JMIR Publications

ABSTRACT

Background:

Due to declining prevalence of dental caries, non-carious tooth defects such as erosive tooth wear gained increased attention over the past decades. While patients more frequently search the internet for health-related information, quality of patient-centered online health information on erosive tooth wear is currently unknown.

Objective:

This study aimed to assess the quality of patient-centered online health information (websites and YouTube videos) on erosive tooth wear.

Methods:

German-speaking websites were systematically identified through 3 electronic search engines (google.de, bing.de/yahoo.de, duckduckgo.com) in September 2021. Eligible websites were independently assessed for (1) technically and functional aspects via LIDA instrument, (2) readability via Flesch reading-ease score test, (3) comprehensiveness of information via a structured checklist, and (4) generic quality and risk of bias via DISCERN instrument by 2 reviewers. An overall quality score generated from all 4 domains was used as primary outcome. Quality scores from each domain were separately analyzed as secondary outcomes and compared by Friedman test followed by Dunn-Bonferroni post-hoc tests. The effect of practice-specific variables on quality scores of websites from private dental offices was assessed using generalized linear modelling (GLM). Eligible YouTube videos were judged based on (1) comprehensiveness of information, (2) viewers’ interaction, and (3) viewing rate. Comprehensiveness of information was compared between websites and YouTube videos using Wilcoxon rank-sum test.

Results:

A total of 231 eligible websites and 7 YouTube videos was identified and assessed. The median overall quality of the websites was 33.6% (IQR 29.8%-39.2%). Secondary outcome scores amounted to 64.3% (IQR 59.8%-69.0%) for technical and functional aspects, 40.0% (IQR 34.0%-49.0%) for readability, 11.5% (IQR 3.9%-26.9%) for comprehensiveness of information, and 16.7% (IQR 8.3%-23.3%) for generic quality and risk of bias. While comprehensiveness of information and generic quality and risk of bias were low, technical and functional aspects as well as readability resulted in higher scores (both P_adjusted<.001/Friedman test). Regarding readability, websites from foreign private dental offices (P=.04/GLM, B=–6.64, 95% CI –12.85 to –0.42) or from dentists being a dental society member (P=.049/GLM, B=–3.55, 95% CI –7.09 to –0.01) resulted in lower scores (ie, were more difficult to read), while a shorter time since dentists’ examination resulted in higher scores (P=.01/GLM, B=0.24 per year, 95% CI 0.05 to 0.43). The comprehensiveness of information of YouTube videos was 34.6% (IQR 13.5%-38.5%). However, comprehensiveness of information did not vary between websites and YouTube videos (P=.09/Wilcoxon rank-sum test). Also, viewers’ interaction (1.7%, IQR 0.7%-3.4%) and viewing rates (101.0%, IQR 54.6%-112.6%) were low.

Conclusions:

The quality of German-speaking patient-centered online information on erosive tooth wear was found to be limited. Especially, comprehensiveness and trustworthiness of the available information was insufficient. Online information on erosive tooth wear requires improvement to inform patients comprehensively and reliably.