Cultural Adaptation in Music-Based Oral Health Education: A Comprehensive Review

Music-based oral health education is widely used to promote preventive behaviors among children, as rhythm and melody are thought to enhance memory and knowledge retention. As these interventions have expanded across culturally distinct populations, adaptation efforts have frequently emphasized linguistic translation while leaving visual imagery, musical structure, and embedded cultural values largely unchanged. This review examines the extent to which music-based oral health interventions for children reflect genuine cultural adaptation rather than translation alone. Using a comparative qualitative approach, the review synthesizes evidence from pediatric oral health, music cognition, behavioral theory, and cross-cultural adaptation science, examining how linguistic content, visual imagery, musical structure, and embedded social values shape cultural responsiveness. Findings indicate that interventions developed collaboratively within target communities show greater cultural responsiveness than standardized programs applied with minimal adaptation, which often retain unfamiliar elements that may plausibly reduce engagement and limit music-based education’s mnemonic benefits. Existing interventions rarely draw on established cultural adaptation frameworks; adjacent literatures on cultural adaptation suggest that adaptation depth may be relevant to intervention outcomes, though this relationship has not been directly tested for music-based programs specifically. These findings suggest that translation alone is insufficient for culturally responsive music-based oral health education. This review proposes the Four-Dimension Music-Based Cultural Adaptation (MBCA) framework to guide future design and evaluation of such interventions.