Researchers have found that misleading online content, from fluoride myths to DIY dentistry, is widespread, but there is still little direct evidence that it changes patient behavior or clinical outcomes.
Research: Online oral health misinformation and information quality: A scoping review. Image credit: PeopleImages/Shutterstock.com
recent BDJ open A scoping review mapped how oral health misinformation and the quality of online information are defined, measured, and reported. We also investigated whether patient-level outcomes were directly investigated.
The problem of misinformation in healthcare
Misinformation in healthcare refers to false, misleading, or unconfirmed information that can influence public perception or patient decisions. It can spread rapidly through social media algorithmic systems and user-generated content.
The problem of online misinformation can be particularly problematic in the dental industry as it relates to aesthetic trends and the popularity of home treatments. Because some dental products are treated as cosmetics (such as some toothpastes in Australia), marketing claims may be subject to less stringent regulations in many jurisdictions. Online promotions like this can quickly gain visibility on platforms like Instagram and shape public perception.
Misinformation online can foster distrust and anxiety about professional care. Misinformation about root canals and fluoride is debated in the dental community. However, there has been little systematic synthesis of dental-focused academic literature. The current study revealed how research defines misinformation and several other aspects related to low-quality online information about oral health.
A review of online oral health misinformation
Because research in this area includes a variety of terminology and models and spans multiple online platforms, a scoping review approach was adopted. The population included producers or consumers of oral health information, and the central interest was to assess the quality of online oral health misinformation and related information.
Studies published in English that directly assessed misleading, false, or unsubstantiated claims were also included. Various online platforms and social media sites were considered. Last search date was June 26, 2025, and 864 records were retrieved (Scopus: 288, Web of Science: 357, Ovid Medline: 219). However, only 61 cases reached the final dataset.
From each study, the definition of misinformation or related concepts assessed were extracted. Engagement metrics (likes, comments, shares, number of followers, etc.) were also highlighted. Findings were grouped thematically and described what tools and alternatives were used, how misinformation and quality of information were studied, and whether patient-level effects were inferred or directly measured.
The authors also distinguished between misinformation and related measures such as information quality, reliability, readability, promotional framework, and regulatory compliance, noting that low-quality information is not automatically considered false.
Heterogeneity between platforms and key content themes
The review notes that extensive social media research suggests that content is algorithmically amplified or visually optimized. You might get more engagement. YouTube was the most studied platform, appearing in 34.4% of papers. High-scoring videos within individual studies were typically uploaded by professional or academic sources. Instagram appeared in 27.9% of studies, primarily dealing with aesthetic marketing and fluoride narratives. There was also evidence that low-quality and misinformation was available through web searches and general browsing. Few studies featured Facebook, X, and TikTok, and the content mainly focused on orthodontic and aligner-related short videos.
Studies covered a variety of topics, but the most common were fluoride and water fluoridation. Cosmetic and esthetic dentistry was the focus of four studies, although some studies assessed the reliability and quality of information about root canal treatment. Do-it-yourself (DIY) remedies feature prominently in three studies examining short-form content on TikTok and YouTube. There were repeated concerns about unreliability and incomplete disclosure regarding dental implants. Other topics included orthodontics and aligners, tobacco-related oral health claims, and biological dentistry.
Evidence of misinformation and patient-level effects
Across topics and platforms, information quality did not correlate with platform engagement. The most viewed, liked, and shared posts aren’t necessarily the ones that score higher on high-quality tools. a A significant proportion of the offending content involved promotions that featured exaggerated claims about professional qualifications, implants, whitening, and aligners. Competent authority audits noted a lack of balance, disclosure, and verifiability, but enforcement outcomes were rarely discussed or evaluated in writing.
Patient-level evidence was less common, with only 29 studies addressing patient behavior or health-related outcomes and only 17 addressing harm or treatment delay. Although most of the evidence is indirect, areas of concern remain. The study presented findings related to preventive, trusting, and anxiety behaviors as plausible hypotheses and evidence gaps rather than established causal relationships.
Gaps in the literature and recommendations reported by included studies
This review identified several important gaps in the current evidence. Most notably, few studies have directly investigated whether exposure to online oral health information influences patient behavior, dental visits, or treatment delays. Researchers have also found little evidence comparing interventions across different online platforms, and relatively few studies have tested strategies to counter misinformation. The authors noted that the results may not be broadly generalizable because some population groups remain underrepresented, while inconsistent definitions and research methods make it difficult to compare studies and build a stronger evidence base.
Many of the included studies conclude with recommendations for future research, clinical practice, and policy. Several suggested that evidence-based information should be presented in a way that is appropriate for individual online platforms to increase the likelihood of reaching and engaging audiences. Two studies specifically call for targeted education, clearer enforcement standards, and more active monitoring.
Other recommendations include creating clear, evidence-based resources that are easy for the public to find, encouraging greater involvement of dental professionals and academic societies, strengthening regulation and oversight, improving public health education, and fostering closer collaboration between public health agencies, social media platforms, and professional societies.
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