IoT-Enabled Smart Toothbrushes for Oral Hygiene Monitoring: A Multi-Group Comparative Study Among Undergraduates, Dental Students, and Patients Across Educational and Clinical Settings in District Mandi, India

Background: The integration of Internet-of-Things (IoT) technologies into oral healthcare enables real-time monitoring of brushing behaviour through smart toothbrushes. These devices track brushing duration, technique, and frequency, providing personalized feedback to enhance oral hygiene.

Aim: To assess and compare the knowledge, attitude, and practices (KAP) related to IoT-enabled smart toothbrushes among undergraduate students, dental students, and dental patients across educational and clinical settings in District Mandi, India, and to evaluate whether real-time brushing data can improve compliance.

Materials and Methods: A cross-sectional survey was conducted among 885 participants, comprising undergraduate students (n=295), dental students (n=295), and dental patients (n=295). A prevalidated 32-item questionnaire assessed demographics and KAP toward IoT-based smart toothbrushes, including awareness of IoT, understanding of smart toothbrush functions, perceptions of real-time feedback, and usage patterns. Data were analysed using descriptive statistics, Chi-square tests for categorical variables, and one-way ANOVA for continuous variables, followed by post-hoc tests. Statistical significance was set at p < 0.05.

Results: Of the 1,014 questionnaires distributed, 885 were completed (response rate: 87.35%). Significant differences were observed across all KAP domains. Dental students showed the highest knowledge scores (8.12 ± 1.4), followed by undergraduates (5.96 ± 1.9) and patients (4.85 ± 2.1), with ANOVA showing p < 0.001. Post-hoc analysis confirmed significant pairwise differences: dental students vs. undergraduates (p < 0.001), dental students vs. patients (p < 0.001), and undergraduates vs. patients (p = 0.004). Attitude differences were significant (p = 0.008), with 78% of dental students, 61% of undergraduates, and 54% of patients agreeing that real-time data improves compliance; pairwise differences were significant (p = 0.01 and p = 0.04). Practice patterns also varied significantly (p = 0.02). Additional differences were noted in perceived usefulness (p = 0.01), willingness to adopt smart toothbrushes (p = 0.03), and data privacy concerns (p = 0.047).

Conclusion: IoT-enabled smart toothbrushes have strong potential to improve oral hygiene compliance. Despite positive attitudes, significant gaps in knowledge and usage persist, indicating the need for targeted awareness and cost-effective implementation strategies in District Mandi.