Many are familiar with the adage: “Cheap, fast or good … you can only pick two.” However, a fourth term is creeping into the conversation: natural. From juice cleanses to raw water, many American products are being marketed as chemical-free, untreated or pure.
Dentistry, of course, has not been immune to these influences. Two of the most popular trends among patients are charcoal toothpaste and oil pulling. While it is easy to jump to conclusions regarding the safety and efficacy of these techniques, one must consider whether there is science supporting their use. Are they as effective as ADA-approved fluoride toothpastes? Does the “all-natural” label disguise later consequences? As dental professionals, we need to be informed about what our patients may be using or asking about. Knowledge of these methods — whether they are covered in dental school or in the latest BuzzFeed article — is important.
Charcoal toothpaste is one product that has recently become popular, with tubes or powders available at various local grocery stores. Charcoal is actually one of the oldest toothpaste ingredients ever recorded, dating back to Roman times. Ignoring the flavor, activated charcoal is an abrasive material that is relatively cheap, easily accessible and absorbs nasty odors. These qualities make the toothpaste appealing to consumers. Although most charcoal toothpastes start around $8, some companies, such as Sister & Co, offer a 60-ml jar of “activated charcoal tooth whitening polish” for $43.
Charcoal’s abrasive nature may initially support claims that it can whiten teeth. The ADA states that charcoal should not be used regularly as a toothpaste because it wears the enamel. As the enamel prematurely thins, the teeth will look more yellow because the dentin will become more visible. In a literature review published in the Journal of the American Dental Association, 118 studies were compared, and the authors concluded there was not enough data to support the clinical efficiency of charcoal toothpaste. If your patient is interested in using this product, give him or her the most accurate information.
Oil pulling is another method thought to improve oral hygiene, dating back centuries. To properly oil pull, individuals swish an oil, usually coconut oil, around his or her mouth for 10-20 minutes before spitting it out. This is thought to help decrease plaque-forming bacteria, thus reducing gingivitis and caries.
In addition to being a delicious cooking oil, coconut oil is used as a leave-in hair conditioner and skin moisturizer. Unlike charcoal toothpaste, there is evidence suggesting that oil pulling can be beneficial for oral health. Many studies have been conducted detailing the effects of oil pulling. In a study published in the Journal of Indian Society of Pedodontics and Preventive Dentistry, 10 individuals showed statistically significant reductions in Streptococcus mutans counts and plaque and gingival indices after oil pulling with sesame oil for 45 days. Likewise, a similar study by Peedikayil et al. that researched the effects of oil pulling with coconut oil over the span of 30 days showed similar results. Although more research needs to be conducted, there seems to be a net neutral or positive when it comes to oral health. It must be noted that the ADA does not recommend oil pulling as a dental hygiene practice.
In the best case scenario, when used in conjunction with regular brushing with fluoride toothpaste, oil pulling may reduce the number of pathogenic bacteria in one’s mouth, reducing gingivitis. On the flip side, you can use it to exercise your facial muscles for 10-20 minutes and then have a jar of coconut oil that you can use for something else, whether it’s for your food or your body.
No matter what you do with the oil, just make sure to leave the charcoal for your grill.
~Emily Williams, Georgia ’20, Chapter Publications Chair