Comparative Evaluation of Game-Based, Demonstrational, and Interactive Educational Approaches for Oral Health Promotion Among School-Age Children

Oral health education is a fundamental component of preventive dentistry, but children’s engagement across different educational approaches remains an important area of investigation. This study aimed to comparatively evaluate observed behavioural engagement associated with interactive, demonstrational, and game-based educational approaches among school-age children. A pilot, school-based comparative observational study was conducted among 60 second-grade students at a primary school in Sofia, Bulgaria. A standardized 40 min educational session included three approaches: interactive PowerPoint presentations, demonstrations with dental models and visual tools, and game-based activities emphasizing toothbrushing skills and dietary habits. Children’s engagement was assessed using three indicators: active participation and willingness to engage, confidence, and interaction with the educational materials. The game-based approach demonstrated the highest proportion of children classified in the “Very High” engagement category across all indicators. The average proportion of “very high” performance was 63.4% for the game-based approach, compared with 27.8% for the demonstrational approach and 22.8% for the interactive approach. Children participating in game-based activities demonstrated higher observed levels of participation, confidence, and interaction with educational materials. Game-based educational activities were associated with higher observed engagement during oral health education. These findings highlight the potential value of game-based activities for engaging children in oral health education. Further research using randomized designs, validated assessment instruments, and independent observers is needed to determine whether these differences in observed engagement are reproducible.