The Evidence Base of Fluoride Videos on TikTok

The fluoride controversy has intensified in recent years, partly due to new research suggesting negative health effects. Simultaneously, TikTok has become a prominent platform for disseminating oral health-related content, but its accuracy remains uncertain. The purpose of this study is to evaluate TikTok videos addressing fluoride use, comparing the characteristics of videos which are evidence-based to those which are not.

A quantitative content analysis was conducted of the first videos (N = 120) which met the search criteria: provided by TikTok in response to the search string, 'fluoride vs. no fluoride'; publicly accessible; and English-language content. Videos were viewed and coded on the following seven variables: message content (evidence base); source; fluoride position; editing style; length; view rate (views/month); and interaction index (likes/views). Data analysis included descriptive statistics, Pearson Chi square, independent-samples t-tests and Mann-Whitney U tests.

Only 22.5% of the videos were evidence-based and only 40.0% were pro-fluoride, although 54.1% of the sources were health professionals. Evidence-based videos were more likely to be produced by health professionals (χ² = 7.18, df = 2, p = 0.028), carry a pro-fluoride message (χ² = 11.91, df = 2, p = 0.003), and be longer (t = 2.16, df = 118, p = 0.033) than videos without an evidence base. The evidence-based videos did not significantly differ in editing style, view rate, or interaction index.

People using TikTok for clarity on fluoride are less likely to find evidence-based videos, and those videos tend to be pro-fluoride, feature health professionals and be longer than videos which are not evidence based.