GUM: Gum Understanding Mission-A Serious Game to Improve Periodontitis Literacy Among University Students

Background/Objectives: Periodontitis represents a significant global health burden, yet preventive health literacy remains critically low among emerging adults-a developmental stage where lifelong health behaviors crystallize. This study evaluated the effectiveness of the GUM (an acronym of Gum Understanding Mission) game, an interactive gamified digital tool incorporating AI-informed or manual feedback, for improving periodontitis literacy among tenth-semester Software Engineering students at the University of Guayaquil. Methods: In a controlled pre-test/post-test experiment, 50 participants were randomly assigned to either the GUM game intervention or a traditional lecture. Both groups completed identical knowledge assessments immediately before and after their respective 50-min instructional sessions. The GUM game featured adaptive questioning, immediate elaborated feedback, and comprehensive performance analytics, while the control group received instructor-led didactic instruction with a subsequent question-and-answer session. Results: The GUM group improved from a baseline of 21% to 94% correct responses, while the lecture group increased from 22% to 67% (p<0.001). Error reduction was 74% in the GUM group versus 45% in the control group. However, the study's scope is currently limited to a single, digitally literate cohort, and knowledge retention over time was not assessed. Conclusions: These findings suggest that a self-directed, feedback-driven serious game can substantially outperform traditional methods in fostering periodontitis literacy within this population. Further research is needed across diverse populations with extended follow-up periods to assess knowledge retention and generalizability.