Smart plaque control: Emerging mechanical approaches in oral hygiene

Dental plaque biofilm is the primary etiological factor in the development of dental caries, gingivitis, and periodontal diseases, making effective plaque control essential for maintaining oral health. Conventional mechanical plaque control methods, including toothbrushing and scaling and root planing (SRP), remain the gold standard; however, limitations such as incomplete biofilm removal, patient non-compliance, and operator fatigue have encouraged the development of advanced technologies. This review explores emerging mechanical approaches in plaque control and their role in modern preventive dentistry. Recent innovations include nanotechnology-based oral hygiene aids, air-polishing systems, laser-assisted therapies, smart toothbrushes, microrobots, and Guided Biofilm Therapy (GBT). Nanoparticle-coated toothbrushes and flosses exhibit enhanced antibacterial properties, while air-polishing devices using glycine and erythritol powders provide minimally invasive and effective biofilm removal with improved patient comfort. Artificial intelligence-enabled smart toothbrushes offer real-time monitoring, personalized feedback, and improved compliance through digital integration. Emerging microrobotic systems and nanomotors demonstrate promising potential for targeted biofilm disruption at the microscale. Furthermore, GBT has introduced a patient-centered and minimally invasive approach for professional plaque management with superior comfort and clinical outcomes. Despite these advancements, challenges such as high cost, accessibility, limited long-term evidence, and concerns regarding safety and sustainability persist. Future research focusing on AI-driven diagnostics, digital integration, and precision-based oral healthcare may further revolutionize plaque management and periodontal therapy.