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Clinical efficacy and patient-reported outcomes of coconut oil as adjunctive periodontitis treatment: triple-blinded pilot randomized trial.

  • 2026-04-29
  • BMC oral health 26(1)
    • Simón Pardiñas López
    • Ismael Khouly
    • Fabiana Aellos
    • Karol Apaza Alccayhuaman
    • Silvia María Díaz Prado

Study Design

Type
Randomized Controlled Trial (RCT)
Population
Thirty participants with stage II-III periodontitis
Methods
randomly assigned to three groups: coconut oil, 0.12% chlorhexidine, and placebo (coconut-flavored water) mouth rinse for one month, followed by nonsurgical periodontal therapy
Blinding
Single-blind
Duration
one month
Funding
Unclear

Background

Periodontitis is a prevalent chronic disease commonly managed with nonsurgical therapy and adjunctive antimicrobial rinses, though their side effects can hinder long-term use. Coconut oil has emerged as a potential natural alternative due to its antimicrobial and anti-inflammatory effects. This study aimed to evaluate the clinical and patient-reported outcomes of periodontal patients treated with nonsurgical therapy with or without coconut oil as an adjunctive method.

Methods

Thirty participants with stage II-III periodontitis were randomly assigned to three groups: coconut oil, 0.12% chlorhexidine, and placebo (coconut-flavored water) mouth rinse for one month, followed by nonsurgical periodontal therapy. A blinded examiner assessed the plaque index, bleeding on probing, probing pocket depth, clinical attachment level, saliva pH, tooth color, sulfur compounds in breath, and patient-reported outcomes, including the Oral Health Impact Profile-14 before starting the use of mouth rinse (T1), one month after starting the mouth rinse (T2) and one month after nonsurgical periodontal therapy (T3).

Results

Compared with the placebo, both coconut oil and chlorhexidine significantly reduced the plaque index at T2 (p = 0.001; p = 0.006), bleeding on probing at T2 (p = 0.001; p = 0.001) and T3 (p = 0.006; p = 0.009), probing depth at T2 (p = 0.001; p = 0.001), clinical attachment level at T2 (p = 0.001; p = 0.015) and sulfur compounds at T2(p = 0.045; p = 0.003). Compared with chlorhexidine, coconut oil was more effective at decreasing clinical attachment loss at T2 (p = 0.006). At T2, chlorhexidine was associated with increased burning sensation (p = 0.03) and color changes (p < 0.001), whereas coconut oil reduced the degree of mouth dryness perception (p < 0.001). Coconut oil and chlorhexidine improved breath perception (p = 0.003; p = 0.030). Patients preferred the placebo over coconut oil or chlorhexidine (p = 0.006; p = 0.015). The quality of life significantly improved in the coconut oil group at T2 (p = 0.024).

Conclusions

Compared with placebo, coconut oil and chlorhexidine improved periodontal parameters. However, coconut oil reduces mouth dryness and improves quality of life without the adverse effects associated with chlorhexidine. Nonetheless, participants in the placebo group reported a higher preference for the mouth rinse, suggesting that taste and mouthfeel play a crucial role in patient compliance.

Ethical approval and trial registration

The study protocol was approved by the Comité de Ética de la Investigación con Medicamentos de Galicia (CEIm-G) under protocol number 2017/247, registered at ClinicalTrials.gov (NCT06049589) on September 1st 2023 and conducted in compliance with the Declaration of Helsinki and Good Clinical Practice guidelines. All participants provided written informed consent before enrollment.

Research Insights

  • Coconut→Improved Breath Perception

    Coconut oil and chlorhexidine improved breath perception (p = 0.003; p = 0.030)

    Effect
    Beneficial
    Effect size
    Small
    Dose
    mouth rinse
  • Coconut→Improved Clinical Attachment

    coconut oil and chlorhexidine significantly reduced ... clinical attachment level at T2 (p = 0.001; p = 0.015). Compared with chlorhexidine, coconut oil was more effective at decreasing clinical attachment loss at T2 (p = 0.006)

    Effect
    Beneficial
    Effect size
    Moderate
    Dose
    mouth rinse
  • Coconut→Improved Quality of Life

    The quality of life significantly improved in the coconut oil group at T2 (p = 0.024)

    Effect
    Beneficial
    Effect size
    Moderate
    Dose
    mouth rinse
  • Coconut→Reduced Bleeding on Probing (BOP)

    coconut oil and chlorhexidine significantly reduced ... bleeding on probing at T2 (p = 0.001; p = 0.001) and T3 (p = 0.006; p = 0.009)

    Effect
    Beneficial
    Effect size
    Moderate
    Dose
    mouth rinse
  • Coconut→Reduced Mouth Dryness

    coconut oil reduced the degree of mouth dryness perception (p < 0.001)

    Effect
    Beneficial
    Effect size
    Moderate
    Dose
    mouth rinse
  • Coconut→Reduced Plaque Index

    coconut oil and chlorhexidine significantly reduced the plaque index at T2 (p = 0.001; p = 0.006)

    Effect
    Beneficial
    Effect size
    Moderate
    Dose
    mouth rinse (concentration/volume not specified in abstract, used as mouthwash)
  • Coconut→Reduced Probing Pocket Depth

    coconut oil and chlorhexidine significantly reduced ... probing depth at T2 (p = 0.001; p = 0.001)

    Effect
    Beneficial
    Effect size
    Moderate
    Dose
    mouth rinse
  • Coconut→Reduced Sulfur Compound Level

    coconut oil and chlorhexidine significantly reduced ... sulfur compounds at T2 (p = 0.045; p = 0.003)

    Effect
    Beneficial
    Effect size
    Small
    Dose
    mouth rinse

Adverse Events Reported

  • Coconut→mouth dryness

    whereas coconut oil reduced the degree of mouth dryness perception (p < 0.001)

    Finding
    Increased risk
    Significant
    Yes
  • Coconut→Overall tolerability

    coconut oil reduces mouth dryness and improves quality of life without the adverse effects associated with chlorhexidine

    Finding
    Reported
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