Objectives <p>To compare the plaque reducing efficacy of oil pulling with sesame oil compared to distilled water in a randomized, controlled, examiner-blinded parallel group study.</p> Materials and methods <p>Forty probands without advanced periodontal disease of the University Hospital for Restorative Dentistry and Periodontology, Medical University of Innsbruck (Austria) were randomized allocated to test- (sesame oil) or control group (distilled water) and asked to pull daily in the morning for eight weeks with their allotted fluid for 15&#xa0;min. Rustogi Modified Navy Plaque Index (RMNPI) and gingival bleeding index were assessed at baseline and after four and eight weeks. Plaque samples underwent microbiological analysis.</p> Results <p>Pulling with sesame oil was significantly more effective in reducing full mouth RMNPI compared to distilled water after eight weeks (median reduction 18.98% versus 10.49%; <i>p</i> = 0.023), and was most pronounced in anterior, buccal, and lingual subscales. On approximal surfaces, significantly higher plaque reduction was found in the test group after four (24.07% versus 14.29%) and eight weeks (16.00% versus 5.36%) of intervention (<i>p</i> &lt; 0.05). No significant changes in gingival index and mirobiological analysis could be detected.</p> Conclusion <p>Plaque reduction was statistically significantly higher with oil pulling than with distilled water, however, a study bias cannot be ruled out. Further high-quality trials are needed to understand the mechanisms and effectiveness of oil pulling, to finally clarify the evidence.</p> Clinical relevance <p>Oil pulling may be recommended as an adjuvant to mechanical dental cleaning. Individuals with keratosis may experience adverse effects.</p> Trial registration <p>ClinicalTrials.gov NCT06327841.</p>