Clinical Efficacy and Patient-Reported Outcomes of Coconut Oil as Adjunctive Periodontitis Treatment: Triple-Blinded Randomized Trial

Background: To evaluate the clinical 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) 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. Results: Compared with the placebo, both coconut oil and chlorhexidine significantly reduced the plaque index (p=0.001; p=0.006), bleeding on probing (p=0.001; p=0.001), probing depth (p=0.001; p=0.001), clinical attachment level (p=0.001; p=0.015) and sulfur compounds (p=0.045; p=0.003). Compared with chlorhexidine, coconut oil was more effective at decreasing clinical attachment loss (p=0.006). 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 (p=0.024). Conclusions: Compared with placebo, coconut oil and chlorhexidine enhance periodontal health. However, coconut oil reduces mouth dryness and improves quality of life without the adverse effects associated with chlorhexidine. Nonetheless, patients preferred the placebo, indicating that taste and mouthfeel are important for compliance.