Playful and game-based oral health education for children in Latin America

Introduction: Dental caries remains frequent among children in Latin America, and schools and clinics often teach oral hygiene through games, puppets and other playful formats. No regional synthesis was identified. Methods: Systematic review following PRISMA 2020 of reports published from 2013 to 2025 in English, Spanish or Portuguese, searched in five databases. Eligible studies evaluated playful or game-based oral health education in children and adolescents living in Latin America and reported knowledge, plaque, hygiene or gingival outcomes. Results: A total of 24 studies from seven countries were included, 12 of them from Brazil. Two were randomized, 4 were controlled and non-randomized, and 18 were uncontrolled before-after studies. Knowledge improved in 13 of the 15 studies that measured it, and plaque or hygiene indices improved in 14 of 15. Gingival outcomes were reported by 2 studies. In the 6 controlled comparisons, the playful arm was equal or better than the comparator on every reported outcome. Risk of bias was critical in 16 studies, serious in 2, of some concern in 1, and not assessable in 5. Conclusions: Playful education is associated with better knowledge and plaque control in Latin American children, but the evidence is mostly uncontrolled, short term and of very low certainty, and it does not allow estimates of effect size or conclusions on gingival health.