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Dentisha’s debut

April 1, 2010
I don’t like to feel awkward when I’m trying to communicate with the parent of a child who’s been diagnosed with active dental caries and chronic gingivitis.

by Lynne H. Slim RDH, BSDH, MSDH
[email protected]

I don’t like to feel awkward when I’m trying to communicate with the parent of a child who’s been diagnosed with active dental caries and chronic gingivitis. One of the mothers I recently had to talk with was near tears after hearing the diagnosis of her child, and she looked to me for reassurance and counseling.

As an established nerd, I get excited about sharing my knowledge of cariogenic and periodontal biofilms. I eagerly accepted the challenge of educating this family and knew it would involve different educational components.

I never tire of discussing those live, amorphous, and undulating creatures that, when given the right conditions, suck the life out of our teeth and supporting tissues. While I usually feel comfortable discussing science with parents, sometimes my young and “tween” patients are difficult to reach.

Two characters from Attack of the S. Mutans include the heroine, Dentisha, and a sinister bioflim.

Teaching children about biofilm is about to move up a few notches. Thanks to a company called Firsthand Technology that was awarded a generous NIH grant, a stimulating, interactive game called Attack of the S. Mutans! is about to be released for kids ages 8 to 12. The game is part of a hands-on museum exhibit that will debut at the Pacific Science Center in Seattle, Wash., in April 2010.

I spoke with Howard Rose, president, creative director, and principal investigator at Firsthand Technology (, about this ambitious project. He said that serious games and educational simulations have emerged in recent years to give kids an immersive experience.

“The museum game is built and run on a PC,” Howard said. “It’s projected using a stereo projection system and the players wear 3D glasses. It is definitely groundbreaking as 3D screen entertainment or education, especially in a museum context. There is a lot of buzz out there about 3D movies but none of them are interactive.

“Our future plan is to take the game onto more conventional game consoles that individuals could run at home. It would also be accessible to schools, health clinics and dentist practices.”

Dental hygienists know how badly this is needed in educating kids about self-care practices, and we welcome educational innovations with open arms!

Howard also gave me a glimpse into the upcoming interactive game. A virtual character named Dentisha, an 18 to 20-something inventor, is a key player. She loves “junk-tech” projects and conducts an experiment with Streptococcus mutans in her workshop. Kids who participate in different phases of the game watch as biofilms teeming with acid-producing bacteria poop acid on teeth. Dentisha even designs a special camera so she can see biofilms on her own teeth. Eventually, she finds a small hole between two of her own adjacent teeth that is covered with biofilm. Armed with “bristle bombs,” players work to break down biofilm and end up remineralizing the teeth.

Another part of the game focuses on fluoride and enamel with acid raining down from the sky, and kids get damage points when the acid stays on the enamel too long. As kids follow Dentisha in various phases of discovery and accumulate points at various interactive exhibits, they move along what’s called the “Hall of Excuses.” Featured on the walls are educational lenticular images, which are prints that use a special lenticular lens to create 3-D or animated displays that are a lot like holograms.

It was a professional treat for me to chat with cognitive psychologist Dr. Jacqueline Pickrell, who was hired by Firsthand to conduct research on oral health practices. The psychologist’s role was three-pronged: focus groups of 8- to 10- and 11- to 12-year-olds and their parents were formed to help establish a baseline of current knowledge, beliefs, and practices. Information gleaned from these focus groups helped develop the game content and monitor structure to maximize motivational techniques.

Each group included discussion and focused questioning about oral health beliefs and behaviors and the current pop culture of “tweens.” While all participants felt brushing their teeth was very important, and the majority believed a person should brush twice a day, only 30% reported brushing twice a day or more on a regular basis. Discussions revealed that all kids felt they were doing a good job brushing their teeth, even when the dentist told them they should be brushing better or longer.

The parents pointed out that what dentists had to say had little or no impact on changing their children’s behaviors. Half of the children reported enjoying a trip to the dentist, while the next largest group of about 30% said they didn’t care about going one way or another. About 16% reported some fear of the dentist. While all children believed that not brushing would lead to cavities and that food left on the teeth would cause cavities, the knowledge about plaque build up was stronger in the older participants. All children in the focus groups were impressed with the idea that bacteria “poops” acid on teeth, and they acknowledged the role of acid in destroying enamel and leading to holes in teeth.

One clear discrepancy between the parent and child reports had to do with brushing habits. The children reported they needed only occasional reminders to brush while parents reported their children’s lack of motivation to brush was their biggest problem.

Parents reported trying numerous fear, punishment, and reward tactics, but said these attempts to improve behavior were ineffective. New electric toothbrushes, colored rinses, and various other gimmicks motivated children initially but only for short periods of time.

Evaluation of the new interactive game includes an extensive research program, including a randomized, controlled study by the Department of Dental Public Health Sciences (DPHS) at the University of Washington. The effectiveness of the final exhibit will be evaluated to determine if children’s attitudes, knowledge, and motivation will change their oral health behaviors.

Lynne Slim, RDH, BSDH, MSDH, is an award-winning writer who has published extensively in dental/dental hygiene journals. Lynne is the CEO of Perio C Dent, a dental practice management company that specializes in the incorporation of conservative periodontal therapy into the hygiene department of dental practices. Lynne is also the owner and moderator of the periotherapist yahoo group: Lynne speaks on the topic of conservative periodontal therapy and other dental hygiene-related topics. She can be reached at [email protected] or

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