Revisiting Ayurveda for Pediatric Oral Health: A Randomized Controlled Trial Evaluating the Effects of Coconut Oil and Castor Oil Pulling on Plaque Accumulation, Gingival Health, and Salivary Bacterial Load in Children.

Background and aim Oil pulling (OP) has been studied as an adjunct to routine oral hygiene, but pediatric evidence - especially for castor oil - is limited. The registered primary outcome broadly covered gingival health and bacterial flora at two weeks; no secondary outcome was registered. This report compared those components after virgin coconut oil (VCO), virgin castor oil, or distilled-water rinsing. Plaque Index and the direct VCO-versus-castor comparison were exploratory. Materials and methods This exploratory randomized controlled trial enrolled 70 children, of whom 51 met the eligibility criteria and were allocated equally to VCO, castor-oil, or distilled-water groups (n = 17 each). Participants performed the assigned intervention once daily for two weeks. The Turesky modification of the Quigley-Hein Plaque Index, the Löe-Silness Gingival Index, and salivary MacConkey-culturable bacterial counts were assessed at baseline (T0) and after two weeks (T2). Intergroup values were compared using one-way analysis of variance (ANOVA) followed by Tukey HSD tests (p < 0.05). Results Forty-five children (n = 15 per group) completed the study. Both oil-pulling groups showed statistically significant reductions in Plaque Index, Gingival Index, and bacterial load from baseline to the two-week follow-up (p < 0.05). At postoperative evaluation, Group B (castor oil) demonstrated the greatest reduction in Plaque Index (3.90 ± 0.46 to 2.50 ± 0.38) and Gingival Index (2.00 ± 0.32 to 0.90 ± 0.28). Bacterial counts decreased markedly in both Groups A and B (from approximately 6.75 and 6.65 to 5.70 and 5.65 × 10³ CFU/mL, respectively), whereas Group C showed negligible change (6.55 to 6.50 × 10³ CFU/mL). Intergroup comparisons confirmed significantly better outcomes in both intervention groups relative to the control. Conclusion Over two weeks, VCO and castor-OP were associated with lower mean plaque and gingival-index scores and lower salivary MacConkey-culturable bacterial counts than distilled-water rinsing. The small sample, baseline imbalances, short follow-up, and restricted microbiological method limited causal and clinical interpretation. Larger trials using baseline-adjusted analyses and oral-microbiome-specific methods are required before routine paediatric use can be recommended.