Background: Maintaining oral hygiene is crucial for preventing dental plaque and gingivitis, both of which are common oral health issues. Toothpaste formulations play a significant role in controlling these conditions. This study aims to compare the effectiveness of various toothpaste formulations in controlling dental plaque and gingivitis. Materials and methods: A randomized controlled trial was conducted involving 100 participants with mild to moderate dental plaque and gingivitis. Participants were divided into five groups, each assigned to a different toothpaste formulation: fluoride-based, herbal, charcoal, baking soda, and natural. Plaque and gingivitis scores were assessed at baseline and after four weeks of regular toothbrushing with the assigned toothpaste. Plaque scores were measured using the Silness and Löe plaque index, while gingivitis scores were assessed using the Löe and Silness gingival index. Results: After four weeks, participants using fluoride-based toothpaste showed a significant reduction in plaque scores from a mean of 2.5 [standard deviation (SD) 0.8] to 1.2 (SD 0.5) (p < 0.001). Herbal toothpaste also demonstrated a reduction in plaque scores from 2.4 (SD 0.7) to 1.3 (SD 0.6) (p < 0.001). Charcoal, baking soda, and natural toothpaste showed reductions in plaque scores, but they were not statistically significant. Regarding gingivitis scores, fluoride-based toothpaste resulted in a significant decrease from 1.8 (SD 0.6) to 1.0 (SD 0.4) (p < 0.001). Other toothpaste formulations also showed reductions in gingivitis scores, but they were not statistically significant. Conclusion: Fluoride-based toothpaste demonstrated superior efficacy in controlling both dental plaque and gingivitis compared to other formulations. Herbal toothpaste also showed effectiveness in reducing plaque and gingivitis scores, albeit to a lesser extent. Charcoal, baking soda, and natural toothpaste formulations exhibited some reduction in plaque and gingivitis scores, but their effects were not statistically significant. Therefore, fluoride-based toothpaste remains the recommended choice for preventing dental plaque and gingivitis.