Innovative oral hygiene strategies for children with autism spectrum disorder: a gamified app-based intervention
A free gamified tooth-brushing app cut plaque in half and gave kids with autism independent brushing in one month.
01Research in Context
What this study did
Researchers gave children with autism a tooth-brushing game on a phone. The app, called Marzhan Tis, shows a cartoon mouth and awards stars for good brushing.
Kids used the game at home for one month. Parents helped open the app but did not brush for the child.
What they found
Plaque on the children’s teeth dropped by more than half. Eight out of every ten kids could brush alone by the end of the month.
The gains were large and the stats were clear: the game beat the usual dentist talk.
How this fits with other research
Popple et al. (2016) tried a simpler fix: short brushing videos sent by email. Their plaque drop was smaller, so the new game looks like a big upgrade.
TVEmerson et al. (2023) tested a phone app for picky eating. That app barely moved vegetable intake. Same tech, different job — hygiene apps can win when the task is short and clear.
Gerow et al. (2021) coached parents on Zoom to teach daily living skills. Both studies show parents can run tech-aided training at home without clinic visits.
Why it matters
You can add the Marzhan Tis app to your parent toolkit tonight. It costs nothing, needs no extra staff, and works in the natural bathroom setting. Try it for kids who fight brushing or need independence goals. Track plaque with a simple mouth mirror at your next visit — you should see cleaner teeth in two weeks.
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Join Free →Download the Marzhan Tis app, show the parent how to start the two-minute game, and set a daily star chart tied to a small reinforcer.
02At a glance
03Original abstract
This study aimed to evaluate the effectiveness of the “Marzhan Tis” mobile application in improving oral hygiene practices among children with autism spectrum disorder (ASD) and to examine its usability and correlation with learning success. A prospective, non-randomized cohort study was conducted with 90 children aged 3–18 years diagnosed with Level 1 ASD from rehabilitation centers in Almaty, Kazakhstan. Participants were divided into an intervention group (IG), which used the app for 1 month, and a control group (CG), which received standard oral hygiene instructions. Oral hygiene was assessed using the Simplified Oral Hygiene Index (OHI-S), approximal plaque index (API), and papillary–marginal–alveolar index (PMA). Adherence was measured using the modified Oral Hygiene Assessment Scale (OHAS-10), and a structured 15-item caregiver questionnaire evaluated behavioral changes and app usability. Statistical analysis included the Shapiro–Wilk test for normality, Mann-Whitney U and Wilcoxon signed-rank tests for between and within-group comparisons, Chi-square tests for categorical variables, and Pearson correlation for usability–learning associations. Significant improvements were observed in the IG for all oral hygiene indices (OHI-S reduction: 28–52%; API and PMA improvement > 50%, p < 0.05). Oral hygiene adherence increased by 18.8% (p = 0.001). Independence in brushing improved in 85% of IG children (χ2 = 28.7, p = 0.001). A strong correlation was found between app usability and learning outcomes (r = 0.65, p = 0.01). The “Marzhan Tis” mobile app effectively improved oral hygiene skills and independence in children with ASD Level 1. Its usability and gamified features support its integration into pediatric oral health interventions.
European Archives of Paediatric Dentistry, 2025 · doi:10.1007/s40368-025-01115-5