Smart Toothbrushes and AI-Assisted Oral Hygiene Monitoring for Plaque Control, Gingival Health, and Periodontal Care: A Narrative Review

Effective toothbrushing is central to plaque control and periodontal health, yet brushing technique and adherence are often inadequate. Smart toothbrushes and digitally assisted oral hygiene systems record brushing behaviour and return feedback to patients and, in some models, to clinicians. This narrative review, prepared with reference to the SANRA checklist, drew on PubMed/MEDLINE, Scopus, Web of Science, the Cochrane Library, and Google Scholar using a targeted, non-systematic search for publications from January 2012 to February 2026. Eighteen primary studies are summarised in detail. Sensor-based and app-connected systems improved plaque scores, gingival bleeding, brushing behaviour, and, in some studies, adherence, mostly over follow-up periods of 2 weeks to 6 months. Two randomised trials in patients with periodontitis reported additional short-term improvements in periodontal parameters when AI-assisted monitoring was added to periodontal care. However, many commercial devices use fixed thresholds rather than adaptive machine learning, and most trials cannot separate the effects of powered brushing, feedback, app support, and AI. Current evidence suggests that smart toothbrushes and digitally assisted oral hygiene systems may improve plaque control, brushing behaviour, adherence, and short-term gingival outcomes. The incremental benefit specifically attributable to AI-based functions and their impact on long-term periodontal outcomes remain to be established.