A newly developed digital app called Happy Teeth may improve children’s knowledge about oral health, indicating that game-based education may be more effective than traditional methods. The study was recently published in BMC Oral Health.
Additionally, the app’s interactive games and quizzes designed around oral health may increase awareness of healthy eating, the authors wrote.
“Gamification appears to be a promising adjunct to traditional oral health education,” wrote the authors, led by Bahareh Tahani, PhD, of the Isfahan University of Medical Sciences Dental School in Iran (BMC Oral Health, December 30, 2025).
The study evaluated whether the Happy Teeth app improved oral health knowledge, behaviors, and clinical outcomes in school-age children compared with traditional education alone. The clinical trial included 108 children ages 8 to 9 from elementary schools in Iran. Participants were randomly assigned to the intervention group or the control group, and both groups received one session of standard oral health education, they wrote.
The intervention group used the game for three to four weeks, which featured interactive minigames, quizzes, and a tower-defense strategy tied to oral health behaviors. Outcomes measured at baseline and three months later included oral health knowledge, plaque index scores, dietary behavior, and self-reported oral hygiene practices.
Knowledge scores increased significantly in the intervention group overall (p = 0.008), while the control group showed only small gains overall. Difference-in-difference analysis confirmed that knowledge improvements were significantly greater in the intervention group than the control group. Also, dietary behavior scores improved after the intervention, they wrote.
Plaque index scores declined slightly in both groups, but the mean change did not differ significantly between the intervention and control groups (-0.28 ± 0.89 versus -0.59 ± 0.89; p = 0.08), and brushing frequency showed no significant changes within or between groups. Furthermore, 87% of children liked the game, 70% to 80% found it attractive, and 44% were satisfied with its novelty. Among parents who responded, 56% viewed it as effective, and 68% would recommend it to others.
The study, however, had limitations. Further research with a longer follow-up period is needed to better identify changes in habits and plaque levels, the authors added.
“The results highlight the potential value of incorporating enjoyable, interactive tools within school-based oral health programs,” Tahani and colleagues wrote.
