Misinformation and Readability of Social Media Content on Pediatric Ankyloglossia and Other Oral Ties

Diagnosis of pediatric ankyloglossia and other oral ties is increasing in part due to social media, leading to more frenotomies and excess medicalization of often normal anatomy.

To assess the accuracy and readability of social media content on pediatric ankyloglossia and other oral ties.

In this cross-sectional study, the top 200 posts on an image-based social media platform tagged with #tonguetie, #liptie, or #buccaltie were collected using a de novo account on March 27, 2023. Post metadata and caption and content text were extracted.

Misinformation was judged by a 30-point scoring sheet based on clinical practice guidelines and expert consensus that was developed by 3 fellowship-trained pediatric otolaryngologist-head and neck surgeons. Readability was assessed using the Flesch-Kincaid Grade Level, Flesch Reading Ease, and Simple Measure of Gobbledygook scales. Quality was scored using the JAMA Benchmark Criteria.

After removing duplicates and irrelevant content, 71 unique posts from 68 unique accounts were included in the analysis. Business and practice accounts made up most of the account types (60 [84.5%]) compared with individual and personal accounts (11 [15.5%]). Most accounts (49 [69.0%]) were run by individuals who self-identified as health care practitioners, and 21 posts (29.6%) originated from accounts of individuals who self-identified as International Board Certified Lactation Consultants (IBCLCs). On average, the content corresponded to a ninth-grade reading level per Flesch-Kincaid Grade Level. Quality of posts as rated by the JAMA Benchmark Criteria corresponded to a median score of 3.0 (IQR, 2.0-4.0). Of the 71 posts, only 8 (11.3%) contained no misinformation. There was a significant difference in misinformation prevalence between accounts run by IBCLCs vs non-IBCLCs, with posts from IBCLCs less likely to contain over 50% misinformation (odds ratio, 0.22; 95% CI, 0.06-0.81), compared with posts from non-IBCLCs.

This study found a high frequency of misinformation in social media content on ankyloglossia. Most content was generated by self-identified health care practitioners but not physicians. Furthermore, the grade level of the content reviewed was above that recommended for the public. As the public increasingly looks to social media for medical information, health care practitioners should correct medical misinformation.