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Cherry gumdrops bounced around the screen, knocking out teeth left and right. Within seconds, four pearly whites had fallen in the onslaught. And the next wave of tooth-decaying sweets — pink-glazed doughnuts — was fast approaching.

Welcome to “Plaque Attack,” one of America’s earliest health-related video games (which courtesy of you can actually play).

Gaming technology  is hot in the health world these days, as entrepreneurs explore ways to use video games to improve our physical and mental well-being — and our oral hygiene.


The National Institutes of Health recently awarded millions to a Seattle company and researchers at the University of Washington to develop and study a suite of dental health games, including “Attack of the S. Mutans!” and “Keep Your Teeth.” And a British group at the King’s College London Dental Institute is testing a game called “Barney’s Healthy Foods” in a randomized clinical trial to see if children who play it adopt better dental hygiene and get fewer cavities.

All that might seem cutting edge, but the concept is nothing new.


Plaque Attack, for example, was released back in 1983 for the Atari 2600. Players controlled a tube of toothpaste which flew around an open mouth, spurting red paste to protect the teeth from incoming junk food. Hit 35,000 points and Activision would mail you a congratulatory letter praising your “superior tubesmanship” and noting, “Bicuspids everywhere are resting a little bit easier tonight.”

It wasn’t actually meant as a public health initiative. A company called Activision came up with it after the game they’d been planning to showcase at the splashy Consumer Electronics Show fell through. It was up to employee Steve Cartwright to rush together a substitute.

Usually, new titles took at least three months to produce. He had just six weeks.

Cartwright copied code from another game he’d made — Megamania, a space shooter — and adjusted some of the visuals. Outer space turned into the inside of a mouth. Plaque Attack was born.

The game was supposed to be marketed on TV: “The concept for the commercial was that a tooth fairy appeared in somebody’s bedroom to tell them to brush their teeth and play Plaque Attack,” Cartwright said.  “I don’t think it ever aired.”

Also in 1983, Johnson & Johnson released its own oral hygiene Atari game. In “Tooth Protectors,” a monster dropped “snacks” — colored squares — onto teeth at the bottom of the screen. Players controlled a smiling face wielding a strand of dental floss, which deflected the snacks. The player could also call in reinforcements: A toothbrush, toothpaste, and fluoride rinse.

The game’s manual, which is available online, made a point of telling players about “the real tooth protectors” — all J&J products available for purchase at your local drug store.

Tooth Protectors
Instructions from the Tooth Protectors video game. via Atarimania


The game won over Brandon Salter, who’s now a computer programmer. But the oral hygiene message didn’t stick.“I don’t even think I thought about health at all while playing it,” he said.

The same went for Brian McConville, who was a big fan of Plaque Attack. It was, he said, just “another game to shoot stuff.”