Original Research

Customised Enriched Coconut Oil as Panacea for Oral Biofilm Mediated

Diseases - A Prospective Study

Abstract Shamini Sai,

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Aims: To evaluate a customised enriched formulation of coconut (CEC) oil with Arimedadi Raga T Nivedha,
Tailam (AT) and 0.2% chlorhexidine mouth rinse (CHX) for their plaque control and potential Srinivasan
anticaries effects using the oratest in healthy volunteers. Settings and Design: Parallel,
double‑blinded (outcome assessor and statistician), randomised controlled institution‑based pilot Narasimhan1,
study. Methods and Materials: 60 adults (18‑22 years) having DMFT score of 2‑11, gingival and Aruna K. Veronica,
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plaque index as zero, no history of antibiotics for one month or fluoride application in 2 weeks Jayaraman
were randomly divided (computer‑generated list) and allocated into 3 groups (A‑CHX, B‑CEC, Selvakumar2,
C‑AT) of 20 subjects each based on the intervention. Oratest at baseline, days 15 and 30 were Anand V. Susila
recorded. Statistical Analysis Used: Due to 5 dropouts on day 30, data were analysed based on
Department of Conservative
the intention‑to‑treat (ITT) approach. The difference in oratest scores (baseline vs. day 15 and 30)
Dentistry and Endodontics,
were found to be normally distributed (Shapiro‑Wilk test and Levene’s test). One way ANOVA Madha Dental College
followed by Tukey’s post hoc test was used to determine the statistically significant difference (P < and Hospital, Chennai,
0.05) between groups. Results: Plaque and gingival index was zero throughout the study period. Tamil Nadu, India, 1Department
Difference in oratest scores was highest with CEC oil, followed by CHX and AT though there was of Endodontics, Hamad Dental
no statistically significant differences between groups at baseline vs day 15 (P = 0.203) and baseline Center, Hamad Medical
vs day 30 (P = 0.085) and between oils from baseline vs day 30 (P = 0.068). Conclusions: Within Corporation, Doha, Qatar,
the limitations of the pilot study, both oils are comparable to CHX for their antiplaque and anticaries
2
Department of Periodontics,
Adhiparashakthi Dental College
potential. Clinically, CEC was better than AT though statistical difference was not there.
and Hospital, Melmaruvathur,
Tamil Nadu, India
Keywords: Ayurveda, chlorhexidine, mouthwash, oil pulling, oratest

Introduction anti‑plaque, broad‑spectrum antimicrobial

The healthy oral microbiome lives in
a symbiotic relationship with the host
and plays an important role in immune
modulation and cardiovascular health.
Changes in the composition of the
microbiome leading to dysbiosis, results
in oral diseases such as dental caries
and periodontal disease.[1] Dental caries
is characterised by the presence of a
cariogenic biofilm colonised with strains
of acidogenic and aciduric bacteria
such as Streptococcus mutans (SM) and
Lactobacillus species.[1] The treatment
strategy for dental caries includes a
home care plan that focuses on dietary
changes to alter the composition of the
cariogenic biofilm and oral hygiene
measures that include brushing, flossing,
and the use of chemotherapeutic agents
to control plaque formation.[2] A readily
available chemotherapeutic agent with
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Attribution‑NonCommercial‑ShareAlike 4.0 License, which allows
others to remix, tweak, and build upon the work non‑commercially,
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For reprints contact: WKHLRPMedknow_reprints@wolterskluwer.com
activity inclusive of S. mutans is
chlorhexidine (CHX), serving as a chemical
adjunct to mechanical plaque removal
aids. However, its long‑term use is not
recommended because it is associated
with disadvantages.[3] Recent studies show
Address for correspondence:
that one week use of CHX in healthy
Dr. Shamini Sai,
subjects can affect the biodiversity of the Department of Conservative
oral microbiome, decrease salivary pH Dentistry and Endodontics,
Madha Dental College and
and buffering capacity, increase lactate
Hospital, Somangalam,
and glucose in saliva, favouring an acidic
Kavanoor Road, Kundrathur,
environment for dental caries. CHX also Chennai ‑ 600 069, Tamil Nadu,
reduces 80% of the bacteria that break India.
E‑mail: sai.shamini@gmail.com
down nitrate to nitrite, which are known
to have beneficial effects on vascular
health and blood pressure, thus causing a Received : 15‑12‑2022
hypertensive effect.[4] Its use for more than Revised : 12‑02‑2023
Accepted : 27‑02‑2023
four weeks results in tooth discoloration,
Published : ***
taste disturbances, resistance, and rarely
anaphylactic reactions.[3,5] The natural Access this article online
science of Ayurveda recommends Kavala
Website: www.ijdr.in
Graha or Gandoosha, also known as
DOI: 10.4103/ijdr.ijdr_955_22
oil pulling, for oral hygiene, in which
Quick Response Code:
How to cite this article: Sai S, Nivedha RT,
Narasimhan S, Veronica AK, Selvakumar J, Susila AV.
Customised enriched coconut oil as panacea for oral
biofilm mediated diseases - A prospective study.
Indian J Dent Res 2023;34:159-63.

© 2023 Indian Journal of Dental Research | Published by Wolters Kluwer - Medknow 159
 Sai, et al.: Anticaries potential of an enriched oil for pulling
oil is swished in the mouth or held for a while and spat
out without swallowing. Though the exact mechanism of
the oil pulling is unclear, it has a cleansing action in the
mouth resulting from a saponification process due to alkali
hydrolysis of the fat present in the oil. Its viscous nature
may inhibit plaque accumulation and bacterial adherence.
Also, the inherent antimicrobial and anti‑inflammatory
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antioxidant properties of the oils may play a role.[6] Overall,
it improves the health of the mouth and gums, reduces bad
breath, relieves symptoms of dry mouth and chapped lips,
and strengthens the jaw and muscles.[7] The use of oils thus
nYQp/IlQrHD3i3D0OdRyi7TvSFl4Cf3VC4/OAVpDDa8K2+Ya6H515kE= on 04/19/2024
provides an alternative to chemical mouthwashes such as
chlorhexidine and is used as an adjunct to tooth brushing.[8,9]
This study aims to compare and evaluate a customised
enriched formulation of coconut oil: CEC oil (intervention),
with a commercial Ayurvedic oil—Arimedadi Tailam:
AT (intervention) and a 0.2% chlorhexidine mouth rinse:
CHX (control) for their plaque control and potential
anticaries effects (outcome) using the oratest—a caries
activity test, in healthy volunteers (population).
Methodology
The study was designed as a prospective, 3‑arm, parallel,
randomised, double‑blind, active‑controlled pilot study
with equal allocation ratio. The study was prospectively
registered with CTRI (CTRI/2022/07/044194 [Registered
on: 21/07/2022]) with the approval of the institutional
ethics committee (MDCH/STF‑ EC/2019/07/25/01) and
subsequently conducted in the Department of Conservative
dentistry at our teaching institution. The study is conducted
according to the guidelines of CONSORT 2010.[10]
One hundred healthy subjects, aged 20‑25, years
were screened in a gender‑neutral manner over one
month (AKV). Included participants had a DMFT score
of 2‑12, a gingival index of zero (Loe and Silness, 1963),
and agreed to participate in the study visits and procedures.
Exclusion criteria included those who had taken antibiotics
in the past month and had been treated with fluoride in
the past 2 weeks. Since this was a pilot study, we did
not calculate the sample size as apriori information on
effect size was not available. Sixty participants were
recruited and we obtained the informed written consent.
Oral prophylaxis was administered to achieve a plaque
index of zero (Silness and Loe, 1964). Participants were
randomly assigned to three groups of 20 each, using
a computer‑generated list (www.sealedenvelope.com).
The groups were as follows: Group A (control):
CHX (chlorhexidine mouthwash‑0.2%) (ICPA),
Group B (Intervention): CEC (Customised enriched coconut
oil rinse), and Group C (Intervention): AT (Arimedadi
Tailam Rinse) (IMCOPS, Chennai). Randomisation (AVS)
concealed allocation and allocation of the intervention (RN)
were conducted and are shown in Figure 1. Although the
mouthwashes were dispensed in brown opaque bottles with
similar instructions for use, the patients were considered
160
partially blinded because all the rinses had different smell
and taste.
Rinsing protocol
Oil pulling requires 10‑15 minutes of vigorous rinsing,[9]
which can affect compliance in today’s fast‑paced life,[6,11]
hence, we standardised the use of all mouth rinses to one
minute, once daily. Participants were instructed to brush
their teeth in the morning, rinse 10 ml of the mouth rinse
vigorously for 1 minute, and spit it out. After rinsing, they
were asked not to eat, drink or rinse for 20 minutes. The
mouth rinse was used every day for 30 days, only in the
morning. No change in normal diet was recommended.
Plaque and gingival indices were determined at baseline,
after 15 days and after 30 days.
Oratest principle and method
The participants were asked to rinse their mouth
well with 10 ml of sterilised milk for 1 minute. The
expectorate was collected in a sterile cup, from which
3 ml was transferred with a sterile disposable syringe
into a screw‑capped test tube containing 0.12 ml of 0.1%
methylene blue. The expectorated milk and methylene
blue were mixed thoroughly, and the time required for the
colour change (blue to white) was noted at the bottom of
the tube.[12] The time required is inversely proportional
to the microbial load. The oratest was administered to all
participants at baseline, after 15 days and after 30 days
in the department. The procedure was performed when
90 minutes had elapsed after food intake. The outcomes
assessors were blinded to the type of intervention used
(SS, SJ).
Statistical analysis
As the outcome measures were recorded on day 15 and
day 30, we anticipated drop‑outs among participants
during the study period. To preserve the randomization,
data were analysed based on the intention‑to‑treat (ITT)
approach. Multiple imputation was planned to account for
missing data. The data were tabulated in an excel sheet
and analysed statistically using SPSS software Version 28
(IBM Corp, USA). The descriptive statistics (Mean,
SD, and 95% confidence interval) of the oratest scores
change, i.e. 15th day (15th day score minus baseline score)
and 30th day (30th day score minus baseline score) were
calculated are shown in Table 1. Change in the oratest
scores were assessed for normality and homogeneity
of variances using the Shapiro‑Wilk test and Levene’s
test, respectively, and found to be normally distributed
with homogeneous variances. Hence, one way ANOVA
followed by Tukey’s post hoc test was used to determine
the statistical significant difference among the three groups.
Spearman rank correlation test was conducted to determine
any correlation that exist between DMFT scores and
baseline scores. A P value of less than 0.05 is considered
significant.
Indian Journal of Dental Research | Volume 34 | Issue 2 | April-June 2023
 Sai, et al.: Anticaries potential of an enriched oil for pulling

Results between groups on the 15th day (P = 0.203) and

Baseline plaque and gingival index scores were zero,
DMFT and oratest are shown in Table 2. Five patients
were lost to follow‑up on day 30 day (2 each from
groups A and C, 1 from group B Figure 1). Multiple
imputations were used to account for the small amount of
missing data at day 30. Plaque index and gingival index
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30th day (P = 0.085) [Table 1].
Discussion
Efficacy of oil pulling for oral health analysed in a
systematic review and meta‑analysis by Peng et al,[13]
concluded that conventional oils such as coconut oil/sesame

scores remained at 0 throughout the study period in all
subjects. Oratest scores of the 15th day and 30th day were
high with CEC oil (group B), followed by CHX (group A)
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oil can significantly reduce the number of salivary bacteria,
while the plaque and gingival indices were not significantly
different compared to the control (CHX/distilled water).[13]
While comparing coconut oil and sesame oil, a crossover

and AT (group C). Although the change in oratest scores

at 30th day was higher for CEC oil than for AT, this
difference was not statistically significant (P = 0.068).
There were no statistically significant differences
Figure 1: CONSORT flow diagram
clinical trial found both oils similar for their plaque
regrowth inhibition and tooth staining ability despite their
different chemical compositions.[11] In the present study, we
compared two oils with additives based on sesame oil (AT)
and coconut oil (CEC). Both oils demonstrated good
plaque control and maintenance of gingival health and was
comparable to CHX after 15 and 30 days, demonstrating
their effectiveness as a complementary aid to oral hygiene
consistent with literature.[11,13] Both oils were able to reduce
the number of bacteria in the mouth, more so in coconut
oil based than sesame oil as reflected in the oratest scores.
The oratest is a simple, quick, and inexpensive test to
determine the microbial load in the mouth by measuring
oxygen consumption.[12] It has been used as a caries activity
test and when compared with other caries activity tests it
has high sensitivity but low specificity.[12,14] The milk helps
to displace microorganisms in the mouth and provides a
substrate for metabolism, allowing the aerobic organisms
in the expectorated milk samples to use oxygen and create
an anaerobic environment. The methylene blue dye acts
as an electron acceptor and is reduced to leucomethylene

Table 1: Change in oratest values (mins) on 15th day and 30th day
Time period Groups n Mean SD
95% confidence interval for mean P ANOVA effect size
Lower bound Upper bound (Eta‑squared)
Baseline‑15 days A (CHX) 20 42.10 40.18 23.29 60.90 0.203 0.054
B (CEC) 20 58.85 49.94 35.47 82.22
C (AT) 20 34.35 40.36 15.46 53.23
Total 60 45.10 44.20 33.68 56.51
Baseline‑30 days A (CHX) 20 51.70 40.49 32.75 70.66 0.085 0.083
B (CEC) 20 67.37 48.04 44.89 89.86
C (AT) 20 34.90 46.83 12.98 56.82
Total 60 51.32 46.43 39.33 63.32
Significance P<0.05. CHX=Chlorhexidine, CEC=Customised enriched formulation of coconut, AT=Arimedadi tailam

Table 2: The Mean (SD) values of the DMFT scores and oratest scores at Baseline for three mouth rinses
Statistic Group A (CHX) Group B (CEC) Group C (AT)
DMFT* Mean (SD) 3.80 (1.473) 4.30 (2.658) 3.65 (1.694)
Oratest Baseline** (mins) Mean (SD) 136.90 (51.223) 161.40 (56.905) 167.65 (52.715)
n 20 20 20
*DMFT distribution was same across the groups (Kruskal Wallis test P=0.834). **Baseline oratest distribution was same across the groups
(Kruskal Wallis test P=0.176). Spearman rank correlation shows a weak negative correlation (Spearman’s rho ‑0.145) between the oratest
baseline score and the DMFT scores (P=0.270). Significance P<0.05. CHX=Chlorhexidine, CEC=Customised enriched formulation of
coconut, AT=Arimedadi tailam

Indian Journal of Dental Research | Volume 34 | Issue 2 | April-June 2023  161

 Sai, et al.: Anticaries potential of an enriched oil for pulling
blue. The change in colour of the milk from blue to white
is thus an indication of a decreasing redox potential caused
by O2 consumption.[12] Thus, it can be inferred that higher
bacterial loads take lesser time for the colour change and
vice‑versa.[15] Studies show that there is a clear relationship
between oratest scores, clinical caries status, and S.mutans
count in an individual. Caries status has been found to
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have a significant positive linear relationship with S.mutans
and a significant negative linear relationship with oratest
score.[12] In our study, DMFT and baseline oratest scores
had a negative correlation although a weak one (P = 0.270)
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probably due to smaller sample size [Table 2].
In all three groups, there was an increase in oratest scores on
15th and 30th day. CEC showed the most increase followed
by CHX while AT group did not show a discernible
increase [Table 1]. All three rinses performed better in the
first 15 days, while between 15 and 30 days the effect was
marginal, and maximum effect in all groups was at the end
of the 30th day. Though there was a clinically meaningful
difference in oratest values for CEC and CHX groups
compared to AT, it was not statistically significant [Table 1]
probably because of the small sample size.
Coconut oil contains medium‑chain saturated fatty
acids, mainly lauric acid, which has antimicrobial and
anti‑inflammatory properties and is effective against
S.mutans and Candida albicans.[16] Lauric acid can react
with alkalis present in saliva, such as sodium hydroxide
and bicarbonates, to form sodium laureate—a soap‑like
substance that reduces plaque adhesion, accumulation and
has a cleansing effect.[16] A systematic review[17] comparing
coconut oil with alternative interventions concluded that it’s
use can improve dental hygiene and oral health. The plaque,
gingival index and bleeding on probing was comparable
to CHX after 2 weeks. The stain index was higher with
CHX than with coconut oil. Most studies in the SR were
conducted over 2 weeks,[17] while our study was conducted
over 4 weeks and showed plaque and gingival index values
comparable to CHX. Jauhari’s study found that coconut oil
did not produce significant changes in oratest and S.mutans
counts unlike fluoride mouthwash (200 ppm) and a herbal
rinse (Salvadora persica).[15] So to enhance its anticaries
potential, we enriched coconut oil with additives prominent
of which are clove oil, salt and turmeric powder which
demonstrate action against S. mutans.[18] CEC’s oratest
values could thus have improved.
A systematic review[8] of studies comparing sesame oil
with CHX/brushing/placebo concluded that it provided
comparable oral hygiene maintenance benefits compared to
CHX, e.g. plaque index, gingival index, modified gingival
index and salivary S. mutans counts with fewer side effects,
although all were short‑term studies. A disadvantage stated
was that some cases of lipoid pneumonia were reported,
presumably caused by aspiration of oil.[8] Arimedadi
tailam/oil is a formulation mentioned in the ancient
ayurvedic texts for the treatment of dental diseases. AT
162
contains sesame oil which is known to contain sesamin,
sesamolin, sesaminol, linoleic acid and oleic acid which
have antioxidative properties and reduce free radical injury
to the tissues.[6] AT also contains more than 40 ingredients
including Rubia cordifolia, Acacia catechu (khadira),
Syzygium aromaticum (clove)[19,20] with proven astringent,
analgesic, anti‑inflammatory, antimicrobial, anti‑plaque
properties and anticaries properties demonstrated by the
latter two ingredients, although the exact mechanism
of action is unknown.[19] AT’s anti‑plaque efficacy was
similar to 0.2% chlorhexidine gluconate in all cases when
used over 21 days,[19] it reduced bad breath, bleeding
gums and swollen gums in over 80% of patients, reduced
tooth sensitivity in 76% of patients.[20] In our study, AT’s
anti‑plaque efficacy and gingival health were consistent
with the literature. As far as we know, this is the first
study to investigate its caries‑inhibiting properties. Oratest
scores were lowest compared to CEC and CHX at 15th and
30th day period, although there were no statistically
significant differences between them. AT has minimal
anticaries potential, probably due to the shorter rinse time
of one minute compared to the recommended 5‑10 minutes.
While the short duration had an antiplaque effect it was
not sufficient for a significant change in oratest values.
Another factor to consider is the unpleasant taste reported
by some participants in the present study. This is consistent
with previous literature[20] and may have led to problems
with adherence to recommendations, which in turn led to
irregular use in this group of adults. One study comparing
patient’s preference of sesame oil or coconut oil for pulling
found nearly 70% of patients preferred coconut oil.[11] In
the present study, none of the patients complained about
the taste of CEC.
Though all participants reported for the 15‑day follow‑up,
at the 30‑day follow‑up, 8% of participants dropped out for
reasons mentioned in Figure 1. No other adverse effects
were reported during the study period.
Limitations, future scope: This is a short‑term pilot study
with healthy individuals for a specific rinsing protocol.
Though it falls short of statistical power due to less sample
size, it provides information for the effect size which will
be beneficial for further studies. The long‑term studies with
larger samples, different age groups, oral hygiene status
and alternative rinsing protocols could be recommended to
confirm the efficacy of the oils. Additional microbiological
studies could also be conducted to support the findings of
this study.
Conclusion
Within the above limitations, usage of all the rinses was
beneficial for plaque reduction and gingival health. Based
on oratest scores, oral microbial loads were reduced by
CEC oil followed by CHX. CEC can thus be used as an
adjunct to manage the biofilm diseases of the oral cavity
and provide a safe alternative to chlorhexidine.
Indian Journal of Dental Research | Volume 34 | Issue 2 | April-June 2023
 Sai, et al.: Anticaries potential of an enriched oil for pulling
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
References
Downloaded from http://journals.lww.com/ijdr by BhDMf5ePHKav1zEoum1tQfN4a+kJLhEZgbsIHo4XMi0hCywCX1AW
1. Marsh PD. In sickness and in health—What does the oral
microbiome mean to us? An ecological perspective. Adv Dent
Res 2018;29:60‑5.
2. Martignon S, Pitts NB, Goffin G, Mazevet M, Douglas GVA,
nYQp/IlQrHD3i3D0OdRyi7TvSFl4Cf3VC4/OAVpDDa8K2+Ya6H515kE= on 04/19/2024
Newton JT, et al. CariesCare practice guide: Consensus on
evidence into practice. Br Dent J 2019;227:353‑62.
3. James P, Worthington HV, Parnell C, Harding M, Lamont T,
Cheung A, et al. Chlorhexidine mouthrinse as an adjunctive
treatment for gingival health. Cochrane Database Syst Rev
2017;3:CD008676. doi: 10.1002/14651858.CD008676.pub2.
4. Bescos R, Ashworth A, Cutler C, Brookes ZL, Belfield L,
Rodiles A, et al. Effects of chlorhexidine mouthwash on
the oral microbiome. Sci Rep 2020;10:5254. doi: 10.1038/
s41598‑020‑61912‑4.
5. Brookes ZLS, Bescos R, Belfield LA, Ali K, Roberts A.
Current uses of chlorhexidine for management of oral disease:
A narrative review. J Dent 2020;103:103497. doi: 10.1016/j.
jdent.2020.103497.
6. Naseem M, Khiyani MF, Nauman H, Zafar MS, Shah AH,
Khalil HS. Oil pulling and importance of traditional medicine in
oral health maintenance. Int J Health Sci 2017;11:65‑70.
7. Asokan S, Rathan J, Muthu M, Rathna P, Emmadi P,
Raghuraman, et al. Effect of oil pulling on Streptococcus mutans
count in plaque and saliva using Dentocult SM Strip mutans test:
A randomized, controlled, triple‑blind study. J Indian Soc Pedod
Prev Dent 2008;26:12‑7.
8. Gbinigie O, Onakpoya I, Spencer E, McCall MacBain M,
Heneghan C. Effect of oil pulling in promoting oro dental
hygiene: A systematic review of randomized clinical trials.
Complement Ther Med 2016;26:47‑54.
9. Shanbhag VKL. Oil pulling for maintaining oral hygiene – A
review. J Tradit Complement Med 2017;7:106‑9.
10. Eldridge SM, Chan CL, Campbell MJ, Bond CM, Hopewell S,
Indian Journal of Dental Research | Volume 34 | Issue 2 | April-June 2023 
Thabane L, et al. CONSORT 2010 statement: Extension to
randomised pilot and feasibility trials. BMJ 2016;355:i5239. doi:
10.1136/bmj.i5239.
11. Sezgin Y, Memis Ozgul B, Maraş ME, Alptekin NO. Comparison
of the plaque regrowth inhibition effects of oil pulling therapy
with sesame oil or coconut oil using 4-day plaque regrowth
study model: A randomized crossover clinical trial. Int J Dent
Hyg 2023;21:188‑94.
12. Sundaram M, Nayak U, Ramalingam K, Reddy V, Rao A,
Mathian M. A comparative evaluation of Oratest with the
microbiological method of assessing caries activity in children.
J Pharm Bioallied Sci 2013;5:S5‑9.
13. Peng T‑R, Cheng H‑Y, Wu T‑W, Ng B‑K. Effectiveness of oil
pulling for improving oral health: A meta‑analysis. Healthc Basel
Switz 2022;10:1991. doi: 10.3390/healthcare10101991.
14. Kunte S, Singh A, Chaudhary S, Chaudhary M. Evaluation and
co‑relation of the oratest, colorimetric Snyder′s test and salivary
streptococcus mutans count in children of age group of 6‑8 years.
J Int Soc Prev Community Dent 2013;3:59‑66.
15. Jauhari D. Comparative evaluation of the effects of fluoride
mouthrinse, herbal mouthrinse and oil pulling on the caries
activity and streptococcus mutans count using oratest and
dentocult SM strip mutans kit. Int J Clin Pediatr Dent
2015;8:114‑8.
16. Peedikayi F, Remy V, John S, Chandru T, Sreenivasan P,
Bijapur G. Comparison of antibacterial efficacy of coconut oil
and chlorhexidine on Streptococcus mutans: An in vivo study.
J Int Soc Prev Community Dent 2016;6:447‑52.
17. Woolley J, Gibbons T, Patel K, Sacco R. The effect of oil pulling
with coconut oil to improve dental hygiene and oral health:
A systematic review. Heliyon 2020;6:e04789. doi: 10.1016/j.
heliyon.2020.e04789.
18. Shah ST, Loice WG, Simiyu NB, Tonnie KM. Effect of
homemade dental powder on population of streptococcus mutans
in vitro. J Dent Oral Care 2016;2:75‑81.
19. Mali GV. Comparative evaluation of arimedadi oil with 0.2%
chlorhexidine gluconate in prevention of plaque and gingivitis:
A randomized clinical trial. J Clin Diagn Res 2016;10:ZC31‑4.
20. Rao MS, Kranthi J, Rao S, Vallabh S. Arimedadi taila, An
alternative remedy in the management of dental diseases. Int J
Innov Res 2014;3:55‑8.
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