a natural ingredient that effectively reduces inflammation in Diabetic patients with Chronic Gingivitis

OBJECTIVES OF THE STUDY:

1.    To evaluate the efficacy of Coconut Oil as an adjunct to Scaling in Diabetic patients with Chronic Gingivitis.

2.    To compare the efficacy of Coconut Oil with Chlorhexidine mouthwash in Diabetic patients with Chronic Gingivitis post scaling.