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The impact of social media on the selection of dentists based on their social media presence among residents of Vojvodina, Serbia: a cross-sectional study

Abstract

Background

Considering the widespread use of social media, it is unsurprising that dentists are increasingly drawn to these platforms as a means of connecting with patients and sharing valuable insights. The aim of this research is to examine the influence of social media on the selection of dentists among residents of the Vojvodina province in the Republic of Serbia.

Methods

This cross-sectional study surveyed residents of Vojvodina, Serbia, aged 18 years and above, with an account on at least one social media platform. Dentists and dental students were excluded. The questionnaire was divided into three sections: sociodemographic information, social media usage habits, and the influence of social media on the selection of dentist/dental clinic. Descriptive statistics and chi-squared test were used for categorical variables. Binary logistic regression analysis was used to determine the associations between sociodemographic characteristics and the decision to select a dentist based on social media presence.

Results

In this study, 983 participants were involved, with the majority being female (79.5%) and aged between 18 and 25 years (46.7%). Over half of the respondents (60.3%) stated that they would not select dentists based on their social media profiles, with a significant difference across age groups (p鈥<鈥0.001). The main advantage of social media was quick access to information (67.2%), while disadvantages included the promotion of harmful trends (62.4%) and concerns about credibility (55.4%). Binary logistic regression analysis revealed that age (95% CI: 1.144鈥2.983; p鈥<鈥0.001) and educational level (95% CI: 0.472鈥0.891; p鈥<鈥0.05) were significant predictors for selecting dentists based on their social media presence.

Conclusion

Social networks do not play a crucial role in selection of a dentist among the residents of Vojvodina. Age and educational level were significant predictors for selecting dentists based on their social media presence.

Peer Review reports

Introduction

Over the years, social media has evolved beyond personal networking, establishing itself as a crucial platform for information exchange and professional engagement, including in healthcare [1, 2]. Today, these platforms allow users to share information, engage in discussions, and explore different viewpoints on various topics [3, 4]. According to the Digital 2024: Global Overview Report, 90% of the Serbian population uses the internet and 70.3% of these individuals have social media profiles. YouTube is the most popular platform in Serbia, followed by Instagram, Facebook, TikTok, LinkedIn, and Twitter [5].

With its widespread use, social media provides valuable opportunities for dental professionals to connect with both existing and potential patients [2]. By sharing educational content and patient experiences, dentists have the chance to establish friendly relationships with those seeking their services even before they visit the clinic [6, 7]. This can help reduce anxiety surrounding dental visits, which positively impacts patients鈥 willingness to seek treatment [8, 9].

However, alongside its benefits, social media also presents certain risks. While rapid information dissemination can improve healthcare communication, it can also lead to spread of misinformation and promoting potentially harmful trends, raising concerns about accuracy and credibility in health-related content [2, 10, 11]. Additionally, issues like patient privacy and commercialization of healthcare services remain complex and contentious [12,13,14]. Advertising in healthcare is often seen as inconsistent with the dignity of the profession, which should prioritize health and patient well-being. Traditionally, patients鈥 recommendations and positive clinical reviews were the primary ways of attracting new patients [15, 16]. Yet, as patients鈥 expectations evolve and the demand for informed healthcare choice increases, a social media presence enables dental professionals to meet these needs. Today, it is widely accepted that healthcare providers can ethically promote their work, as long as the information shared is accurate, transparent, and respects patients鈥 rights to privacy [15, 17].

Research on social media鈥檚 influence on healthcare choices has been conducted in different regions worldwide. For instance, studies in Saudi Arabia [18] and Kuwait [19] have shown that platforms like Instagram and Facebook affect patients鈥 healthcare choices, with users often consulting online reviews and shared experiences. Similarly, research from Turkey [20], Indonesia [21] and the United Kingdom [8] indicated that patients appreciate dentists who actively engage on social media, as this engagement fosters a sense of trust and connection. These findings reflect a global trend of social media playing a role in healthcare decision-making, highlighting the importance of examining this impact in specific regions.

In the Republic of Serbia, the number of dentists in public healthcare system is relatively low due to limited funding for dental services, which are primarily available for children, students, pregnant women, and certain special patient categories [22]. In Vojvodina, a Serbian province with a population of about 1.7听million, private dental practices far outnumber public ones, with approximately 600 private clinics in the region [23]. Novi Sad, the largest city in Vojvodina with around 415,000 residents, is home to over 300 of these practices [24]. Consequently, residents are frequently exposed to social media content from private dental clinics which may influence their perceptions and choices when selecting a dentist and dental clinic.

Despite this exposure, there is a lack of research investigating the impact of dentists鈥 social media content on patients鈥 choices in Vojvodina. To address this research gap, the study aims to explore the influence of social media on residents鈥 choices when selecting a dentist and dental clinic, with an added focus on understanding which types of posts respondents find most useful. Additionally, the study seeks to gather participants鈥 perspectives on the advantages and disadvantages of social media posts by dental professionals. By examining these preferences and insights, this research will contribute to a deeper understanding of how social media is shaping patient-dentist relationships.

Materials and methods

Study design and participants

This was a cross-sectional study using an original questionnaire based on a literature review. The data collection phase lasted six months, from January to June 2023. The inclusion criteria were residents of the Vojvodina province in Serbia, aged 18 years and above, who had an account on at least one social media platform. Those excluded from the study were dentists, dental students, participants younger than 18 years, those living outside the territory of Vojvodina, and those who did not have an account on any social media platform.

Sampling and sample size

Based on a 5% margin of error, 95% confidence level, 50% response distribution, and the population size of Vojvodina, Serbia (鈮堚1,750,000), a minimum sample size of 385 respondents was determined [24, 25].

Survey design

The questionnaire consisted of 23 questions divided into three sections (See Additional file 1). The first section focused on sociodemographic information, including gender, age, educational level, employment status, and place of residence. The second set of questions examined participants鈥 social media usage habits, including the specific social media platforms they used, whether they followed dentist or dental clinic accounts, and which platforms they preferred for that purpose. In the final section, participants were asked about the influence of social media on their selection of dentists or dental clinics, preferred types of posts, and how dentists鈥 posts on social media impacted their fear of dental procedures and knowledge of oral health. Additionally, questions on the advantages and disadvantages of social media were included.

The questionnaire included a mix of dichotomous questions, questions with specific options, and multiple-choice questions. Dichotomous questions covered topics such as gender, residential area, social media presence, following dental clinics on social media, whether social media helped expand their oral health knowledge, and whether it was their primary source of oral health information. Questions with specific options addressed demographic details such as educational level, time spent daily on social media, and factors influencing the selection of a dentist on social media. Multiple-choice questions focused on the types of social media platforms used by respondents, on which social media platforms they follow dentists, and perceptions of the greatest advantages and disadvantages of social media.

Questionnaire validity and reliability

After the questionnaire was created, it was reviewed by a committee consisting of three dentists, three dental students, and three residents of Vojvodina. Each member of the committee individually assessed each question using a 4-point Likert scale, where 1鈥=鈥塶ot relevant, 2鈥=鈥塻omewhat relevant, 3鈥=鈥塹uite relevant and 4鈥=鈥塰ighly relevant. The content validity index (CVI) was calculated based on their ratings, resulting in a value of 0.89. In addition to rating the questions, committee members were also able to leave comments beside each question. Based on their feedback, a few linguistic modifications and final semantic adjustments were made. Further review of the literature also confirmed the face validity.

To assess test-retest reliability, we asked 10 individuals to complete the survey initially, and then they repeated the survey after a one-week interval. The consistency of their responses was evaluated using kappa statistics. This test focused on the questions 12 to 23 (except Q11, Q15 and Q16).

The construct validity of the last section of the questionnaire was assessed for the entire sample using factor analysis. The Kaiser鈥慚eyer鈥慜lkin measure of sampling adequacy was 0.695, and Bartlett鈥檚 test of sphericity was 1123.138 (p鈥<鈥0.001). These results indicated that the variables were within the normal range and suitable for inclusion in factor analysis. Exploratory factor analysis revealed one factor with an eigenvalue greater than 1.0, with the item factor loadings ranging from 0.329 to 0.825. This indicates that this domain, which includes all the questions from the last section of the questionnaire examining the influence of social media in dentistry among participants, explains 40.434% of the total variance.

Questionnaire distribution

The authors distributed the questionnaire (in the form of an online Google Form) using various social media platforms such as Facebook, Instagram, WhatsApp, and Viber. The respondents were asked to forward the survey to their networks. Additionally, the survey was regularly updated at predetermined times in groups related to residences in Vojvodina, Serbia. This increased response rates and the survey鈥檚 visibility within participants鈥 timelines. Participants also received a cover letter, along with the questionnaire, explaining the purpose of the study and ensuring confidentiality. Participation in the research was voluntary without financial compensation. The participants were allowed to withdraw from the study during the completion of the questionnaire. To ensure that all participants consented to the use of their responses for research purposes, they were required to answer a dichotomous (yes/no) question at the beginning of the questionnaire: 鈥淒o you agree to have your responses used for the purpose of writing a scientific article?鈥. Those who answered 鈥渘o鈥 to this question but submitted their responses were excluded from the study. The research methodology ensured respondents鈥 anonymity by utilizing Google鈥檚 privacy policies.

Statistical analysis

All data obtained from participants were transferred to SPSS Statistics for Windows version 27 (IBM Corporation, Armonk, NY, USA). Descriptive statistics including frequency distributions and percentages were calculated for categorical variables. The chi-squared test was performed to determine the statistical significance of differences between groups.

Binary logistic regression analysis was conducted to examine whether independent variables (gender, age, educational level, area of residence, employment status, and type of dental care - public or private) were associated with the choice of a dentist based on their social media profile (coded as 1 for 鈥測es鈥 and 0 for 鈥渘o鈥). Prior to analysis, it was confirmed that there was no multicollinearity among the independent variables. Results were interpreted within a 95% confidence interval, with p鈥<鈥0.05 considered statistically significant.

Ethical aspects of the research

The study was conducted according to the guidelines of the Declaration of Helsinki. Ethical approval for the research was obtained from the Ethics Committee of the Faculty of Medicine Novi Sad, Serbia (No.: 01鈥39/297/1). Every survey included an informed consent statement, which assured the participants of the confidentiality of their responses through an anonymous questionnaire. In addition, they were informed that their participation was voluntary and that they could complete the questionnaire at any time without any consequences.

Results

In this study, a total of 983 participants were involved. The majority of participants were female (79.5%) and aged between 18 and 25 years (46.7%). Furthermore, the highest percentage resided in urban areas (86%) and visited dentists working in the private sector more frequently (73.3%) (Table听1).

Table 1 Sociodemographic characteristics of the respondents (n鈥=鈥983).

The majority of the respondents had accounts on Facebook (95.3%) and Instagram (89%) (Fig.听1). Regarding daily usage, the highest percentage of respondents (58.5%) spent one to three hours per day on social media. There was a statistically significant difference across age groups (p鈥<鈥0.001) (Table听2).

Fig. 1
figure 1

Prevalence of social media usage among participants and following dentist accounts on social media.

Approximately 54.8% of the respondents reported that they followed any dentist or dental clinic accounts on social media. There was a statistically significant difference regarding gender (p鈥<鈥0.05) and age groups (p鈥<鈥0.05) (Table听2). Figure听1 illustrates that the majority of respondents who followed dentists鈥 accounts mostly did so on Instagram (43.3%) and Facebook (29.4%). 60% of the respondents stated that they would not select a dentist based on their social media profile. There was no statistically significant difference in this regard between genders, but there was a statistically significant difference across age groups (p鈥<鈥0.001) (Table听2).

Table 2 Participants鈥 responses regarding social media and dental practice by gender and age categories.

Comments on posts (46.4%) were identified as the most significant parameter associated with the dentist鈥檚 profile among respondents who stated that they would select a dentist based on their social media profile (Fig.听2).

Fig. 2
figure 2

The most influential parameters regarding dentists鈥 social media profiles among respondents who would select dentist based on social media presence.

Participants perceived posts about patients鈥 experiences as the most helpful (37.5%), followed by photographs demonstrating the dental treatment results (before and after posts) (25%). Approximately 20% of respondents believed that dental posts on social media were not helpful (Fig.听3).

Fig. 3
figure 3

The most helpful posts regarding dentists鈥 social media profiles among respondents.

The main advantages of social media, as identified by most respondents, were quick and easy access to information (67.2%) and the availability of educational content for all ages (48.3%). In contrast, the main disadvantages included the promotion of potentially harmful trends (62.4%) and concerns about the credibility and accuracy of information (55.4%) (Fig.听4).

Fig. 4
figure 4

The main advantages and disadvantages of social media among participants.

Posts from dentists on social media helped the majority of respondents to increase their knowledge about oral health (63.3%). There was no statistically significant difference in relation to gender, but there was a statistically significant difference among the different age groups (p鈥<鈥0.001). Most respondents (57.5%) stated that they were not afraid of dental procedures. Among those who experienced fear, 43.5% noted that posts helped them overcome their fear, with statistically significant difference among gender (p鈥<鈥0.05). The majority of respondents (78%) said that social media is not their main source of information about dental procedures. There was no statistically significant difference in relation to gender, but there was a significant difference in relation to age groups (p鈥<鈥0.05) (Table听3).

Table 3 Participants鈥 responses to dental-related posts on social media by gender and age group.

The results of binary logistic regression analysis showed that age (p鈥<鈥0.001) and educational level (p鈥<鈥0.05) were significant predictors for selecting dentists/dental clinics based on their accounts on social media (Table听4).

Table 4 Multivariable binary regression model; Association between independent variables and selecting dentists based on their social media presence

Discussion

The oral health is a public concern in the Republic of Serbia, where high rates of dental caries, periodontal disease, and edentulism are often exacerbated by limited access to dental care. Approximately 600 private dental practices employ around 650 dentists across Vojvodina [23]. Yet, the majority are concentrated in urban centers, leaving smaller towns and rural areas with limited or no access to dental services [26]. The study aimed to explore the role of social media in influencing residents鈥 choices when selecting a dentist and dental clinic. It also investigated which types of posts respondents found most helpful and gathered their views on both the advantages and limitations of social media in relation to content shared by dental professionals.

The majority of participants in our study had Facebook (95.3%) and Instagram (89.3%) accounts, mirroring trends noted in the Digital 2024: Global Overview Report, which ranks Facebook, Instagram, and YouTube as the top platforms in Serbia [5]. These patterns align with findings from Saudi Arabia and Kuwait [19, 27]. Over half of our participants (58.5%) spent 1鈥3听h daily on social media, with younger individuals, particularly those aged 18鈥25, leading in usage听(Table 2). This finding is consistent with global averages and research showing higher activity levels among younger generations [5, 28,29,30].

More than 50% of our participants followed a dentist or dental clinic account, a notably higher percentage than that reported in similar studies [31,32,33]. Female participants were significantly more likely to follow these accounts than male participants (Table听2). This trend may partly reflect the gender imbalance in our sample, as women often place higher value on social media interactions and are more inclined to follow health-related content, including dentistry [34]. Additionally, social media platforms, especially Instagram, are often focused on aesthetics and visual content. Since dental services are frequently associated with aesthetic aspects, women may be more interested in following dentists鈥 content on these platforms [35]. Respondents aged 26鈥35 years were notably more likely to engage with dentists on social media (61%). This age group, familiar with digital technologies, frequently turns to online platforms for information due to their internet proficiency, critical thinking skills, and growing trust in social media as a source of reliable information [36].

Most participants who followed a dentist or dental clinic on social media preferred Instagram (43.4%), followed by Facebook (29.4%) (Fig.听1). In contrast to findings from India, where YouTube was the primary platform for dental information [33, 37]. We believe that Instagram鈥檚 user-friendly interface and the ability to browse public accounts likely contributed to its popularity among our participants, allowing easy access to images and videos posted by dentists [38].

Although 67.2% of respondents in our study highlighted quick and easy access to information as a benefit of social media (Figs.听4), 60.3% stated that they would not select dentist/dental clinic based on its social media presence (Table听2). The majority of participants (62.4%) expressed concern about the promotion of potentially harmful trends, and more than half (55.4%) questioned the credibility and accuracy of information. In study conducted in Kuwait [19], some participants were influenced by social media posts to try new products, while some claimed that such posts led them to make incorrect oral health decisions. However, in contrast to our study, more than half respondents from the same research [19], would select a dentist based on their social media presence. This disparity can be explained by the higher percentage of Kuwaiti participants (76.3%) following a dentist on social media compared to our study (54.8%), reflecting the complexity and dynamics of social media.

As shown in Fig.听3, those who would select a dentist based on their social media presence primarily considered the number and type of comments on dentists鈥 profiles (46.41%), followed by patient experiences shared by dentists (37.5%). However, it is important to note that social media reviews can be subjective and may not always accurately reflect quality of the services offered by dentist [39]. Individuals have different standards and expectations, which can influence their ratings. Furthermore, some dentists or clinics may pay for fake positive reviews, or even negative reviews to harm competitors [40], which can significantly distort the true picture of service quality. Moreover, before-and-after photos of dental procedures that promise quick and miraculous results can create unrealistic expectations among patients, leading them to expect similar outcomes without fully understanding the complexities involved.

It seems that the majority of respondents in our study are aware of limitations of social media as a source of information. Although most participants reported that posts from dentists expanded their oral health knowledge, only a small percentage considered it their primary source of information (22%), even among youngest categories (26%) (Table听3). This suggests that individuals across all age groups may still rely more on traditional sources of information, such as advice from healthcare professionals, family members, or friends when making decisions about dental procedures [41]. Older individuals, in particular, may place more trust in traditional sources of information or view social media as less reliable for healthcare information [42]. The level of trust in social media content can also vary depending on the culture and social norms. For instance, in India [31], a majority of respondents (56.6%) trusted posts from dentists on social media, whereas research by A Vinita Mary et al. [33] showed that many participants were neutral regarding the information they receive from dentists on social media. While social media offers significant potential for health promotion, it should not be considered a replacement for traditional, trusted sources of health information [2]. Health-related content on social media is often simplified to fit the platform鈥檚 format, which can lead to an oversimplification of complex health issues. Unlike official medical recommendations, social media posts are not subjected to rigorous review by medical experts [43]. As a result, dentists may unintentionally or, in some cases, intentionally share information that is not scientifically supported or may be outdated. This can lead patients to make decisions based on incomplete or misleading information obtained from social media, potentially resulting in the selection of inappropriate treatments or neglect of necessary dental care.

According to various studies, approximately 10鈥20% of the population experiences significant dental anxiety, which can range from mild apprehension to severe phobia, affecting individuals鈥 willingness to seek dental care [44]. In our study, 42.5% of respondents reported fear of visiting dentists, which is higher than the global average. This may be attributed to the higher proportion of female participants, as studies indicate that women are more likely to experience dental anxiety [44]. Among those who reported fear, 56.5% felt that dentists鈥 social media posts did not help alleviate it听(Table 3). Buchanan et al. [45], suggest that online support groups can be valuable role in providing understanding for individuals facing dental phobia. While social media posts can offer useful information and support, deeply rooted dental fears may require additional support beyond online content, such as professional reassurance or therapy.

Furthermore, the results of multivariable binary logistic regression analysis revealed that age and educational level were significant predictors of selecting a dentist/dental clinic based on their social media presence听(Table 4). The probability of participants aged 18 to 25 years selecting a dentist/dental clinic based on their social media account was 1.848 times greater compared to those older than 46 years (95% CI: 1.144鈥2.983; p鈥<鈥0.001). These findings are consistent with those reported by other studies [46, 47]. Additionally, participants with a high school education were 1.54 times less likely to select a dentist/dental clinic based on their social media presence compared to those with the highest level of education (95% CI: 0.472鈥0.891; p鈥<鈥0.05). This finding concurs with the results obtained in other studies suggesting that better educated individuals are more likely to utilize online resources [48, 49].

While the study provides insightful data on the role of social media in selecting dentist, there are limitations regarding sample population. The generalizability of the findings is constrained due to regional differences, as Vojvodina generally has a higher level of educational attainment and a more diverse population compared to other parts of Serbia. Additionally, the survey participants were not evenly distributed across gender and age groups, with a higher proportion of female and younger respondents. In both Vojvodina and Serbia, females outnumber males. Consequently, gender differences in survey participation are consistently observed, with women being more likely to respond than men, especially in mail or web-based cross-sectional surveys [50]. However, the proportion of female respondents in our study (nearly 80%) is higher than in similar studies, where females typically account for around 60% of the sample [32]. This gender imbalance is difficult to explain, given a significant lack of understanding about the individual reasons for (non)participation in academic research [50]. Available evidence indicates that males who adhere to traditional masculinity norms often exhibit less interest in engaging in constructive communication with others and authorities [51]. These gender differences contribute to lower survey participation rates among men in patriarchal societies. As Serbian society is still based on a traditional male-female social organization model, this might have led to a lower response rate among men in our research. Moreover, reliance on self-reported data raises the possibility of bias because those who were more interested in the subject may have been more likely to participate [52]. Additionally, a limitation of this study is that the questionnaire has not been tested for reliability, which may impact the consistency.

Considering the growing reliance on social media as a source of health-related information, it is crucial to further explore how dental professionals can leverage these platforms effectively. Building on the findings of this study, future research should focus on investigating how dental professionals can use social media to build trust, challenge misconceptions, and provide evidence-based information to the public. Future studies could analyze the effectiveness and engagement of different social media platforms individually to understand which platforms are more influential in healthcare choices. Expanding the study to include diverse regions outside of Vojvodina or a cross-national sample could reveal regional or cultural differences. Additionally, research could explore whether social media impacts patients鈥 choice of specific dental interventions across various branches of dentistry, which may highlight unique preferences or informational needs related to each specialty.

Conclusion

Currently, social media is not a sufficiently reliable source for patients when selecting a dentist. Despite the widespread use of social media platforms, a significant proportion of participants stated that they would not select a dentist/dental clinic based solely on their social media profiles. Notably, age and educational level were identified as significant predictors for selecting dentists based on their social media presence. Social media offers quick access to information. However, concerns persist regarding the promotion of potentially harmful trends and the credibility of shared information. These findings underscore the importance of understanding social media鈥檚 influence on healthcare decision-making and highlight the need for ethical promotion and dissemination of information by dental professionals on social media.

Data availability

The dataset utilized in the analysis of this study is available upon request from the corresponding author, dr. Marija Stojilkovi膰, via email. Readers interested in accessing the data may submit a formal data borrowing application to the corresponding author via email. Subject to reasonable requests, the author will facilitate the provision of the dataset associated with this study.

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Acknowledgements

We would like to thank dr. Sr膽an Vujkov for providing us with the necessary data on the number of dental practices and employed dentists in Vojvodina.

Funding

No funding.

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Authors and Affiliations

Authors

Contributions

Conceptualization of the study: I.G., M.S., and S.A.; design of the study and methodology I.G., M.S., and S.A.; investigation and data collection: I.G., M.S., S.A. and D.P.; formal analysis and interpretation I.G., M.S., S.A., and D.P.; writing of the main manuscript 鈥 original draft: I.G., M.S., D.P., J.M., and T.V.; Review and editing: I.G., M.S., D.P., J.M., and T.V.; Visualization: I.G., M.S., D.P., J.M. and T.V. All the authors reviewed the manuscript.

Corresponding author

Correspondence to Marija Stojilkovi膰.

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Ethics approval and consent to participate

Ethical approval for the research was obtained from the Ethics Committee of the Faculty of Medicine, University of Novi Sad, Serbia (No. 01鈥39/297/1). The study was conducted according to the guidelines of the Declaration of Helsinki. Informed consent was obtained from all the participants.

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Not applicable.

Competing interests

The authors declare no competing interests.

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Gu拧i膰, I., Stojilkovi膰, M., Alija, S. et al. The impact of social media on the selection of dentists based on their social media presence among residents of Vojvodina, Serbia: a cross-sectional study. 樱花视频 24, 3348 (2024). https://doi.org/10.1186/s12889-024-20884-0

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  • DOI: https://doi.org/10.1186/s12889-024-20884-0

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