Analysis of 100 Most-Viewed YouTube Toothbrushing Videos

Purpose: Parental education regarding the importance of toothbrushing and how to brush children's teeth is a key factor influencing pediatric oral health and You Tube videos have become a popular source of health information. The purpose of this study was to examine the descriptive features of the 100 most frequently viewed English-language YouTube toothbrushing videos and evaluate their usefulness relative to professional guidelines.Methods: A structured YouTube web search identified the 100 most frequently viewed toothbrushing videos during a six-month period (10/1/17 - 4/30/18). Two independent evaluators assessed each video for consistency with professional recommendations using a priori criteria. Each video was also assessed for descriptive characteristics, user engagement, and content. Comparative analyses by video source (health care professionals, commercial, and independent media) were performed, and an exploratory regression model was used to test the relationship between video characteristics and usefulness for parent education.Results: The top 100 YouTube videos were most often posted by independent media outlets (78%), targeted toward children (70%), and less than 2 minutes long (56%). Few videos aligned with professional recommendations regarding toothbrushing frequency (38%), toothbrushing duration (24%), amount of toothpaste (21%), fluoride toothpaste use (19%), post-brushing behavior (10%), toothbrush selection (4%), and toothbrush replacement (3%). A stepwise bidirectional regression model found that videos posted by health care professionals were significantly more likely to contain recommendations consistent with professional recommendations compared with other upload sources.Conclusion: The most frequently viewed toothbrushing videos were not uploaded to the Internet by health care professionals. Videos uploaded by health care professionals contained significantly higher counts of professional recommendations however, they differed in audio and visual format and production style compared to those from commercial and independent media sources.