JMIR Publications

ABSTRACT

Background:

Oral health is a vital determinant of overall well-being and quality of life. Treating oral pathologies can be expensive and is often not covered by universal healthcare. Individual behaviors, such as oral hygiene practices, plaque control, and dietary habits, play a central role in oral health. Motivation is a crucial factor in promoting behavior change, and gamification offers a means to boost health-related knowledge and encourage positive health behaviors.

Objective:

Evaluate the impact of gamification and its mechanisms on oral healthcare of children and adolescents.

Methods:

A systematic search covered multiple databases: Pubmed/Medline, PsycINFO, The Cochrane Library, Science Direct, and Lilacs. Grey literature, conference proceedings, and WHOQOL internet resources were considered. Studies from January 2013 to December 2022 were included, except for Pubmed/Medline, which was searched until January 2023. Fifteen studies were selected following PRISMA guidelines. Eligibility criteria were: peer-reviewed, full-text, empirical research related to gamification in oral healthcare, reports of impact and oral healthcare outcomes. Exclusion criteria encompassed duplicate articles, unavailable full texts, non-original articles, non-digital game-related, non-oral health-related, and protocol studies. Selected studies were scrutinized for gamification mechanisms and outcomes. Two main questions were raised " Does gamification in oral healthcare impact oral health?" and "Does oral healthcare gamification enhance health promotion and literacy?" PICO framework guided the scoping review.

Results:

Initially, 617 records were obtained from five databases and grey literature sources. After removing duplicates and records that did not meet inclusion criteria, 15 records were selected. Sample size in the selected studies ranged from 34 to 190 children and adolescents. A significant portion, 73% (11/15), of the studies discussed oral self-care applications supported by evidence-based oral health. The most clearly defined information’s in the applications were “brushing time” 100% (11/11) and “daily amount brushing” 91% (10/11). Most studies, 73% (11/15), mentioned oral healthcare behavior change techniques and included "prompt intention formation" 42% (11/26), "providing instructions" 42% (11/26), "providing information on the behavior-health link" 38% (10/26), "providing information on consequences" 35% (9/26), "modeling or demonstrating behavior" 35% (9/26), "providing feedback on performance" 31% (8/26), and " providing contingent rewards" 31% (8/26). Furthermore, 80% (12/15) of the studies identified game design elements incorporating gamification features in oral hygiene applications. The most prevalent gamification features were "ideological incentives" 83% (10/12) and "goals" 56% (9/16), found in user-specific and challenge categories, respectively.

Conclusions:

Gamification in oral healthcare shows potential as an innovative approach to promote positive health behaviors. Most studies reported evidence-based oral health and incorporated oral healthcare behavior change techniques. Further research is needed to better understand the clinical, psychological, and social factors influencing the selection of effective gamification mechanisms. While the use of mobile health in oral healthcare is still emerging, gamification has proven effective in enhancing individual health-related practices. Clinical Trial: No trial registration.