Findings

What do systematic reviews say?

262 questions · 304 findings · 17 reviews · Dental caries

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No studies found 40 · 13.2%GRADE not reported 169 · 55.6%Very low 46 · 15.1%Low 25 · 8.2%Moderate 24 · 7.9%High 0 · 0%

Gamified oral health interventions (mobile apps, serious games, augmented reality, game-based education) vs Non-digital gamified oral health interventions (card/board games, storytelling, printed aids)

Long-term behavior change and overall oral health outcomes · Children or adolescents

Digital gamified interventions appear more effective than non-digital alternatives for long-term behavior change and oral health outcomes, but the evidence is narrative and ungraded.

1 finding from 1 review

The Application of Gamification in Children's Oral Health Management: Systematic Review. 2025 All outcomes
Long-term follow-up (sustained behavior change) · Schools, dental clinics, and mobile-app user-testing environments
Digital-based interventions were more effective in fostering long-term behavior change compared with nondigital alternatives and consistently outperformed nondigital alternatives in improving oral health outcomes;…
Studies not reported
GRADE not reported

Gamified oral health interventions (mobile apps, serious games, augmented reality, game-based education) vs Conventional or traditional oral health education, or non-gamified interventions (comparator varied; several studies were single-arm/uncontrolled)

Adherence to oral hygiene routines by people with ID or their carers · Children or adolescents

Gamified interventions appear to increase children's engagement and adherence to oral hygiene routines, but the evidence is narrative and ungraded.

1 finding from 1 review

The Application of Gamification in Children's Oral Health Management: Systematic Review. 2025 All outcomes
Post-intervention (predominantly short-term; long-term follow-up in a minority of studies) · School-based settings, specialized dental clinics, and home-based environments
The regular use rate was significantly higher (72.4%) in the gamified mobile health app group than in the nongamified intervention group (48.3%) [Zolfaghari 2021]; quiz-based challenges in mobile apps encouraged higher…
Studies not reported
GRADE not reported

Gamified oral health interventions (mobile apps, serious games, augmented reality, game-based education) vs Conventional or traditional oral health education, or non-gamified interventions (comparator varied; several studies were single-arm/uncontrolled)

Plaque index (PI) / oral hygiene · Children or adolescents

Gamified interventions appear to improve plaque control and oral hygiene status in children versus conventional methods, but the evidence is narrative and ungraded (individual-study P values only).

1 finding from 1 review

The Application of Gamification in Children's Oral Health Management: Systematic Review. 2025 All outcomes
Post-intervention (predominantly short-term; long-term follow-up in a minority of studies) · School-based settings, specialized dental clinics, and home-based environments
In the gamified mobile health app group, plaque control was superior (P<.05) compared with the conventional method group [Zolfaghari 2021]; a gamified/reminder sticker-book group showed a significant improvement in…
Studies not reported
GRADE not reported

Gamified oral health interventions (mobile apps, serious games, augmented reality, game-based education) vs Conventional or traditional oral health education, or non-gamified interventions (comparator varied; several studies were single-arm/uncontrolled)

Oral health knowledge (1-9 scale) · Children or adolescents

Gamified interventions appear to improve children's oral health knowledge compared with conventional education, but the evidence is narrative and ungraded.

1 finding from 1 review

The Application of Gamification in Children's Oral Health Management: Systematic Review. 2025 All outcomes
Post-intervention (predominantly short-term; long-term follow-up in a minority of studies) · School-based settings, specialized dental clinics, and home-based environments
The effectiveness of digital-based interventions was generally positive, with 38% (9/24) of the experimental studies reporting improvements in oral health knowledge and behaviors; game-based teaching significantly…
9 studies
GRADE not reported

Gamified oral health interventions (mobile apps, serious games, augmented reality, game-based education) vs Conventional or traditional oral health education, or non-gamified interventions (comparator varied; several studies were single-arm/uncontrolled)

Oral hygiene behavior (brushing habits, preventive dental visits, dietary choices) · Children or adolescents

Gamified interventions appear to improve oral hygiene behaviors (brushing habits, preventive dental visits) in children, but the evidence is narrative and ungraded.

1 finding from 1 review

The Application of Gamification in Children's Oral Health Management: Systematic Review. 2025 All outcomes
Post-intervention (predominantly short-term; long-term follow-up in a minority of studies) · School-based settings, specialized dental clinics, and home-based environments
A gesture-based motion-capture game enhanced brushing independence and skill retention (P<.001) [Kang 2021]; 58.8% of caregivers reported their children brushed more often when using gamified applications [France…
Studies not reported
GRADE not reported

Any of the interventions (CR, SE, SW, sealing with sealant materials, Hall Technique, or NRCC) vs Each other, placebo, or no treatment

Adverse events (any type) and safety of sealant · Children and/or adults with permanent or primary teeth, vital (sensitive) pulps, and cavitated or dentine carious lesions conventionally…

The review found no eligible studies for this question.

1 finding from 1 review

Interventions for treating cavitated or dentine carious lesions 2021 · Cochrane All outcomes
None of the studies reported adverse effects.
0 studies
No studies found

Any of the interventions (CR, SE, SW, sealing with sealant materials, Hall Technique, or NRCC) vs Each other, placebo, or no treatment

Subjective evaluation of the treatments by participants · Children and/or adults with permanent or primary teeth, vital (sensitive) pulps, and cavitated or dentine carious lesions conventionally…

The review found no eligible studies for this question.

1 finding from 1 review

Interventions for treating cavitated or dentine carious lesions 2021 · Cochrane All outcomes
We found no studies reporting subjective evaluation of the treatments by participants.
0 studies
No studies found

Theory-based oral health education/promotion interventions (HBM, TPB, SCT, HAPA, TTM, PMT, SOC, PRECEDE-PROCEED, MI) vs Control (waitlist, routine/standard oral health education, or minimal intervention)

Self-efficacy related to oral health · school‐age children and adolescents

Theory-based educational interventions significantly improved oral health self-efficacy (SMD 1.49; low certainty), though between-study heterogeneity was very high.

1 finding from 1 review

Health promotion theory-based educational interventions for improving oral health in children and adolescents: a… 2025 All outcomes
Post-intervention (follow-up 4 weeks to 12 months, varies by study) · School-based and community settings; multiple countries (predominantly Iran; also Pakistan, Hong Kong, Lithuania, Thailand) · Overall
SMD 1.49 [0.99, 2.00]
10 studies · 4513 participants
Low

Theory-based oral health education/promotion interventions (HBM, TPB, SCT, HAPA, TTM, PMT, SOC, PRECEDE-PROCEED, MI) vs Control (waitlist, routine/standard oral health education, or minimal intervention)

Oral health attitudes (1-7 scale) · school‐age children and adolescents

Theory-based interventions significantly improved oral health attitude (SMD 9.32; low certainty); the very large effect warrants cautious interpretation.

1 finding from 1 review

Health promotion theory-based educational interventions for improving oral health in children and adolescents: a… 2025 All outcomes
Post-intervention (follow-up immediately after to 6 months, varies by study) · School-based and community settings; multiple countries (predominantly Iran; also Pakistan, Hong Kong, Lithuania, Thailand) · Overall
SMD 9.32 [7.08, 11.55]
3 studies · 2370 participants
Low

Theory-based oral health education/promotion interventions (HBM, TPB, SCT, HAPA, TTM, PMT, SOC, PRECEDE-PROCEED, MI) vs Control (waitlist, routine/standard oral health education, or minimal intervention)

Oral health-related quality of life · school‐age children and adolescents

Theory-based interventions significantly improved oral health-related quality of life (SMD 7.38; low certainty), with very high heterogeneity.

1 finding from 1 review

Health promotion theory-based educational interventions for improving oral health in children and adolescents: a… 2025 All outcomes
Post-intervention (follow-up 0.5 to 12 months, varies by study) · School-based and community settings; multiple countries (predominantly Iran; also Pakistan, Hong Kong, Lithuania, Thailand) · Overall
SMD 7.38 [5.57, 9.19]
4 studies · 4751 participants
Low

Theory-based oral health education/promotion interventions (HBM, TPB, SCT, HAPA, TTM, PMT, SOC, PRECEDE-PROCEED, MI) vs Control (waitlist, routine/standard oral health education, or minimal intervention)

Mean DMFT (decayed, missing, filled permanent teeth) · school‐age children and adolescents

Theory-based interventions showed no significant effect on DMFT scores (SMD -0.11; low certainty).

1 finding from 1 review

Health promotion theory-based educational interventions for improving oral health in children and adolescents: a… 2025 All outcomes
Post-intervention (follow-up 3 to 12 months, varies by study) · School-based and community settings; multiple countries (predominantly Iran; also Pakistan, Hong Kong, Lithuania, Thailand) · Overall
SMD -0.11 [-0.27, 0.04]
4 studies · 2556 participants
Low

Theory-based oral health education/promotion interventions (HBM, TPB, SCT, HAPA, TTM, PMT, SOC, PRECEDE-PROCEED, MI) vs Control (waitlist, routine/standard oral health education, or minimal intervention)

Periodontal health status · school‐age children and adolescents

Theory-based interventions significantly improved periodontal health (SMD -1.18; moderate certainty).

1 finding from 1 review

Health promotion theory-based educational interventions for improving oral health in children and adolescents: a… 2025 All outcomes
Post-intervention (follow-up 2 weeks to 6 months, varies by study) · School-based and community settings; multiple countries (predominantly Iran; also Pakistan, Hong Kong, Lithuania, Thailand) · Overall
SMD -1.18 [-1.83, -0.53]
4 studies · 3342 participants
Moderate

Theory-based oral health education/promotion interventions (HBM, TPB, SCT, HAPA, TTM, PMT, SOC, PRECEDE-PROCEED, MI) vs Control (waitlist, routine/standard oral health education, or minimal intervention)

Oral health behaviour (1-9 scale) · school‐age children and adolescents

Theory-based interventions significantly improved oral health behavior (SMD 2.58; low certainty), with very high heterogeneity.

1 finding from 1 review

Health promotion theory-based educational interventions for improving oral health in children and adolescents: a… 2025 All outcomes
Post-intervention (follow-up 0.5 to 24 months, varies by study) · School-based and community settings; multiple countries (predominantly Iran; also Pakistan, Hong Kong, Lithuania, Thailand) · Overall
SMD 2.58 [2.03, 3.12]
6 studies · 13973 participants
Low

Theory-based oral health education/promotion interventions (HBM, TPB, SCT, HAPA, TTM, PMT, SOC, PRECEDE-PROCEED, MI) vs Control (waitlist, routine/standard oral health education, or minimal intervention)

Oral health knowledge (1-9 scale) · school‐age children and adolescents

Theory-based interventions significantly improved oral health knowledge (SMD 1.09; low certainty).

1 finding from 1 review

Health promotion theory-based educational interventions for improving oral health in children and adolescents: a… 2025 All outcomes
Post-intervention (follow-up immediately after to 24 months, varies by study) · School-based and community settings; multiple countries (predominantly Iran; also Pakistan, Hong Kong, Lithuania, Thailand) · Overall
SMD 1.09 [0.80, 1.39]
7 studies · 10904 participants
Low

Theory-based oral health education/promotion interventions (HBM, TPB, SCT, HAPA, TTM, PMT, SOC, PRECEDE-PROCEED, MI) vs Control (waitlist, routine/standard oral health education, or minimal intervention)

Plaque index (PI) / oral hygiene · school‐age children and adolescents

Theory-based interventions significantly reduced dental plaque (SMD -1.92; moderate certainty).

1 finding from 1 review

Health promotion theory-based educational interventions for improving oral health in children and adolescents: a… 2025 All outcomes
Post-intervention (follow-up 1 to 24 months, varies by study) · School-based and community settings; multiple countries (predominantly Iran; also Pakistan, Hong Kong, Lithuania, Thailand) · Overall
SMD -1.92 [-2.42, -1.42]
9 studies · 12562 participants
Moderate

Behaviour change / oral health promotion interventions delivered by non-dental professionals and health workers (nurses, midwives, health visitors, community health workers) vs control (no intervention/usual care/isotonic exercise)

Caries experience at the surface level (dmfs/defs) · Children (mean age newborn to ~5.2 years) and their parents/carers

Behaviour change interventions delivered by non-dental health workers produced a small, statistically significant reduction in caries experience at the surface level (dmfs SMD -0.15, 95% CI -0.25 to -0.04; 12 studies); the review judged the overall evidence to be of low quality (not GRADE-rated).

1 finding from 1 review

The effectiveness of behaviour change interventions delivered by non-dental health workers in promoting children's… 2022 All outcomes
Primary care and community settings; interventions delivered by non-dental health workers (multiple countries: Australia, Brazil, Canada, India, UK, USA, etc.)
SMD -0.15 [-0.25, -0.04]
12 studies
GRADE not reported

Behaviour change / oral health promotion interventions delivered by non-dental professionals and health workers (nurses, midwives, health visitors, community health workers) vs control (no intervention/usual care/isotonic exercise)

Caries experience · Children (mean age newborn to ~5.2 years) and their parents/carers

Behaviour change interventions delivered by non-dental health workers produced a small-to-moderate, statistically significant reduction in caries experience at the tooth level (dmft SMD -0.34, 95% CI -0.54 to -0.13; 6 studies); the review judged the overall evidence to be of low quality (not GRADE-rated).

1 finding from 1 review

The effectiveness of behaviour change interventions delivered by non-dental health workers in promoting children's… 2022 All outcomes
Primary care and community settings; interventions delivered by non-dental health workers (multiple countries: Australia, Brazil, Canada, India, UK, USA, etc.)
SMD -0.34 [-0.54, -0.13]
6 studies
GRADE not reported

Primary school-based interventions (one or more of: school health policy, oral health education, healthy school environment, access to oral health services, community involvement) vs usual practice

Plaque index (PI) / oral hygiene · Primary school children (aged 3-16 years) attending primary school in low- and middle-income countries (LMICs)

School-based interventions may reduce dental plaque scores (SMD -0.32, favouring intervention), but the certainty of evidence is very low.

1 finding from 1 review

Effectiveness of primary school-based interventions in improving oral health of children in low- and middle-income… 2022 All outcomes
Post-intervention; follow-up varied across studies (interventions ranged from <2 years to >=2 years and longer) · Primary schools in low- and middle-income countries (Southeast Asia, Africa, the Americas, Europe, eastern Mediterranean)
SMD -0.32 [-0.46, -0.18]
7 studies · 3339 participants
Very low

Primary school-based interventions (one or more of: school health policy, oral health education, healthy school environment, access to oral health services, community involvement) vs usual practice

Oral hygiene measured by mean gingival scores · Primary school children (aged 3-16 years) attending primary school in low- and middle-income countries (LMICs)

The effect of school-based interventions on gingival scores is uncertain and not statistically significant (SMD 0.12; very low certainty).

1 finding from 1 review

Effectiveness of primary school-based interventions in improving oral health of children in low- and middle-income… 2022 All outcomes
Post-intervention; follow-up varied across studies (interventions ranged from <2 years to >=2 years and longer) · Primary schools in low- and middle-income countries (Southeast Asia, Africa, the Americas, Europe, eastern Mediterranean)
SMD 0.12 [-0.32, 0.55]
3 studies · 1573 participants
Very low

Primary school-based interventions (one or more of: school health policy, oral health education, healthy school environment, access to oral health services, community involvement) vs usual practice

Dental caries · Primary school children (aged 3-16 years) attending primary school in low- and middle-income countries (LMICs)

Among children aged 6-8 years, DMFT scores were significantly reduced (SMD -0.11); subgroup not separately GRADE-rated.

8 findings from 1 review

Effectiveness of primary school-based interventions in improving oral health of children in low- and middle-income… 2022 All outcomes
Post-intervention; follow-up varied across studies (interventions ranged from <2 years to >=2 years and longer) · Primary schools in low- and middle-income countries (Southeast Asia, Africa, the Americas, Europe, eastern Mediterranean) · Age 6-8 years
SMD -0.11 [-0.17, -0.04]
Studies not reported
GRADE not reported
Effectiveness of primary school-based interventions in improving oral health of children in low- and middle-income… 2022 All outcomes
Post-intervention; follow-up varied across studies (interventions ranged from <2 years to >=2 years and longer) · Primary schools in low- and middle-income countries (Southeast Asia, Africa, the Americas, Europe, eastern Mediterranean) · <=3 intervention activities
SMD -0.58 [-1.62, 0.45]
Studies not reported
GRADE not reported
Effectiveness of primary school-based interventions in improving oral health of children in low- and middle-income… 2022 All outcomes
<2 years · Primary schools in low- and middle-income countries (Southeast Asia, Africa, the Americas, Europe, eastern Mediterranean) · Intervention duration <2 years
SMD 0.01 [-0.16, 0.18]
3 studies
GRADE not reported

Show 5 more findings

Effectiveness of primary school-based interventions in improving oral health of children in low- and middle-income… 2022 All outcomes
Post-intervention; follow-up varied across studies (interventions ranged from <2 years to >=2 years and longer) · Primary schools in low- and middle-income countries (Southeast Asia, Africa, the Americas, Europe, eastern Mediterranean) · Age 8-15 years
SMD -0.41 [-0.50, -0.32]
Studies not reported
GRADE not reported
Effectiveness of primary school-based interventions in improving oral health of children in low- and middle-income… 2022 All outcomes
>=2 years · Primary schools in low- and middle-income countries (Southeast Asia, Africa, the Americas, Europe, eastern Mediterranean) · Intervention duration >=2 years
SMD -0.49 [-0.79, -0.19]
4 studies
GRADE not reported
Effectiveness of primary school-based interventions in improving oral health of children in low- and middle-income… 2022 All outcomes
Post-intervention; follow-up varied across studies (interventions ranged from <2 years to >=2 years and longer) · Primary schools in low- and middle-income countries (Southeast Asia, Africa, the Americas, Europe, eastern Mediterranean)
SMD -0.33 [-0.56, -0.10]
7 studies · 6766 participants
Very low
Effectiveness of primary school-based interventions in improving oral health of children in low- and middle-income… 2022 All outcomes
Post-intervention; follow-up varied across studies (interventions ranged from <2 years to >=2 years and longer) · Primary schools in low- and middle-income countries (Southeast Asia, Africa, the Americas, Europe, eastern Mediterranean)
SMD -0.26 [-0.70, 0.18]
5 studies · 3506 participants
Very low
Effectiveness of primary school-based interventions in improving oral health of children in low- and middle-income… 2022 All outcomes
Post-intervention; follow-up varied across studies (interventions ranged from <2 years to >=2 years and longer) · Primary schools in low- and middle-income countries (Southeast Asia, Africa, the Americas, Europe, eastern Mediterranean) · >3 intervention activities
SMD 0.02 [-0.13, 0.17]
Studies not reported
GRADE not reported