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Quality is a fundamental focus in the South African higher education context, especially in terms of the deteriorating student results in the subject Tooth Morphology and low throughput rates. This prompted an investigation into the quality, content, delivery and assessment of the subject Tooth Morphology, through which a Tooth Morphology board game was developed. It was perceived that the game could make the morphological abstractions of the subject more tangible for first-year students in the Dental Technology diploma offered at the Durban University of Technology. Arguments for the potential benefits of games in higher education have generated an increasing volume of research. The general focus of these studies, however, is based largely on empirically documented work with little theorisation about the pedagogy of games, particularly in terms of providing students with epistemological access. Using a mixed methods sequential explanatory research design this study examined the quality of pedagogy through the Tooth Morphology board game in facilitating access to the target epistemology. Analysis of evaluations of preliminary work conducted from 2003 to 2006 (n=128) and pilot work conducted in 2007 and 2008 (n=62) suggested that the game enabled students to access morphological knowledge. In the main study conducted during 2009, 2010 and 2011(n=83), data was gathered using surveys, pre- and post-tests, observational data, debriefing sessions and student focus groups. Quantitative analyses entailed using descriptive statistics, t-tests, factor analysis and cross tabulations. Qualitative analyses entailed using the conceptual frameworks of Bernstein's knowledge codes and Maton's Legitimation Code Theory (LCT) of Specialisation. Statistically, the results revealed that an integrated game design with an appropriate mix of instructional content and applicable game features and mechanisms facilitates the provision of epistemological access. An LCT (Specialisation) analysis revealed that the Tooth Morphology board game represented a knowledge code, hence students acquired access to morphological knowledge. [ABSTRACT FROM AUTHOR]