Many interesting projects are under way in the development of serious games that will promote oral health care. App BrushDJ. Source: BrushDJComputer games and digital media are playing an increasingly important role in the daily life of children and adolescents. Public debates tend to highlight the health risks of intensive computer gaming. Nevertheless, there is another side to the coin: Serious games can help to promote the oral health of patients and could therefore be beneficial to oral prophylaxis. Find out more from our guest writer.

by Priv.-Doz. Dr Johan Peter Wölber, Freiburg/Germany

Public debates often highlight the negative health effects of intensive computer gaming – such as aggression, lethargy and dependency as well as muscular and skeletal damage. Nevertheless, computer games are available that promote good health. They are known as serious games. These games contain learning and motivational content, such as languages and scientific and health-related subjects, which are conveyed in an entertaining and game-like fashion.

Oral health: A number of serious games are already available

Serious games are already being used in many different fields. A meta analysis of the health benefits of these games showed significant improvements in different branches of the health sector (DeSmet et al., 2014). Nevertheless, it must be noted that the results were very heterogeneous with regard to the game played. A few games have also been developed for the purpose of promoting oral health.

Two categories of digital media

Computer games are as varied as their applications. The digital media available for promoting oral health can be divided into two general categories:

  1. Computer games that promote cognitive development and therefore impart knowledge, boost self-confidence and stimulate motivation (e.g. oral hygiene, fluoride) Example: Protectus
  2. Computer games that promote motor development by means of feedback mechanisms (Nintendo Wii, Playbrush and certain apps)

These two categories can be combined. The games that promote motor development also influence motivational factors, such as self-confidence, since the experience of practicing good oral hygiene automatically boosts the self-confidence of the player.

Motivation apps: Smartguide, BrushDJ and co.

Apart from these games, digital application-based motivational aids are also available (e.g. the Oral-B app Smartguide, BrushDJ, applications with WhatsApp). However, they are not considered to be real games.

Initial studies reveal interesting results

Studies and investigations have already been conducted on this subject. Here are just a few examples:

  1. Digital teeth cleaning game produces excellent results
    In the German-speaking region, the working group of Höfer et al. (2017) examined 49 preschool children and found that the children who played a computer-based teeth-cleaning game (Rainbow, Vigilant) showed a significant drop in the plaque and gingivitis values compared with the children who did not play the game. The values of the experimental group after six weeks of playing the game and after six weeks of not playing it were also much better than those of the control group.
  2. Tooth selfies: less plaque and gingivitis
    In a study involving 80 adolescents who used other types of digital motivation aids, Zotti et al. (2016) found that the participants who regularly took photographs (selfies) of their teeth and shared them in a WhatsApp group showed significantly lower plaque and gingivitis levels.
  3. Longer cleaning sessions due to a helpful app
    In a user survey involving 189 participants, Underwood et al. (2015) studied the effectiveness of the BrushDJ app. The app regularly sends the user push notifications about oral hygiene recommendations and information. The majority of the people surveyed reported that they were brushing their teeth longer. They also said that they would recommend the app to friends.

Conclusion: Very promising initial results, but no long-term evidence

Many interesting projects are under way in the development of serious games that will promote oral health care. Nevertheless, there is only very little evidence about the effects of such games. In contrast, studies on application-based motivational and tooth brushing aids have produced positive and promising results.

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The author

Priv.-Doz. Dr Johan Peter Wölber works in the Department of Operative Dentistry and Periodontology at the University Medical Center Freiburg/Germany. He specializes in the fields of periodontology and oral health promotion. 

The original paper was published in the German professional journal “Zahnärztliche Mitteilungen” (issue 20/2017).