The Effectiveness of Peer Interaction-based Edutainment in Oral Health Promotion among Elementary School Students: A Systematic Review.

Objectives: To systematically review the effectiveness of edutainment with a peer-interaction approach in improving knowledge, attitudes, and oral health behaviors among elementary school students (aged 6-12 years). Methods: A systematic search of PubMed, Scopus, and Web of Science was conducted through July 2025 following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Methodological quality was assessed using the Joanna Briggs Institute Critical Appraisal tool. Studies were included if they utilized interactive games or social learning methods to promote oral health. Results: Eight studies met the inclusion criteria, with a predominance of quasi-experimental designs. Various edutainment modalities were identified, including board games (Snake and Ladder and Dental Jumanji), role-playing, and drama. All eight studies reported significant gains in oral health knowledge. Four studies demonstrated improved oral health attitudes, and five reported positive behavioral changes in brushing frequency. However, the quality of evidence was limited by short follow-up durations and reliance on self-reported outcome measures in several studies. Conclusion: Peer-interaction edutainment is a promising strategy for school-based oral health promotion, offering high engagement and immediate knowledge gains. However, given the predominance of quasi-experimental data and heterogeneous outcome measures, these findings should be interpreted with caution. Well-designed randomized controlled trials are required to establish the long-term sustainability of these behavioral changes.