Is coconut oil pulling dangerous?

Lipoid pneumonia is lung inflammation caused by oil getting into the airways. It is rare, and most cases come from other sources such as oily nose drops or vaping, but oil pulling has been linked to it in published case reports:

• In 2015, doctors in Japan reported two adults, aged 66 and 38, who developed lipoid pneumonia after months of habitual sesame oil pulling. One needed steroids and lung washing; the other recovered without intensive treatment.
• In 2018, a hospital in Hong Kong reported two women with a history of tongue cancer whose pneumonia would not clear until they stopped oil pulling and had repeated lung washing.
• A 2014 report from Korea described recurrent lipoid pneumonia associated with oil pulling.

These are case reports, so they show the risk exists but not how common it is. The 2015 cases involved sesame oil, but there is no reason to think coconut or any other oil is safe to inhale.

The risk depends on how likely you are to inhale liquid. Cleveland Clinic lists conditions that make aspiration easier, such as neuromuscular disorders and chronic acid reflux, as risk factors for lipoid pneumonia. Based on the case reports, extra caution makes sense for:

• People with swallowing difficulty for any reason
• People who have had head and neck cancer or its treatment
• Anyone with a neurological or muscle condition affecting the throat
• Young children
• Anyone who gargles the oil or swishes while lying down

If any of these apply to you, skip oil pulling or ask your doctor first.

An ADA spokesperson said in ADA News that swishing food-safe oil is unlikely to be detrimental, but that people should never choose oil pulling instead of evidence-based treatment. The ADA's consumer site says there is no reliable evidence that oil pulling reduces cavities or improves oral health.

In practice, the risk is someone with a toothache, swollen gums or a bad infection trying oil pulling for weeks instead of seeing a dentist. Cleveland Clinic puts it plainly: a cavity is a hole, and no home method fills it.

• Jaw ache from swishing for 20 minutes. Shorter sessions help.
• Nausea or gagging in some people, especially with a full tablespoon.
• Clogged drains. Coconut oil hardens when cool. Spit into the trash, not the sink or toilet.
• Allergy. Do not use an oil you are allergic to.
• Calories. Swallowing the oil adds calories, though spitting it out avoids that.

1. Sit or stand upright. Never oil pull lying down.
2. Use a small amount, a tablespoon or less.
3. Swish gently, keep your mouth closed and do not gargle.
4. Stop right away if you cough, choke or feel oil at the back of your throat.
5. Spit into the trash, rinse with water, then brush and floss.
6. Keep it optional, and see a dentist for any pain, swelling or bleeding.

Full instructions are in our how-to guide.