Efficacy of Oil-pulling Versus Chlorhexidine Mouthwash in Reducing Oral Streptococcus Mutans Count: A Systemic Review and Meta-analysis

Purpose: To determine whether oil-pulling with sesame or coconut oil yields a better result in reducing Streptococcus mutans count compared to conventional chlorhexidine mouthwashes.

Methods: Multiple databases were used to search for articles up to and including August 2019. Studies which reported use of oil-pulling and chlorhexidine mouthwashes to reduce Streptococcus mutans bacterial count were analyzed procedurally. Studies that fulfilled the inclusion criteria were then undertaken for qualitative and quantitative analysis.

Results: Five studies were included in this analysis, which used oil-pulling (test group) and chlorhexidine mouthwash (control group). The follow-up period ranged from 14 to 30 days. The oil used in oil-pulling group were either sesame or coconut oil. Quantitative analysis showed a significant reduction in oral Streptococcus mutans count with oil-pulling as compared to chlorhexidine mouthwash at follow-up (Q value = 6.61, DF = 4, I2 = 39.50%).

Conclusion: Use of oil-pulling showed better result in reducing cariogenic bacterial count as compared to the gold standard chlorhexidine mouthwashes. More clinical trials, evaluating additional oral hygiene parameters, would further validate the effects of oil-pulling on the oral cavity. Clinicians may advise their patients to use oil-pulling instead of chlorhexidine mouthwashes, as it is safe, cost-effective, and easily available.