Oral hygiene practices have evolved significantly over time, with traditional methods and modern approaches offering distinct advantages for maintaining oral health. This review provides a comparative analysis of Siddha oral hygiene practices and contemporary modern methods, focusing on their techniques, efficacy, safety, and consumer acceptance. Siddha oral hygiene practices include the use of herbal mouthwashes, oil pulling, and tooth powders such as Thiripala Chooranam and Padigara Neer. These methods rely on natural ingredients with antimicrobial, anti-inflammatory, and antioxidant properties. In contrast, modern oral hygiene practices involve commercial mouthwashes, fluoride toothpaste, and electric toothbrushes, which are supported by extensive clinical research demonstrating their effectiveness in plaque reduction and gingival health maintenance. The review highlights that while traditional Siddha practices have shown potential benefits, the scientific evidence is limited compared to the robust clinical data supporting modern products. Safety profiles differ, with traditional methods generally being well-tolerated, though they may pose risks for allergic reactions, whereas modern products can sometimes cause mucosal irritation or sensitivity. Consumer preferences are shifting towards natural solutions, but modern practices remain widely accepted due to their proven efficacy and convenience. The potential for integrating traditional Siddha techniques with modern practices is discussed, suggesting a holistic approach could enhance overall oral health. The review concludes with recommendations for future research to further investigate the synergistic effects of combining these approaches.