JMIR Publications

ABSTRACT

Background:

Dental care expenses are reported to present higher financial barriers than any other type of health care service in the United States. Social media platforms such as Twitter have become a source of public health communication and surveillance. Previous studies have demonstrated the usefulness of Twitter in exploring public opinion on aspects of dental care. To date, no studies have leveraged Twitter to examine public sentiments regarding dental care affordability in the U.S.

Objective:

The aim of this study was to understand public perceptions of dental care affordability in the U.S. on the social media site, Twitter.

Methods:

Tweets posted between September 1, 2017 and September 30, 2021 were collected using the Snscrape application. Query terms were selected a priori to represent dentistry and barriers to affordable care. Data were analyzed qualitatively using both deductive and inductive approaches. Ten percent of all included tweets were coded to identify prominent themes and subthemes. The entire sample of included tweets were then independently coded into established thematic categories. Quantitative data analyses included: geographic distribution of tweets by state; volume analysis of tweets over time; distribution of tweets by content theme.

Results:

A final sample of 5,314 tweets were included in the study. Thematic analysis identified the following prominent themes: 1) general sentiments (1614 tweets, 30.4%); 2) delaying or forgoing dental care (1190 tweets, 22.4%); 3) payment strategies (1019 tweets, 19.2%); 4) insurance (767 tweets, 14.4%); and 5) policy statements (724 tweets, 13.6%). Geographic distributions of tweets established California, Texas, Florida, New York as the states with the most tweets. A word cloud revealed that “insurance”, “need”, and “work” were the most frequently used words. Qualitative analysis revealed barriers faced by individuals to accessing dental care, strategies taken to cope with dental pain, and public perceptions on aspects of dental care policy. The volume and thematic trends of tweets corresponded to relevant societal events: The Coronavirus disease 2019 (COVID-19) pandemic and debates on healthcare policy resulting from the election of President Joseph Biden.

Conclusions:

Findings illustrate the real-time sentiment of social media users toward the cost of dental treatment and suggest shortcomings in funding that may be representative of greater systemic failures in the provision of dental care. Thus, this study provides insights for policy makers and dental professionals who strive to increase access to dental care.