Coconut oil pulling is generally safe for most people when done correctly, but it comes with a few real risks worth knowing about. The practice involves swishing about a tablespoon of coconut oil in your mouth for 10 to 20 minutes, then spitting it out. Since coconut oil is food-safe, the act of swishing it around your teeth and gums is unlikely to cause harm on its own. The concerns start when things go wrong during the process, or when people use it as a substitute for proven dental care.
The Serious Risk: Oil in the Lungs
The most significant safety concern with oil pulling is accidental aspiration, meaning oil slips into your airway instead of staying in your mouth. This can lead to a condition called lipoid pneumonia, where oil deposits in the lungs trigger persistent inflammation. A case report published in Monaldi Archives for Chest Disease documented two women who developed unresolved pneumonia that was ultimately traced back to their oil pulling practice. Both had a history of tongue cancer, which may have impaired their swallowing control, but the underlying lesson applies broadly: swishing any oil in your mouth for extended periods increases the chance of inhaling small amounts.
This risk is higher for people who have trouble controlling their swallow reflex, those with respiratory conditions, or anyone who tries to swish for the full 20 minutes and loses control of the oil as their jaw fatigues. If you gag easily or have any condition affecting your throat or airway, oil pulling carries more risk for you than for the average person.
Common Side Effects
Beyond the lung risk, most side effects of oil pulling are minor but worth noting. Swishing oil for 10 to 20 minutes is a genuine workout for your jaw muscles. People who are new to the practice or who push themselves to hit the full 20 minutes sometimes experience jaw soreness or aggravation of existing jaw joint problems. Starting with 5 minutes and working up is a practical way to avoid this.
Nausea is another common complaint, particularly if you accidentally swallow some of the oil. After swishing, the oil becomes loaded with bacteria and debris from your mouth. Swallowing that mixture can upset your stomach. You should always spit the oil into the trash when you’re done, not into the sink, where it can solidify and clog your plumbing.
What Coconut Oil Actually Does in Your Mouth
Coconut oil is roughly 50% lauric acid, a fatty acid with well-documented antimicrobial properties. When you swish the oil around your teeth, the fatty acids attract and trap bacteria, physically pulling them off tooth surfaces. There’s also a cleansing effect: the oil interacts with saliva in a way that reduces how well bacteria and plaque stick to enamel.
One small clinical trial compared oil pulling (using sesame oil, which works through a similar mechanism) to chlorhexidine, the gold-standard antibacterial mouthwash dentists prescribe. After 10 days, both groups showed statistically significant reductions in plaque levels, gum inflammation scores, and bacterial counts, with no meaningful difference between the two groups. That’s a genuinely interesting result, though the study involved only 20 participants and lasted less than two weeks.
So coconut oil pulling does appear to reduce bacteria and plaque in the short term. The question is whether that translates into long-term dental health, and that’s where the evidence thins out considerably.
What the ADA Says
The American Dental Association does not recommend oil pulling as a dental hygiene practice. Their position is straightforward: there are no reliable scientific studies showing that oil pulling reduces cavities, whitens teeth, or improves oral health and well-being over the long term. The existing studies are small, short in duration, and don’t meet the evidence threshold the ADA requires before endorsing a practice.
That said, the ADA’s position isn’t that oil pulling is dangerous. As one ADA-affiliated dentist put it, swishing food-safe oil in the mouth is “unlikely to be detrimental.” The concern is when patients use oil pulling as a replacement for brushing, flossing, or professional dental treatment. Oil pulling does not remove hardened tartar, it cannot treat cavities, and it doesn’t deliver fluoride to strengthen enamel. Treating it as a substitute for evidence-based care is where the real dental risk lies.
How to Minimize Risk If You Try It
If you want to try coconut oil pulling, keeping it safe comes down to a few practical steps. Use about one tablespoon of coconut oil and let it melt in your mouth before you start swishing. Pull the oil gently between your teeth rather than swishing aggressively, which reduces both jaw strain and the chance of accidentally inhaling oil. Start with 5 minutes rather than the commonly recommended 20, especially if you’re new to the practice.
When you’re finished, spit the oil into the trash. Rinse your mouth with water afterward, then brush your teeth as you normally would. Oil pulling should come before brushing, not after, so you’re not leaving a residue of oil on your teeth that could interfere with fluoride from your toothpaste.
The bottom line is simple: coconut oil pulling is a low-risk addition to an existing oral hygiene routine for most healthy adults. It becomes unsafe when oil is aspirated into the lungs, when it replaces proven dental care, or when people with swallowing difficulties or respiratory conditions attempt it. It’s a supplement to brushing and flossing, not a replacement for either.