I’ve been recommending oil pulling for years. I wrote about it back in January and a lot of you tried it — some of you for the first time. I loved reading your replies and success stories.
But I’d like to share today some points I’ve been rethinking…
I used to recommended coconut oil. That’s what Ayurvedic practitioners have used for thousands of years. And I still think it’s better than mouthwash — almost anything is.
But the more I’ve studied biofilm science, the more I think we can do better. Because coconut oil is a broad-spectrum antimicrobial. It’s rich in lauric acid, which disrupts bacterial cell membranes — not selectively, but across the board. That means it can thin or destabilize beneficial microbial communities right alongside the harmful ones.
And if you’ve been reading this newsletter, you know how I feel about that. “Broad spectrum” is a bad word in my vocabulary. It’s the same scorched-earth logic behind mouthwash — kill everything and hope for the best.
Your biofilm is not the enemy. It’s the structural foundation of a healthy oral ecosystem. Your mouth’s beneficial microbes need that living surface to attach to and function. So the goal isn’t to wipe the slate clean. It’s to work more gently and intelligently.
The oil pulling blend I use is better than straight coconut oil because it uses MCT oil — a refined verion of coconut oil made mostly of caprylic (C8) and capric (C10) acids, with very little lauric acid. The difference in lauric acid matters a great deal. Where coconut oil aggressively disrupts cell membranes, MCT oil does something more elegant: it penetrates the biofilm due to its smaller chain length, reduces cohesion, and loosens the extracellular matrix — but leaves much of the microbial architecture intact.
Think of it as controlled thinning and restructuring. Not removal. And certainly not nuking everything and allowing the bad bacteria to grow back stronger. You’re disorganizing the biofilm just enough to give it a chance to rebuild itself the way it should — especially if you’re feeding it properly with the right diet and supporting it with good habits.
And that distinction has real functional consequences. A thinner, more dynamic biofilm means improved oxygen diffusion, fewer stagnation zones where acid accumulates, better interaction with your saliva’s natural buffering system, and — this is key — preservation of the beneficial commensals that keep your mouth healthy.
There are practical benefits too. MCT oil stays liquid at room temperature — no warming the bottle, no waxy texture. It pours easily, feels lighter in the mouth, and works better with additional ingredients like CoQ10, which is worth mentioning: people with gum disease consistently show depleted CoQ10 in their gum tissue, and clinical trials suggest that supplementing it can help reduce periodontal inflammation. Whether there’s meaningful absorption through oil pulling into the gum tissue and interproximal pockets is still an open question — but if there is, that’s a real added benefit. The blend I use also includes bromelain, which loosens plaque’s adhesion before you even pick up a toothbrush.
The largest review to date (Jong et al., 2024 — 25 trials, 1,184 participants) found that chlorhexidine still beats oil pulling at stripping plaque. That shouldn’t surprise anyone. That’s what scorched-earth antimicrobials are designed to do — they’re very efficient at it. Chlorhexidine has its place — after oral surgery, when you can’t brush, it’s the right call.
But using it daily is like taking antibiotics every morning as a preventive. You wouldn’t do that to your gut. Why would you do it to your mouth? And one of the most common side effects of chlorhexidine — even when used as prescribed — is severe staining of the teeth. Want to see your hygienist sweat? Tell them you’ve been using chlorhexidine for two weeks. They’ll schedule a follow-up just to finish cleaning off the stains.
So both oil pulling and chlorhexidine can support gingival health — that review found comparable benefits. But only one of them preserves your oral microbiome. And only one of them doesn’t turn your teeth brown.
The review rated the overall evidence “very low.” But before you let that scare you — the clinical studies that demonstrate the need for flossing aren’t much better, and I still tell you to floss. “Very low” evidence doesn’t mean “this doesn’t work.” It means nobody has funded the kind of large-scale, well-designed trial that would produce high-certainty evidence. And nobody’s going to fund a $2M multi-site RCT on swishing oil in your mouth — there’s no pharmaceutical IP to protect. But the biochemistry makes sense.
And here’s the other thing: every one of those studies used traditional coconut oil, which saponifies the most, because it has the highest lauric acid. Nobody has tested what happens when you swap in MCT oil that modulates biofilm instead of stripping it. That’s a different practice entirely.
Here’s something else I’ve noticed that nobody talks about. A thicker, more viscous biofilm is more likely to trap coffee tannins, blueberry anthocyanins — all those pigments that stain your teeth. A thinner, healthier biofilm holds onto it less. I’ve started oil pulling before my morning coffee, and the difference in staining is noticeable. Your coffee may even taste better — because you’ve thinned the biofilm on your tongue too.
And then there’s how it feels. If your reference point for rinsing is mouthwash — the burn, the sting, the dryness fifteen minutes later — this is the opposite experience. It feels like you’re hydrating your mouth. Your mouth tissues feel smoother, nourished, and not dried out, because you haven’t used a strong emulsifier. Your mouth doesn’t dry out afterward because you haven’t wiped out the bacteria that support healthy saliva production.
If you want to try it, here’s what I’d suggest: floss first — this breaks up plaque bridges between your teeth so the oil can actually reach those interproximal areas. Then swish for 2–5 minutes. And yes — you can spit it in the sink if it’s an MCT oil blend like this one, which I use daily. One of the advantages of MCT oil is that it stays liquid at room temperature, so unlike coconut oil, it won’t solidify and clog your pipes. Then brush with your nano-hydroxyapatite toothpaste — and don’t rinse after, so the nano-HAP has time to sit on your teeth and work.
It doesn’t have to be perfect to be worthwhile. Just try it. Notice how your mouth feels after.
Then hit reply and tell me what you notice.
– Dr. B
Further Reading & Citations
- Littarru, G.P. et al. “Study of CoQ10-enzymes in gingiva from patients with periodontal disease and evidence for a deficiency of coenzyme Q10.” Proceedings of the National Academy of Sciences, 68(10), 2332–2335 (1971). PubMed
- Manthena, S. et al. “Effectiveness of CoQ10 oral supplements as an adjunct to scaling and root planing in improving periodontal health.” Journal of Clinical and Diagnostic Research, 9(8), ZC26–ZC28 (2015). PubMed
- Jong, T. et al. “The effect of oil pulling in comparison with chlorhexidine and other mouthwash interventions: A systematic review and meta-analysis.” International Journal of Dental Hygiene (2024). Wiley
From the Ask the Dentist Archives
- I was trained to remove it. Now I help patients protect it. — Why I changed my mind about biofilm.
- If your gums bleed, this seal is already failing — What’s really at stake when your gums are inflamed.
- Podcast Episode #48: What are the benefits of Oil Pulling? — I go deeper on oil pulling in this episode.
- My two secret weapons against coffee stains — More on why staining is a biofilm problem.
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