Over the past two decades, communication has changed beyond imagination. Mobile phones, laptops, portable computing devices, and the Internet have all become widely accessible and provide entirely new avenues to access information, connect, and communicate regardless of geographic location.
The definition of “social media” is broad and constantly evolving. The term generally refers to Internet-based tools that allow individuals and communities to gather and communicate; to share information, ideas, personal messages, images, and other content instantly using social media applications. One can also express his or her opinion freely and discuss multiple topics that they are interested in.
The most popular social media tools worldwide are Facebook, YouTube, Twitter, LinkedIn, Whatsapp and Instagram, but the technology is constantly evolving, and there are many more available.
Social media has brought tremendous changes in business, educational, and political systems. Moreover, dental education is no exception. Many social media tools are available for health-care professionals (HCPs), including social networking platforms, blogs, microblogs, wikis, media-sharing sites, and virtual reality and gaming environments. As its utilization increases, so must the profession's dedication to implementing and utilizing those technologies to improve patient health outcomes. These tools can be used to improve or enhance professional networking and education, patient care, patient education, and public health programs. By using technologies efficiently and securely, oral health professionals can reinforce the oral health care of the patient in both face-to-face and virtual associations. As online technologies expand and change, clinicians should remain at the forefront of technological innovation for patient-centered care. The use of diverse digital technology to educate the patients may contribute to oral and overall health development.
It is seen that today almost everyone has web access regardless of age, gender, academics, or economics. We have seen kids below 10 years with smart phones using Skype, and our grandparents exchanging photos via Whatsapp. You can safely assume that most of your target population can find links on the Internet. However so far, despite through literature, we could not find any study conducted about the impact of social media on dental treatment choices.
However, they also present potential risks to patients and HCPs regarding the distribution of poor-quality information, damage to professional image, breaches of patient privacy, violation of personal–professional boundaries, and licensing or legal issues. Many health-care institutions and professional organizations have issued guidelines to prevent these risks. Social media also helps to attract a diverse group of people that we may not have thought would be interested in oral health; working together, we can keep the oral health message alive. There are several benefits to the use of social media for health communication, the information exchanges need to be monitored for quality and reliability, and the users' confidentiality and privacy should also be maintained.
Therefore, the purpose of the present study was conducted to find out the best social media apps to impart dental health education and to evaluate the impact of social media on dental treatment choices.
MATERIALS AND METHODS
The present cross-sectional web-based survey was conducted among the users of Facebook, Instagram, and Whatsapp. Online questionnaire link was constructed using Google survey form through Gmail. Questionnaire was sent through snowball exchange, i.e., link was sent to friends or added contact person on the phone and then was forwarded to the next friend circle. It was ensured that the link was distributed to all nondental Indian professionals and personals. Participants who were under the age of 13 years were excluded from the study as ideally, they are not authorized to use these social media apps. This study was approved by the institutional ethical committee and followed the ethical guidelines of the Declaration of Helsinki.
The sample size was determined using formula N = Zα2 (P [1 − P])/d2 Where, N = Sample size, Zα = Standardized Normal Deviate at 95%, confidence level = 1.96 P = Anticipated prevalence of social media use = 38% (as derived from pilot study) d = Absolute Precision, required on either side of the prevalence = 5%. Thus, the minimum sample size obtained to conduct this study was 361. Due to the unpredictability of response, the questionnaire link was sent to a lot of social media users (around 700). All the questionnaires with even 1 incomplete response were excluded from the analysis. Thus, final analysis was done on 545 complete questionnaire responses. Due to lack of time, all the responses were analyzed in a span of 1 week.
Questionnaire used was adopted, and modified from the survey questions used by Al Awdah et al. in their study. The pilot study was conducted among 50 participants; the results of which are not included in the present data analysis. The results of the pilot study showed acceptable validity with Cronbach's α = 0.897. The validated questionnaire then included 13 questions with four domains for making dental treatment choices, i.e., demographic domain, reliability domain, the effect of advertisement domain, and influence from family/friends or celebrities domain. Few of the questions did not fit in any domains of the present questionnaire, so we illustrated the frequency analysis of major positive responses in figures. Majority of the options for all the questions were on the dichotomous scale of YES or NO and only a few questions had distinct options.
All the online responses were entered into the electronic database and were analyzed using SPSS-21 (IBM Inc., Armonk, NY, USA). Frequency distribution was used for descriptive analysis. Chi-square test was used for finding out the association between variables. Principal component analysis was performed for data reduction. The level of statistical significance was set at P < 0.05.
Frequency analysis on dichotomous scale showing the influence of social media on dental treatment choices is given in Table 1. Results of the present study showed that a higher proportion was comprised male participants and was in the age group of 21–30 years [Figure 1].
Application-wise distribution of the responses is presented domain wise in Figures 1-4 for only significant differences.
Distributions of responses based on the reliability of the information on social media (only Facebook as the maximum response was found to be in favor of the Facebook app) are reported in Figure 2. Subject's own dental experience or the experiences of their family and friends showed a significant impact on dental treatment choices on Facebook, Instagram, and Whatsapp (P < 0.05) [Figure 3]. Significantly, a large proportion of survey participants reported the effect of different social media apps on dental treatment choices P < 0.05.
The correlation matrix [Table 2] was shown by Bartlett's test of sphericity to be statistically significant (P < 0.001). According to the principal component analysis, Eigen values were found to be more than 1 for only three questions (component 1 – 26.67%, component 2-10.72%, component 3 = 9.98%), probably due to the variability of responses gathered through the survey thus results for all the components are reported in the present study.
People use social media in different countries in different ways. Brazilians are the top social media users worldwide. Social media connect like-minded communities and people and help them participate creatively in public life. Social media support the effective way to connect a diversity of people, traditions, opinions, and places with each other across the world without being restricted by the limitations of time and distance.
The present questionnaire-based survey entitled “IMPACT OF SOCIAL MEDIA ON DENTAL TREATMENT CHOICES” was a nationwide survey accommodating the responses from different cities of India, thus removing any cultural, emotional or environmental limitations.
The current survey showed that out of all the respondents, 49.5% were using Whatsapp, 36.7% were using Instagram, and 12.8% were using Facebook. According to the survey report by AudienceNet – a social and consumer research agency entitled “Social Media/Messaging Platforms in India,” it has been found that most of the Indian people prefer to use WhatsApp over any other social media app when it comes to their choice of messaging app.
It was also observed that high frequencies (81.8%) of people were found to be using social media apps multiple times a day. Approximately 60% of HCPs see social media as an avenue for delivering a better quality of life to their patients. Of course, that does not mean that there are not concerns. For instance, the ways that people choose to use Facebook can lead to negative outcomes in the form of misleading information to avail health-care services. Still, the impact social media is having and stands to have on global healthcare is a topic worth exploring as there are significant benefits and drawbacks it can cast on both patients and medical practitioners.
The highest age group that responded to the survey is 21–30 years old. This age group usually are employed, and according to a report done by Pew Research Center “Technology's Impact on Workers,” 53% of Internet users are employed full time or part time, in positions from executive to business owner to skilled and semiskilled workers. Furthermore, a high proportion of the participants had a bachelor's degree.
Although a majority of the participants (60.9%) were not following any dentist or a dental clinic, they significantly agree that dentists should communicate with people through social media rather than conventional media (89.4%). This comes in agreement with several western studies where patients appreciated the presence of healthcare providers on social media. McNab pointed out this didactic method of communication allows them to communicate rapidly and without any filtration.
This study showed that a significant number of respondents would refer to social media to get information about a dental treatment or a clinic. Almost 62.9% of the participants trusted the information they get from social media about dentistry. Hamm et al. showed that a high percentage of people were using the Internet to look up health-related information. Another survey posted by Pew Research Center in 2013 confirms that 72% of adult Internet users sought support and medical information online. Our findings also corroborated with the findings of the study conducted look by Al Awdah et al., i.e., approximately 55% of people trusted information gathered from social media. The majority (62.4%) of the participants would get affected by written experiences and criticism about dental care on social networking sites, and almost half of them get affected in choosing a dentist by the activity of their account.
Participants were asked, “what will attract them the most to visit a dentist or a dental clinic when viewing their sites on social media;” most of them chose to trust their own dental experience or someone from their family, followed by comments and opinions on social media then the number of followers of the dentist/dental clinic and lastly by the pictures posted about the case.
Furthermore, the study showed that most of the respondents to this survey get affected by their families' and friends' dental experience, followed by advertisements, and were least affected by celebrities. Fox and Duggan, also found that 68% of all adults in their study ask a friend or family member about health information. Similar findings were reported by Al Awdah et al. in their study on the power of social media on dental treatment choices. A high proportion of the participants (69.7%) claimed that they watch instructional videos uploaded on social media, but the majority of them (78.5%) do not have any applications related to dentistry.
No research comes without limitations. Although social media is considered a potential tool for health education, it requires careful application and may not always achieve the expected outcomes.
Social media can be used as a best-suited technology for assessing and resolving the various concerns or treatment choices dilemmas of the general population as it the most widely used platform in this era.
Social media as a web 2.0 of social networking has become incumbent on health professionals to promote information by the most effective means. In our opinion, social networks are an invaluable and under-utilized educational resource for most of the HCPs. If proper guidelines for the use of social media in the medical or dental fraternity are followed, there is no reason why social media cannot be used as an integral part of learning and development. In this regard, social media can be used as one of the fruitful platforms for imparting dental knowledge pertaining to dental health education or treatment choices and preferences, but the reliability of information from different social media is still narrow, but to an extent, they can be best utilized for professional networking, health communication and opinion modification for making dental treatment choices.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
The authors would like to acknowledge and thank the participants for their time and for sharing their experiences and insight.
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