This group received the AOTSM game experience followed by additional oral health information. They did not receive any follow-up treatment after the exhibit.

Instead of playing Attack of the S. Mutans!, children in the control group attended a 90 minute classroom session about virtual reality applications for relieving pain and for therapy. This content was unrelated to oral health.

Children assigned to the Treatment-Plus conditions not only had the Attack of the S. Mutans video game experience, but also gained access to an educational website that reinforced the exhibit's teachings two months later. These students received a special login and password in the mail and were instructed to visit the site before completing their next questionnaire.

A research assistant led groups of students through the Attack of the S. Mutans exhibit. All participants played all the games and viewed all the graphical content of the exhibit.

Follow-up surveys were conducted at 3 points after the intervention for all groups. The survey included questions about the children's attitudes (self-efficacy) toward oral health and taking care of their teeth. Surveys were paper-pencil self-reports from both parents and children. Items were drawn from Morowatisharifabad and Shirazi, (2007) and adapted for ease of understanding for English speaking children.

Separate surveys of children and their parents were conducted at 3 points after the intervention all groups. The survey included questions about how often and how well the children took care of their teeth.

we assessed children's oral health knowledge in two ways. First, children reported their overall oral health knowledge using three-point rating scales (=not really to 3=mostly) to respond to six items, including, "By brushing and flossing my teeth, I am less susceptible to tooth decay." Negatively worded items were reverse-coded, and the estimated internal consistency (Cronbach's alpha) of the pre-game survey was.49. Second, children indicated their brushing knowledge using five-point rating scales (1=strongly disagree to 5=strongly agree) to respond to four items, including "Tooth brushing gets rid of bad breath."