UCSF

Background: Twitter is a social networking site that has become a leading global real-time communications platform. Twitter users post brief 140-character long messages (`tweets') on a variety of topics. To date, it is not known what parents are saying about their children's oral health on Twitter.

Purpose: The purpose of this study was to understand parents' actions and perceptions towards their child's oral health on the Twitter.

Methods: Publically available tweets on Twitter were extracted from 14 randomly selected non-consecutive days in December 2012 and January 2013. A total of 1451 tweets meeting the search criteria were extracted and, after excluding ambiguous or irrelevant tweets, a total of 1073 tweets were included and analyzed. Tweets were coded using pre-established non-mutually exclusive categories.

Results: The 1073 included tweets were coded into 5 main categories: attitude (n=606, 56.6%), event (n=535, 49.9%), action (n=499, 46.5%), concern/question (n=203, 19%), and behavior (n=77, 7%). The proportions of tweets with negative (n=321, 53.0%) and positive (n=285, 47.0%) attitudes expressed by parents were similar. The most frequent reported events included eruption (n=237, 44.3%), exfoliation (n=194, 36.3%) and grinding (n=62, 11.6%). The most frequently reported actions were general dental appointment (n=204, 40.9%), prevention (n=165, 33.1%), and extraction (n=44, 8.8%). A majority of the tweets describing children's behaviors were negative (n=55, 71%) rather than positive (n=22, 29%) ones. The most frequent concerns and questions were about esthetics (n=57, 28%), eruption (n=34, 17%) and dental home/access to care (n=27, 13%).

Conclusions: Twitter can serve as a rich source of data on parental perceptions and actions towards their child's oral health. Parents report their child's dental events, actions and behaviors, as well as express concerns, questions and attitudes on Twitter. Parents frequently report their child's dental visits. Among those who report an attitude about these dental visits, only 1 in 3 are positive. Future research is warranted to understand factors contributing to positive and negative attitudes toward pediatric dental care. As Twitter evolves the way society interacts and communicates, it is critical for oral health professionals to actively monitor and engage in the dialogue to improve societal health and well-being.