The Journey of Oral Hygiene: The Past, the Present, the Future

This narrative review traces the evolution of personal oral hygiene from antiquity to the present, examining the shift from rudimentary tools to evidence-based, technologically advanced systems. Historical developments were reviewed alongside current clinical research, including systematic reviews and professional guidelines (e.g., EFP S3-level), to evaluate the efficacy, safety, and behavioral aspects of oral hygiene practices. Oral hygiene has progressed from ancient chewing sticks to modern powered toothbrushes and interdental devices. While manual toothbrushes remain effective, oscillating-rotating and sonic technologies offer more plaque reduction and better gingival outcomes. Interdental cleaning has increasingly favored interdental brushes over dental floss, though rubber picks and oral irrigators provide effective and patient-preferred alternatives. Dentifrices have evolved from simple abrasives to vehicles for fluoride, antimicrobial, and other therapeutic agents. Despite these innovations, oral disease persists, largely due to discrepancies between perceived and actual brushing behaviors, including inadequate duration and technique. Optimal gingival health continues to depend on the quality and consistency of self-performed mechanical plaque removal. Emerging technologies and sustainable, eco-friendly materials may enhance compliance and accessibility, yet they cannot replace professional instruction or habit formation. Future strategies should prioritize personalized, evidence-based oral care that balances clinical efficacy, environmental sustainability, and equitable access.