JMIR Publications

ABSTRACT

Background:

Behavioural management in pediatric dentistry is a core yet challenging component of dental education. Traditional teaching methods have limitations in providing standardized, repeatable, and risk-free practice for behavioural management, digital simulation tools offer new solutions. However, the design principles, implementation strategies, and effectiveness of digital and gamified simulation tools lack systematic review and evaluation.

Objective:

This systematic review aims to systematically evaluate the design, implementation, and educational effectiveness of digital and gamified simulation tools in pediatric dental behavior management education.

Methods:

Following the PRISMA guidelines, 6 databases were searched from 1st January 2015 to 10th December 2025. Included studies involved dental educators and trainees, with interventions consisting of digital simulation tools (e.g., 2D/3D, VR, AR, gamification, AI chatbots) for behavioural management training. Standardised tools were used for the risk of bias assessment.

Results:

A total of 20 studies were included. Haptic Virtual Reality Systems (HVRS) demonstrated advantages in enhancing specific procedural skills and were perceived by students as improving understanding and operational confidence. VR scenario simulations enhanced students’ empathy and self-efficacy in communicating with child patients, although this effect required reinforcement through repeated use. An AR simulator significantly improved the efficiency of local anesthesia administration. 3D-printed models and role-playing with professional actors were notably effective in enhancing clinical realism and communication skills. AI-driven chatbots effectively improved the oral health knowledge and behaviours of children’s caregivers. However, most studies emphasised that these digital tools should serve as an effective “complement” rather than a “replacement” for traditional teaching.

Conclusions:

Digital and gamified simulation tools provide substantial support for teaching behavioural management in pediatric dentistry, demonstrating unique value particularly in cultivating procedural skills, empathy, and communication techniques. Current evidence supports their beneficial integration and role as a complement to traditional teaching methods. Clinical Trial: PROSPERO (Registration number: CRD420251177517).