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ABSTRACT
Background
Oral diseases and public knowledge of these diseases remain a critical concern, necessitating innovative approaches in communication to promote oral health to the public. TikTok’s popularity offers a potential avenue for patient education, as well as misinformation. This study examines the quality of dental-related content on TikTok.
Methods
This study is an observational mixed-methods analysis of TikTok videos with #dentist. Engagement metrics and sentiment were quantified. Quality assessment utilized validated the PEMAT-A/V (Patient Education Materials Assessment Tool for Audiovisual Materials) and DISCERN instruments. Videos posted by dental professionals and nonprofessionals were compared.
Results
Of 1,550 videos reviewed over a three-month period, 75.5% were posted by dental professionals. Additionally, videos posted by dental professionals had higher engagements compared with videos posted by non-dental professionals. Video sentiment often conveyed fear or humor. Quality assessment revealed moderate to low scores, with videos posted by dental professionals exhibiting higher scores.
Conclusions
TikTok videos with the #dentist are posted and engaged with. Videos posted by dental professionals receive more views, likes, comments and shares compared to videos posted by non-dental professionals. The quality of healthcare information varies but is of overall low to moderate quality. There is the potential for dental professionals to post and promote high-quality evidence-based oral health information on TikTok which can impact the oral health knowledge and perceptions of the public.
Introduction
Oral health is one of the most unmet health care needs in adolescents.Citation1 Unlike early childhood caries, caries incidence among adolescents has not been declining. According to the Centers for Disease Control and Prevention three in five adolescents from the ages of 12 to 19 have caries, while 15% have untreated decay.Citation2 Adolescents have specific oral health concerns, including high rates of caries, increased sugar intake, poor dietary habits, potential alcohol and drug use, and an increased prevalence of orthodontic care.Citation1 As adolescence is an impressionable time to create long-term habits, dentistry needs innovation for oral health promotion for this group.
Emerging social media platforms can provide opportunities for health communication and patient education. TikTok is a video-based social media platform that launched in September 2016. In 2022, TikTok had more than 1 billion active global monthly users. The average American viewer watched TikTok for 80 min a day.Citation3 As of July 2023, videos listed under the hashtag #dentist had over 36.2 billion views. Sixty-three percent of American adolescents use TikTok on a weekly basis.Citation4 TikTok contains many videos about dentistry; however, the public's engagement with these videos and quality of information is largely unknown.
The current research on dental content on TikTok includes a study that evaluated the quality and reliability of 148 TikTok videos on dental implants. Researchers concluded that these videos had low to moderate quality of information and that TikTok may not provide reliable information. Other researchers have looked at the content, reliability, and quality of orthodontic TikTok videos. In one study, they concluded that the quality was moderate, while another study concluded that the quality and reliability of the content were “very low.”Citation5,Citation6 Researchers in France assessed 69 videos with the hashtag #oralhealtheducation and determined that TikTok users were more satisfied with videos, while oral health professionals were less satisfied with the content.Citation7
This study aimed to assess the quality of dental-related content on TikTok by describing and characterizing videos with #dentist, analyzing quality of these videos and comparing videos posted with #dentist by dental professionals and non-dental professionals.
Methods
Search Strategy
This was an observational, mixed-methods descriptive analysis. A structured review of the video sharing platform TikTok was conducted over a three-month study period in 2022. Videos were searched for including #dentist. Every two weeks the top one hundred all-time most-liked #dentist videos were reviewed. This identified the most popular videos with #dentist. Additionally, daily the fifteen most liked #dentist videos that were uploaded within the past twenty-four hours were reviewed. This identified the most-popular recently posted videos with #dentist. Videos were included in the study if they were tagged with #dentist. Videos that were not in English or not relevant to dentistry were excluded. TikTok videos are publicly available and this study was deemed IRB exempt as not including human subject research (#22–36451).
Measures
Quantitative Analysis
The number of views, likes, comments, and shares were recorded for each video. Each video was categorized by its uploader type as being posted by a dental professional or non-dental professional. Uploader type was determined by reviewing the profile of the individual posting the video. If the username included the title doctor, or user descriptions including doctor (DDS/DMD), dental assistant (RDA), dental hygienist (RDH/RDHAP), or described themselves as a dental student, then the video was identified as being posted by a dental professional. If a video depicted a specific treatment discipline, this was further categorized. Other user types were identified by reviewing the profiles of video posters. Additional poster type categories identified included dental offices, profiles that post memes, company/industry, patient/layperson, comedian, parent/guardian of patient, and other.
Qualitative Coding
A qualitative evaluation and coding approach was adapted from DISCERN, the PEMAT-AV, and previous published studies.Citation8–11 Our codebook consisted of intended validity, narrative reliability, video production, and video sentiment (). Video coding was completed by one author with calibration and review of 40 charts for consensus on coding structure by two authors. Coding was completed for a set of videos for the designated study time span and did not intend to reach saturation.
Table 1. Qualitative codebook applied to all videos analyzed. This includes intended validity, narrative reliability, video production, video sentiment.
Intended validity classified whether the uploader aimed to provide useful information. Examples of videos that were not informative included those in which uploaders were dancing or lip-syncing in a dental office without providing relevant dental information. Narrative reliability classified whether the uploader was “misleading” or “intended to inform.” Examples of misleading information included incorrect facts about dentistry or dental professionals harming a patient during a skit. Video production categorized the types of video editing and props used. Video sentiment categorized the video’s overall mood or attitude.
Content Quality Analysis
The PEMAT (Patient Education Materials Assessment Tool)Citation12 and the DISCERN instrumentCitation13 were used to describe and evaluate video content as patient education resources. The PEMAT-A/V is a validated tool that measures understandability and actionability of patient education resources. The DISCERN instrument is a reliable and valid method used to assess treatment-related health information and has been previously used to evaluate video content, including TikTok.Citation8,Citation14–17 If dental treatment was depicted in the video, the DISCERN instrument was used to measure the quality of patient education resources. The DISCERN instrument is a reliable and validated tool that is designed to help evaluate consumer health information to determine the quality of information about healthcare treatment.
The PEMAT-A/V tool answered sixteen questions with Agree, Disagree, or Not Applicable regarding the content of the TikTok video posted. The PEMAT-A/V tool is separated into two domains, understandability and actionability.
If dental treatment was depicted in a video, the DISCERN instrument was applied. Section one of DISCERN measures if the video is reliable. Section two of the DISCERN instrument measures the quality of information provided on healthcare treatment. The final section of the DISCERN instrument measures the overall quality of the information presented.
Statistical Analysis
Video demographics were analyzed using descriptive statistics.
Data was analyzed to determine statistically significant differences between videos posted by dental professional and non-dental professionals. Data was analyzed in aggregate by daily (recently posted) top liked video or a bi-weekly (all time) top liked video. Distribution and normality of data was reviewed through histograms. Mann-U Whitney tests were applied to continuous variables. Chi-square tests were applied for count and categorical variables. If Chi-square tests identified a difference in data distribution between the two groups, a pairwise analysis with Bonferroni correction was used. The statistically significant p-value was set a < 0.05. Investigators reviewed for inclusion and exclusion criteria and extracted study data from the videos. Calibration of the investigators was performed on 40 videos after training until 90% agreement was met (Cohen’s kappa score 0.9 or higher).
Results
A total number of 1,550 videos were reviewed over the study period: 1,050 most-liked videos published the day they were assessed and 500 most-liked videos of all time, assessed every two weeks. Five hundred and forty-five videos did not meet the inclusion criteria. A total of 1,005 were included in the final analysis.
Video Uploader Demographics
A total of 759 (75.5%) of videos were posted by dental professionals (). Most videos posted by a dental professional were posted by someone who identified themselves as a dentist (71.5%).
Table 2. Description of distribution of video uploaders including if the video was uploaded by a dental professional, type of dental provider, and dentist type or specialty. Video uploader type identified with an *, were included as “dental professionals” in the analysis.
Videos were posted by a variety of dental disciplines. Most videos were posted by a general or unknown specialty dentists (n = 547), followed by videos posted by pediatric dentists (n = 118), oral surgeons (n = 25), orthodontists (n = 19), and periodontists (n = 10). Of the videos uploaded by non-dental professionals, 58% were (n = 224) were videos uploaded by patients or laypeople.
Video Engagement
Daily Top Liked Videos
Daily top liked videos posted by dental professionals had a median of 74,100 (Interquartile Range (IQR) 192,00) total views, compared with non-dental professionals 7,130 (IQR 16,103). This data did not follow a normal distribution. Daily top liked videos posted by dental professionals with #dentist had a statistically significant higher number of views, likes, comments and shares compared with videos posted by non-dental professionals (p < 0.001) ().
Table 3. Video likes, comments, shares, and followers for videos posted by non-dental professionals, dental professionals, and all videos in aggregate.
All Time Top Liked Videos
The all-time top liked videos with #dentist had a median of 10,200,000 (IQR 14,200,000) total views. All-time top liked videos posted by dental professionals had a median of 12,900,000 (IQR 16,300,000) total views, compared with non-dental professionals 6,900,000 (IQR 7,600,000). This data did not follow a normal distribution. All-time top liked videos that were posted by dental professionals with #dentist had a statistically significant higher number of views, likes, comments and shares compared with videos posted by non-dental professionals (p < 0.001) ().
Video Production, Content, and Sentiment
The most common props used were radiographs and/or intraoral photographs (n = 441). Five hundred and eighty-eight videos depicted dental treatment, with 481 of such videos depicting in-office dental procedures and 126 specifically depicted scaling and/or calculus removal. The most common content in videos was music in background (n = 657), healthcare workers (n = 413) and exposé (273). In videos uploaded by dental professionals, the most common primary video sentiment was fear (39.13%), followed by neutral (25.03%), humor/parody (25.43%), and empathy (10.41%) (). For non-dental professionals, the most common video sentiment was humor/parody (55.28%). Chi-square test results comparing video sentiment distribution between dental and non-dental professionals, showing raw and Bonferroni corrected p-values. Statistically significant differences are observed in the sentiments of fear, humor/parody, and neutral, while no significant difference is found in empathy. (p < 0.001).
Table 4. Primary sentiment of each video for videos posted by dental professionals, non-dental professionals and all videos in aggregate.
Narrative Reliability (PEMAT and DISCERN)
Overall, the quality scores of videos posted with #dentitst were lower in the PEMAT-A/V Actionability Domain (19.91%), compared with the Understandability Domain (77.57%) (). There was no statistically significant difference in the PEMAT-A/V understandability score between videos posted by dental professionals and non-dental professionals (p = 0.79). In the PEMAT-A/V Actionability, both dental and non-dental professionals had overall low scores; however, videos posted by dental professionals had a statistically significant higher score (p < 0.001).
Table 5. PEMAT-A/V and DISCERN scores by section for videos posted by dental professionals, non-dental professionals, and all videos in aggregate.
The DISCERN instrument was applied to 591 videos depicting dental treatment (). There was a statistically significant difference between average DISCERN scores for videos posted by dental professionals’ (median = 3) and non-dental professionals (median = 2). Videos posted by dental professionals had a higher overall DISCERN assessment compared to videos posted by non-dental professionals (p < 0.001). This data did not follow a normal distribution.
Discussion
Videos with #dentist had a very high level of engagement, and there is an opportunity for the dental profession and oral health advocates to use social media to promote oral health, especially given the high prevalence of TikTok use among adolescents.Citation18 While there are known risks and challenges to using social media to promote health, this method of communication has also been recognized as having the potential to educate large groups of individuals.Citation19,Citation20 Importantly, the dental profession must understand that information related to dentistry and oral health already exists on social media and the dental profession should be actively involved in promoting social media related to dentistry that is evidence based.
Audiences that do not have high oral health literacy or routine access to dental professionals can potentially receive oral health knowledge through the TikTok application. According to the American Dental Association, oral health literacy is defined as the degree that “individuals have the capacity to obtain, process and understand basic health information and services needed to make appropriate oral health decisions.”Citation21 Several videos created by dental professionals explained dental procedures using vocabulary that was easy to understand. For example, starting last year, a dental professional created a series of TikToks in which they explain dental procedures and processes to their viewers. In one video, they display a video of scaling and root planing in the background while speaking directly to the camera. They state the tartar used to be soft and can be cleaned by brushing and flossing, but once hardened by minerals and saliva, a deep cleaning is needed to remove the tartar. They point out that ultrasonic scalers are used to vibrate off the tartar in little chunks. This dentist’s attempt to improve their viewers’ oral health literacy by defining keywords in a simple way should be modeled by other dental professionals on TikTok as well as other social media websites. Some comments from viewers included “running to brush my teeth” and “it’s life changing to get something like that removed.” However, most videos depicting scaling and root planing do not have any explanation as to what is occurring on the screen, and the viewer is left to depend on reading the comments section to try to understand what they are watching. With the TikTok Creator Fund, dental professionals also have the potential to earn an additional income by making videos.Citation22 The American Dental Association outlines some advantages of using social media for marketing.Citation23 Compared to traditional marketing strategies such as print, social media is less expensive and can be more powerful. ADA’s Guidelines for Practice Success includes a checklist for engaging in social media to guide dental professionals to effectively use these applications; this includes determining one’s target audience, the content’s tone, and purpose, and creating a content calendar to pre-arrange topics to post.Citation24
Overall, the videos with #dentist were of low quality, with their overall average DISCERN score indicating “potentially important but not serious shortcomings” as indicated by the DISCERN instrument in the quality of information presented. Information presented in videos posted by dental professionals was statistically different in quality score compared to non-dental professionals but was still assessed overall as moderate quality. This is similar to studies regarding other medical procedures and conditions.Citation10,Citation25
Based on the TikTok videos included in this study, only a handful of dental professionals are taking advantage of the opportunity that social media provides as a powerful tool for education and advocacy for patients, especially adolescents who frequently use social media. Some dental professionals do use their platform to educate their patients using everyday language, visual cues, easy-to-read text, and videos of dental procedures and processes. Many use TikTok to participate in trends, such as dancing, using popular audio clips, or dialogue. For example, a recent viral trend involves the TikTok user highlighting a part of their identity and stating daily situations they encounter by starting the video with, “I’m [insert particularity], of course …” A dental professional participated in this trend by saying that they will “ask you to floss more,” “ask you to open wide,” and “tell you you’re their favorite patient.” This trend gently pokes fun at stereotypes associated with one’s profession or identity. While it is not meant to be educational, it allows viewers to see dentists in a different light. But it becomes troublesome when misinformation is spread or fear is instilled. The primary video sentiment identified in our analysis of videos posted by dental professionals was fear. This is especially concerning if his or her fearful presentation is being observed by children and adolescents who frequent social media and TikTok. This has the potential to negatively impact one’s perception of dentistry and oral healthcare from a young age. One example of a video which was coded with the primary sentiment of fear included a dentist supposedly walking out of a patient room, putting on sunglasses, walking to music, while the text on the screen reads: “Me after destroying your gums with my sharp instruments and telling you that your gums bleed because you don’t floss” (). Another example is a close-up recording of a deep dental cleaning in which the teeth are covered in calculus; after the ultrasonic scaler removes calculus, blood seeps from the gums, while the theme song from the horror film “Halloween” plays in the background (). These videos do not present a positive portrayal of the dental professional or dental care, yet were posted by dental professionals themselves. Portraying fearful videos on social media has the potential to increase individuals’ exposure to negative portrayals of dentistry. The dental profession should carefully consider its participation in contributing to social media posts that have the potential to elicit fear in viewers.
Figure 1. An example of a TikTok video posted with the sentiment categorized as “fear.” In this video, a dentist is supposedly walking out of a patient room, putting on sunglasses, walking to music while the text on the screen reads: “Me after destroying your gums with my sharp instruments and telling you that your gums bleed because you don’t floss.”
Figure 2. An example of a TikTok video posted with #dentist with the sentiment categorized as “fear.” The video portrays a close-up recording of a deep dental cleaning in which the teeth are covered in calculus; after the ultrasonic scaler removes calculus, blood seeps from the gums, while the theme song from the horror film “Halloween” plays in the background.
There are several ways that dental professionals can utilize TikTok to educate viewers. TikTok’s format encourages short, visually appealing content that is highly engaging. Short, engaging videos on topics such as proper brushing and flossing techniques, the importance of fluoride, and debunking common dental myths would be useful to the typical TikTok user. Dental professionals could host live question & answer sessions to address common concerns and misconceptions in real-time, providing personalized advice and building rapport with viewers. Behind-the-scenes glimpses of dental procedures can demystify the process and alleviate patient anxiety. As mentioned before, many dental professionals participate in popular TikTok trends; incorporating them into their educational content could reach a wider audience and increase engagement. Advocacy campaigns promoting the importance of water fluoridation or tobacco cessation would raise awareness about important oral health issues. Adolescents are the most susceptible to initiating tobacco use and are also developing their oral hygiene habits. As one of the primary audiences for TikTok and social media, dental professionals have the opportunity to use TikTok to engage adolescents. Finally, incorporating humor such as puns, jokes, or funny sketches into educational content can make TikTok videos more relatable and shareable. TikTok continues to grow, especially among younger demographics. Many turn to the platform as a source for information and entertainment. By establishing a presence on the social media platform, dental professionals can reach a larger audience, especially those who do not usually engage with traditional forms of dental education, dental education could become more accessible and relevant.
Recently, lawmakers in the United States, Canada, and Europe have been attempting to restrict access to TikTok due to potential security threats. India banned TikTok in mid-2020, while in May 2023, a bill was signed banning TikTok in the state of Montana; several states banned TikTok on government-issued devices, while some colleges blocked it from campus Wi-Fi networks and a national TikTok ban could be placed into U.S. law.Citation26–28 Besides these privacy concerns, healthcare professionals should also consider Health Insurance Portability and Accountability Act (HIPAA) when posting videos of patients and potentially sharing protected health information.Citation29,Citation30 The ADA offers five rules of engagement for both dentists and dental team members regarding social media: 1. Do not post copyrighted material without permission or citation from the content owner, 2. Do not disclose the practice’s confidential information, 3. Do not post information about a patient or employee, including a testimonial, photograph, radiograph, or name without the appropriate written consent, 4. A designated individual should monitor all social media posts for compliance, and 5. Maintain the final approval for posts. In this study, there were many videos in which patients were clearly seen, but it is unknown as to whether the dental professionals who recorded the videos received appropriate written consent.
This cross-sectional study has several weaknesses. This study was conducted over a short time period. Thus, the findings of this study may not be generalizable. Also, trends in social media can change and evolve rapidly. Many dental-related videos may have used a different hashtag than #dentist or no hashtags at all and were thus not included in this study. Another weakness of this study is that we only evaluated each video and did not evaluate individual users. We also relied on self-reported roles as dental professionals. While anyone who called themself a “doctor” on social media was included in the analysis of dental professionals, it is likely that not all individuals who portray themselves as professionals on social media are. This is another potential source of misleading or misinformation, as individuals can misrepresent themselves on social media. A longer prospective analysis of the use of social media and dentistry is warranted.
Conclusion
Videos with the #dentist are posted and engaged with on the social media platform TikTok.
Videos with #dentist posted by dental professionals receive more views, likes, comments and shares compared to videos posted by non-dental professionals.
The quality of healthcare information in videos with #dentist varies but is of overall low to moderate quality.
Institutional Review Board
This study was deemed exempt by the Institutional Review Board at the University of California San Francisco (#22–36451).
Disclosure Statement
No potential conflict of interest was reported by the author(s).
Additional information
Funding
Notes on contributors
Reeva Darren Gestre
Ms. Reeva Darren Gestre is a fourth year student at the University of California San Francisco School of Dentistry, she will earn her Doctor of Denta Surgery Degree in June 2025. She graduated from the University of California Los Angeles with a degree in Psychobiology.
Jean Marie Star
Dr. Jean Marie Star is a pediatric dentist and full time Assistant Professor of Clinical Orofacial Sciences at the University of California San Francisco.
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