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Cited by 76Misinformation and Its ImpactsSocial Media in Health EducationDental Health and Care Utilization

Characterization of False or Misleading Fluoride Content on Instagram: Infodemiology Study

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Lotto, Matheus, Sá Menezes, Tamires, Zakir Hussain, Irfhana, Tsao, Shu-Feng, Ahmad Butt, Zahid, P Morita, Plinio, Cruvinel, Thiago·2022·Journal of Medical Internet Research
DOI 10.2196/37519PMC PMC9164089

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Abstract

BACKGROUND: Online false or misleading oral health-related content has been propagated on social media to deceive people against fluoride's economic and health benefits to prevent dental caries. OBJECTIVE: The aim of this study was to characterize the false or misleading fluoride-related content on Instagram. METHODS: A total of 3863 posts ranked by users' total interaction and published between August 2016 and August 2021 were retrieved by CrowdTangle, of which 641 were screened to obtain 500 final posts. Subsequently, two independent investigators analyzed posts qualitatively to define their authors' interests, profile characteristics, content type, and sentiment. Latent Dirichlet allocation analysis topic modeling was then applied to find salient terms and topics related to false or misleading content, and their similarity was calculated through an intertopic distance map. Data were evaluated by descriptive analysis, the Mann-Whitney U test, the Cramer V test, and multiple logistic regression models. RESULTS: Most of the posts were categorized as misinformation and political misinformation. The overperforming score was positively associated with older messages (odds ratio [OR]=3.293, P<.001) and professional/political misinformation (OR=1.944, P=.05). In this context, time from publication, negative/neutral sentiment, author's profile linked to business/dental office/news agency, and social and political interests were related to the increment of performance of messages. Although political misinformation with negative/neutral sentiments was typically published by regular users, misinformation was linked to positive commercial posts. Overall messages focused on improving oral health habits, side effects, dentifrice containing natural ingredients, and fluoride-free products propaganda. CONCLUSIONS: False or misleading fluoride-related content found on Instagram was predominantly produced by regular users motivated by social, psychological, and/or financial interests. However, higher engagement and spreading metrics were associated with political misinformation. Most of the posts were related to the toxicity of fluoridated water and products frequently motivated by financial interests.

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  • False or misleading fluoride content online may generate fear, reduce acceptance of fluoridation and fluoride-based prevention, and worsen inequalities.

    “False or misleading fluoride content online may generate fear, reduce acceptance of fluoridation and fluoride-based prevention, and worsen inequalities (Lotto et al 2022).”

    From New Frontiers for Implementation Science in Oral Health: Digital and Equity-Driven Pathways (2026) · cites this paper as Lotto et al 2022

    The Introduction (page unavailable) says online misinformation discourages consumption of fluoridated water and oral-care products and may generate or reinforce fluoride refusal. The Discussion’s Principal Findings (page unavailable) describe users’ fears surrounding fluoridated products and water. The cited passages do not address whether misinformation worsens inequalities. (LLM, conf=0.87)

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Cited by

Sorted by citations

Authors
Lotto, M., Sá Menezes, T., Zakir Hussain, I., Tsao, S.-F., Ahmad Butt, Z., P Morita, P., & Cruvinel, T.
Affiliations
  • University of Waterloo (CA)
  • Universidade de São Paulo (BR)
Corresponding author
Cruvinel, Thiago
ORCID
Venue
Journal of Medical Internet Research
Publisher
JMIR Publications Inc.
Published
2022-05-19
Volume
24
Issue
5
Pages
e37519
ISSN
1438-8871 (ISSN-L)
DOI
10.2196/37519
PMC
PMC9164089
OpenAlex
W4224015395
Cited by
76
References
5
Citations by year
2026: 15 · 2025: 17 · 2024: 24 · 2023: 17 · 2022: 3
FWCI
21.94
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • Journal of Medical Internet Research (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
Funders
Fundação de Amparo à Pesquisa do Estado de São Paulo (2019/, 2021/)
Topics
  • Social Sciences › Sociology and Political Science › Misinformation and Its Impacts
  • Social Sciences › Health › Social Media in Health Education
  • Health Sciences › Dentistry › Periodontics › Dental Health and Care Utilization
Keywords
Instagram, social media misinformation, political misinformation, fluoride toxicity, fluoridated water, dental caries prevention, engagement metrics, sentiment analysis, topic modeling, infodemiology
MeSH terms
Infodemiology, Communication, Dental Caries, Fluorides, Humans, Social Media

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