YouTube as an information source for bleeding gums: A quantitative and qualitative analysis

Jiali Wu; Danlin Li; Minkui Lin

doi:10.1371/journal.pone.0298597

. 2024 Mar 6;19(3):e0298597. doi: 10.1371/journal.pone.0298597

YouTube as an information source for bleeding gums: A quantitative and qualitative analysis

Jiali Wu ¹, Danlin Li ², Minkui Lin ^1,^2,^*

Editor: Tanay Chaubal³

PMCID: PMC10917331 PMID: 38446816

Abstract

Gum bleeding is a common dental problem, and numerous patients seek health-related information on this topic online. The YouTube website is a popular resource for people searching for medical information. To our knowledge, no recent study has evaluated content related to bleeding gums on YouTube™. Therefore, this study aimed to conduct a quantitative and qualitative analysis of YouTube videos related to bleeding gums. A search was performed on YouTube using the keyword "bleeding gums" from Google Trends. Of the first 200 results, 107 videos met the inclusion criteria. The descriptive statistics for the videos included the time since upload, the video length, and the number of likes, views, comments, subscribers, and viewing rates. The global quality score (GQS), usefulness score, and DISCERN were used to evaluate the video quality. Statistical analysis was performed using the Kruskal–Wallis test, Mann–Whitney test, and Spearman correlation analysis. The majority (n = 69, 64.48%) of the videos observed were uploaded by hospitals/clinics and dentists/specialists. The highest coverage was for symptoms (95.33%). Only 14.02% of the videos were classified as "good". The average video length of the videos rated as "good" was significantly longer than the other groups (p <0.05), and the average viewing rate of the videos rated as "poor" (63,943.68%) was substantially higher than the other groups (p <0.05). YouTube videos on bleeding gums were of moderate quality, but their content was incomplete and unreliable. Incorrect and inadequate content can significantly influence patients’ attitudes and medical decisions. Effort needs to be expended by dental professionals, organizations, and the YouTube platform to ensure that YouTube can serve as a reliable source of information on bleeding gums.

1. Introduction

Bleeding gums are a common dental problem for people in their daily lives. Patients frequently present to the dental clinic with bleeding gums when brushing their teeth or blood in their mouth in the morning after waking up [1]. Bleeding gums are mainly triggered by periodontal disease and occasionally by peri-implant diseases, direct trauma, viruses, fungal or bacterial infections, medications, pregnancy, dermatoses, and systemic disorders [2–10]. One of the earliest clinical signs of periodontal disease is bleeding gums [11]. According to the new classification of periodontal and peri-implant diseases and conditions for 2017 [12], periodontal diseases and conditions were separated into the following categories: 1. periodontal health, gingival diseases and conditions; 2. periodontitis; and 3. other conditions affecting the periodontium. Gingivitis is considered reversible, but without treatment, it can progress to periodontitis [13]. Severe periodontitis is the sixth most widespread disease worldwide and affects approximately 10.8% of the global population [14, 15]. It can result in tooth loss and negatively influences chewing ability, general health, and quality of life [16, 17]. Therefore, bleeding gums caused by periodontal disease should be treated immediately. However, according to a poll, only 2.8% of adults with symptoms of bleeding gums seek professional dental care, while 60% disregard the condition [18]. Although the current epidemic of COVID-19 has hindered travel and medical treatment, it should not delay people’s decisions to seek medical attention, which can accelerate the progression of periodontal disease. The importance of educating patients about oral health cannot be overstated.

Health advice is traditionally sought from dental clinicians. The internet is a convenient and accessible source of health advice, and patients can ask questions anytime and anywhere without experiencing psychological stress. Internet use can reduce transmission rates by decreasing contact, particularly during the COVID-19 outbreak. Furthermore, smart devices have made people more reliant on their mobile phones in the information age. The continuous updating of social platforms and entertainment methods has split time into unlimited fragments. Short videos on video streaming sites have a variety of forms, and they can be searched and are richer in content than other sources. Compared to clinical situations in which physicians provide patients with medical information orally or in writing and patients frequently cannot comprehend or retain the data, mobile short videos feature concise and clear images and may be viewed multiple times. They can therefore comprehensively satisfy the informational needs of all types of people. The literature indicates that a considerable proportion of patients search the internet for health information [19–21].

YouTube is the most popular video-sharing site with more than 2 billion views per day [22], and it is one of the sites most visited by people seeking medical information [23]. YouTube is open access, which means that user-generated content is not peer reviewed; while it offers effective health education resources, there may also be a great deal of misinformation and inaccuracy [22]. Consequently, numerous studies have evaluated the informational quality of YouTube videos with regard to oral-related topics [24–26]. To our knowledge, however, no recent study has evaluated content related to bleeding gums on YouTube™. Therefore, in this study, we aimed to conduct quantitative and qualitative analyses of YouTube videos related to bleeding gums.

2. Materials and methods

2.1. Research design

For this investigation, a cross-sectional design was used. Because it may be difficult for users to differentiate the quality of videos, we analyzed the videos’ parameters and sources as well as their quality and reliability with the goal of conducting quantitative and qualitative analyses of YouTube videos related to bleeding gums.

2.2. Search strategy

Google Trends (https://Trends.Google.com) is an online search engine designed to determine the frequency of searches for phrases over a certain period of time. Google Trends was used to identify the most popular preferred search keywords [27]. A YouTube search for "bleeding gums" was conducted on 28 August 2022 (one day). "Bleeding gums," "teeth bleeding," "bleeding in gums," "stop bleeding gums," and "bleeding gums remedy" were the most regularly used terms for this topic. According to Google Trends, when the search parameters were set for "past 5 years," "worldwide," "all categories," and "YouTube searches," "bleeding gums" was the most frequently used search term (Fig 1). Two researchers used the Microsoft Edge browser to browse "https://www.youtube.com." The computer history and cookies were deleted. YouTube searches were performed using the identified search terms. Filters are rarely used when non-experts search the internet [28, 29]. This study evaluated videos using YouTube’s default "relevance" filter.

The results of the search query were displayed in order of site relevance, as evaluated by the YouTube website using a mixture of characteristics such as "views," "viewing rate," and "upload date." Commercial advertisements displayed on the side, above, or at the end of search results by YouTube were ignored and eliminated from the analysis. According to previous studies, the majority of YouTube viewers search for the top 60 to 200 videos [30]. Based on these data, the top 200 videos for the search terms were viewed and reviewed, and their links were kept for future reference. Notably, YouTube considers how closely the title, description, and video fit the query criteria and the query’s engagement and watching duration, resulting in a dynamic ranking [31].

2.3. Inclusion and exclusion criteria (Fig 2)

A preliminary screening was performed to identify videos related to bleeding gums.

The inclusion criteria were as follows [32, 33]: 1. video quality of 240p or more; 2. videos in English (not in any other language, such as Chinese, Arabic, or French) that were translated using iFLYTEK-SR302 and passed manual calibration (the details, including web links, of the 107 videos on bleeding gums on YouTube are listed in the S1 Table; and 3. video duration limited to 15 min (longer videos are less likely to capture the attention of online viewers according to a previous study) [26].

The following exclusion criteria were applied [34]: 1. repetition of videos; 2. videos without audio or descriptions; 3. inadequate audio quality; 4. irrelevant to the topic; and 5. deleted or private and therefore inaccessible.

2.4. Video parameters

The video upload date, length (in min), and number of likes, views, comments, subscribers, and viewing rate were retrieved. The viewing rate was determined using the techniques provided in prior research [22, 35]:

\frac{n u m b e r o f v i e w s}{n u m b e r o f d a y s s i n c e u p l o a d} \times 100 %

2.5. Sources of the videos

The videos were classified by the upload source: hospital/clinic, dentist/specialist, professional organization/association/university, business (i.e., dental manufacturing company or dental supply company), health information website, TV channel or news agency, and others.

2.6. Assessment of quality

The Global Quality Score (GQS), a five-component scale used to estimate the educational value of each video, was utilized to assess the quality of all selected videos [36] (Table 1). Since the videos were primarily intended for nonprofessional audiences, the five main contents of the videos were evaluated systematically based on the usefulness score, which included local and systemic etiologies, symptoms, treatment, and prognosis. The content was scored as 0 (not mentioned), 1 (brief introduction) or 2 (detailed introduction) depending whether each item was specifically discussed (Table 2). The combination of the global quality score (GQS) and the usefulness score determined the total score (Table 3). The total score was categorized as "poor" (0 to 5), "moderate" (6 to 10), or "good" (11 to 15 points). When the two researchers disagreed, discussions were held until consensus was reached.

Table 1. Global quality score (GQS) criteria.

GQS Description	GQS Score
Overall poor quality, poor flow of video, most of the information missing, not at all useful for patients	1
Generally poor quality and poor flow, some information listed but many important topics missing, of minimal use to patients	2
Moderate quality, suboptimal flow, some vital information adequately discussed but others poorly discussed, somewhat beneficial for patients	3
Good quality and generally good flow, most relevant information listed but some topics not covered, beneficial for patients	4
Excellent quality and flow, very useful for patients with complete information	5

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Table 2. Usefulness score.

Scoring item	Score
Local etiologies	0/1/2
Systemic etiologies	0/1/2
Symptoms	0/1/2
Treatment	0/1/2
Prognosis	0/1/2
Total	0–10

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(0, not mentioned; 1, briefly introduced; 2, introduced in detail)

Table 3. Total score.

Total Score Description	Total Score
Poor	0–5
Moderate	6–10
Good	11–15

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2.7. Assessment of reliability

To assess the dependability of the YouTube videos, a modified version of the DISCERN tool developed by Charnock et al. [37] was used. The modified DISCERN reliability tool consists of five questions, each of which requires a yes or no response [37, 38]. A five-item questionnaire (score: 1 to 5) was used to evaluate health information. All "yes" responses were worth 1 point. The maximum possible score was 5 [37, 38] (Table 4). A score of 5 indicated excellent reliability, 4 indicated good reliability, 3 indicated moderate reliability, 2 indicated generally poor reliability, and a score of 1 indicated poor reliability [39].

Table 4. DISCERN reliability tool (1 point per question for yes answers).

Are the explanations given in the video clear and understandable?

Are useful reference sources given (publication cited, from valid studies)?

Is the information in the video balanced and neutral?

Are additional sources of information given from which the viewer can benefit?

Does the video evaluate areas that are controversial or uncertain?

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2.8. Statistical analysis

IBM SPSS Statistics 27 software was used for statistical tests, and descriptive statistics were calculated for all the variables described above. The normality of the data was determined using the Shapiro‒Wilk test. Non-parametric tests were used for data that did not adhere to the normal distribution: the Kruskal-Wallis test (for more than two samples), the Mann-Whitney test (for two independent samples), and Spearman’s correlation coefficient. The Kruskal‒Wallis test was used to compare video characteristics between “poor”, “moderate” and "good" videos. The Mann‒Whitney test was used to determine differences between videos’ variable characteristics and length, and Spearman’s correlation coefficient was used to assess correlations between general YouTube video characteristics. Kappa coefficients of correlation were calculated to assess interrater reliability. The significance level was set at p <0.05.

2.9. Ethics statement

This research did not include humans or animals. The research examined YouTube videos that were open to the public. As a result, ethics committee approval was not necessary for this research. The data collection and analysis technique conformed with the rules and regulations of both Google Trends and YouTube.

3. Results

All videos were independently checked and evaluated by two researchers. The kappa coefficient used to measure interrater reliability was 0.674 for the video quality assessment.

Based on the inclusion and exclusion criteria, we excluded 93 (46.5%) videos (reasons for video exclusion are listed in the S2 Table). A total of 107 (53.5%) videos were included in further assessments. Among the 93 videos that were eliminated, 9.5% (19) were duplicates, 10% (20) lacked sound or explanation, 10% (20) had poor sound quality, 8.5% (17) were irrelevant to the topic, 6.5% (13) were not in English, 1.5% (3) were longer than 15 min, and one video was inaccessible because it had been deleted or because of privacy breaches (Table 5).

Table 5. Reasons for excluding videos for each search term.

Reasons for excluding	N	%
Repeat video	19	9.5
Videos without audio and description	20	10
Inadequate audio quality	20	10
Irrelevant to the topic	17	8.5
Deleted or private, therefore unreachable	1	0.5
Long video (>15 min)	3	1.5
Non-English	13	6.5
Total	93	46.5

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Descriptive statistics for the 107 YouTube videos that were assessed are shown in Table 6. The average number of days since upload of videos on YouTube related to bleeding gums was 1,172 days, the average video length was 3.04 min, the average number of likes was 624, the average number of views was 81,610, the average number of comments was 59, and 11 videos had closed comments. The average number of subscriptions was 355,696, the average viewing rate was 23,464.14%, the average DISCERN was 2.47, the average usefulness score was 4.53, the average GQS was 2.89, 75.70% of the videos (n = 81) had GQS scores less than 4 (Table 7), and the average total score was 7.42.

Table 6. Descriptive variables of the YouTube™ videos.

	Minimum	Maximum	Mean	SD
Days since upload	31	4731	1172.45	915.55
Video length (min)	0.06	12.2	3.04	2.69
No. of likes	0	23000	624.07	2432.33
No. of views	3	4476045	81610.81	462670.97
No. of comments	0	2030	59.49	227.05
No. of subscriptions	2	8500000	355696.78	1102613.67
Viewing rate (%)	1.77	2081881.40	23464.14	201237.61
Usefulness score	1	9	4.53	1.98
GQS	1	5	2.89	0.93
Total score	2	14	7.42	2.79
DISCERN	0	4	2.47	0.89

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Table 7. Frequency and percentage of the global quality scale score.

Item Scored	n (%)
1. Overall poor quality, poor flow of video, most information missing, not at all useful for patients	7 (6.54%)
2. Generally poor quality and poor flow, some information listed but many important topics missing, of minimal use to patients	32 (29.91%)
3. Moderate quality, suboptimal flow, some vital information adequately discussed but other information poorly discussed, somewhat beneficial for patients	42 (39.25%)
4. Good quality and generally good flow, most relevant information listed but some topics not covered, beneficial for patients	22 (20.56%)
5. Excellent quality and flow, very useful for patients with complete information	4 (3.74%)

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In light of the usefulness score, five specific components of the videos were systematically assessed. The highest coverage was for symptoms (95.33%), which were described in detail in 42 videos, followed by management (90.65%), local etiology (79.44%) and systemic etiology (38.32%). Prognosis was discussed in 16.82% of the videos but was not described in detail in all videos (Table 8).

Table 8. Distribution of the usefulness score items.

	0 point (Not mentioned)	1 point (Briefly introduced)	2 points (Introduced in detail)
Local etiologies	22	52	33
Systemic etiologies	66	19	22
Symptoms	5	60	42
Treatment	10	52	45
Prognosis	89	18	0

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In terms of the total score, only 14.02% of the videos received a "good" grade overall, followed by 55.14% "moderate" and 30.84% "poor." Most videos (n = 69, 64.48%) were uploaded by hospitals/clinics and dentists/specialists. Among the videos uploaded by hospitals/clinics, 20 (68.97%) were classified as “moderate” and 3 (7.69%) as "good.” Among the videos uploaded by dentists/specialists, 18 (45.00%) were classified as "moderate" and 8 (20.00%) as "good"; 1 video uploaded by an association was rated as "poor" due to its short duration, and the content mentioned was relatively limited. Eight (61.54%) of the videos uploaded by commercials were in the "poor" category (Table 9).

Table 9. Comparison of YouTube™ video uploaders between poor, moderate, and good informational videos about bleeding gums.

	Poor	Moderate	Good	Total (N/%)
Hospital/clinic	6 (20.69%)	20 (68.97%)	3 (7.69%)	29(27.10%)
Dentist/specialist	14 (35.00%)	18 (45.00%)	8 (20.00%)	40(37.38%)
Professional organization/association/university	1 (100.00%)	/	/	1(0.93%)
business	8 (61.54%)	4 (30.77%)	1 (7.69%)	13(12.15%)
Health information website	1 (6.67%)	11 (73.33%)	3 (20%)	15(14.02%)
TV channel or news agency	/	2 (100.00%)	/	2(1.87%)
Others	3 (42.86%)	4 (57.14%)	/	7(6.54%)
Total	33 (30.84%)	59 (55.14%)	15 (14.02%)	107(100%)

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The Kruskal‒Wallis test was used to compare the characteristics of the "poor," "medium," and "good" videos, as shown in Table 10. Videos rated "good" had a shorter mean time (866.13 min) after upload, videos rated "medium" had a longer mean time after upload (1,255.15 min), and there was no significant difference between the groups (p >0.05). Similarly, the average viewing rate of videos rated "poor" (63,943.68%) was significantly greater than that of the other groups (p <0.05). The average length of the videos, the average number of likes, and the average number of comments on the "poor," “medium” and "good" videos were significantly different (p <0.05).

Table 10. Comparison of video parameters among poor, moderate, and good informational videos about bleeding gums.

Parameters	Poor (n = 33)		Moderate (n = 59)		Good (n = 15)		P
Parameters	Mean	SD	Mean	SD	Mean	SD	P
Days since upload	1163.82	901.27	1255.15	999.45	866.13	471.33	0.534
Video length (min)	1.38	1.49	3.18	2.41	6.17	2.97	<0.001
No. of likes	137.58	390.41	438.41	914.85	2424.67	6066.45	0.011
No. of comments	11.11	24.43	36.93	73.07	243.29	556.95	0.002
Viewing rate (%)	63943.68	362261.74	3608.90	6817.96	12506.42	28451.11	0.023
DISCERN	1.73	0.98	2.76	0.63	2.93	0.594	<0.001

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The Kruskal‒Wallis test (p value <0.05).

As shown in Table 11, video length was positively correlated with the number of likes, viewership, usefulness score, GQS, total score, and DISCERN (p <0.05). Video length was moderately correlated with the usefulness score (r = 0.605), GQS (r = 0.554), total score (r = 0.617) and DISCERN (r = 0.424). The number of likes was strongly correlated with the viewing rate (r = 0.920, p <0.05). The total score was strongly correlated with the usefulness score and GQS (r = 0.980, p <0.05; r = 0.923, p <0.05) and moderately correlated with DISCERN (r = 0.610, p <0.05). As shown in Table 12, the viewing rate for videos greater than 4 min in length was extremely weakly correlated with video length (r = 0.044), and the viewing rate for videos less than 4 min in length was weakly correlated with video length (r = 0.275). However, neither was significantly different (p >0.05).

Table 11. Correlation of the data.

		Video length (min)	No. of likes	Viewing rate (%)	Usefulness Score	GQS	Total Score
Video length (min)	r
Video length (min)	p
No. of likes	r	0.294
No. of likes	p	0.002
Viewing rate (%)	r	0.229	0.920
Viewing rate (%)	p	0.017	<0.001
Usefulness Score	r	0.605	0.220	0.144
Usefulness Score	p	<0.001	0.023	0.139
GQS	r	O.554	0.577	0.550	0.837
GQS	p	<0.001	<0.001	<0.001	<0.001
Total Score	r	0.617	0.355	0.286	0.980	0.923
Total Score	p	<0.001	<0.001	0.003	<0.001	<0.001
DISCERN	r	0.424	0.179	0.089	0.580	0.566	0.610
DISCERN	p	<0.001	0.066	0.359	<0.001	<0.001	<0.001

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r: Spearman’s rank correlation coefficient (p value <0.05).

Table 12. Comparison between video length and viewing rate of YouTube™ videos on bleeding gums.

			Video length (min)	Viewing rate (%)
<4 min (n = 77)	Video length (min)	r	1	0.044
	Video length (min)	p	-	0.703
	Viewing rate (%)	r	0.044	1
	Viewing rate (%)	p	0.703	-
>4 min (n = 30)	Video length(min)	r	1	0.275
	Video length(min)	p	-	0.142
	Viewing rate (%)	r	0.275	1
	Viewing rate (%)	p	0.142	-

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r: Spearman’s rank correlation coefficient (p value<0.05).

Table 13 highlights seven variables that differed significantly (p <0.05) between videos less than 4 min in length and those greater than 4 min in length, namely, the average number of likes, the average number of comments, the average number of views, the average DISCERN score, the average usefulness score, the average GQS, and the average total score. The data show that videos greater than 4 min in length had a greater average number of likes (1,807.53) and comments (170.30) and a lower average number of views (10,574.02). Videos longer than 4 min in length had a higher average DISCERN score, usefulness score, GQS, and overall score.

Table 13. Comparison of video variables based on duration.

	<4 min (n = 77)		>4 min (n = 30)		P
	Mean	SD	Mean	SD	P
No. of likes	162.99	361.46	1807.53	4389.66	0.013
No. of comments	16.13	39.17	170.30	408.19	<0.001
Viewing rate (%)	28486.26	237112.34	10574.02	21024.21	0.017
Usefulness Score	4.03	1.77	5.83	1.91	<0.001
GQS	2.65	0.86	3.50	0.84	<0.001
Total score	6.68	2.51	9.33	2.60	<0.001
DISCERN	2.32	0.92	2.83	0.70	0.014

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Mann‒Whitney test (p value<0.05).

4. Discussion

To the best of our knowledge, this is the first study to explore the content of YouTube videos about bleeding gums. People commonly use the YouTube platform to search for health-related concerns due to the increased popularity of social networks and the internet and the ease and accessibility of the available information. The tendency to use such applications appears to have increased during the COVID-19 pandemic [39]. The risk of infection with COVID-19 is high in dental practice due to the close contact between dentists and patients and the formation of aerosols in dental practices [40–42]. This has led people to avoid dental clinics during the COVID-19 epidemic [40]. However, studies have found that periodontal diseases are associated with severe COVID-19-related complications [43]. Therefore, the American Academy of Periodontology (AAP) emphasizes the importance of maintaining periodontal health during the COVID-19 outbreak. Currently, YouTube shows an advantage in sharing medical content related to bleeding gums.

Moreover, since the cost of internet communication has declined significantly, there are objective reasons for people to consult online. In this study, the total number of views of the videos exceeded 8,732,400, the total number of likes was 66,800, and the videos received a total of 5,711 comments. These statistics indicate that most people learn about bleeding gums on YouTube. All registered users on YouTube are permitted to submit and distribute health-related videos for free without peer review. Inaccurate videos with no scientific basis are often uploaded on YouTube because the sources of the material are sometimes ambiguous [22]. Thus, this study quantitatively and qualitatively analyzed YouTube videos about bleeding gums.

This study combined the GQS with the usefulness score to assess the included videos and used the DISCERN score to rate the videos’ reliability. Similar to earlier studies, GQS and DISCERN were used in recent studies [25, 44, 45]. In terms of the analysis of upload sources, the majority (n = 69, 64.48%) of the observed videos were uploaded by hospitals/clinics and dentists/specialists, indicating that with the development of video sites, medical professionals are aware of the importance of these sites for the dissemination of expertise. More than 60% of the videos uploaded by hospitals/clinics and dentists/specialists were moderate or above, while the percentage of videos uploaded by businesses or others was "poor," indicating that the videos uploaded by dental clinicians are higher quality and more comprehensive. Previous studies have shown that high-quality videos are created by medical experts or organizations, while low-quality videos are created by medical advertising, for-profit organizations, and individual users [44]. These findings are consistent with our study. The mean DISCERN value for the videos was 2.47. The low scores reflect the low reliability of videos on YouTube about bleeding gums. The DISCERN score was positively connected with the total video score (p <0.05), indicating that the reliability of the videos was positively connected with the video quality. To evaluate the overall quality of the video, we used the GQS and the usefulness score. The average GQS was 2.89 and the average total score was 7.42, indicating moderate quality. Various outcomes have been observed in prior research. In research conducted by Ramadhani et al. [46], lay users posted the majority of videos about bad breath which can result from oral or extra-oral sources [47]. The study results showed poor quality, poor reliability, and inadequate video content. This may be because lay users have limited medical knowledge, so the quality of the uploaded videos is poor. In studies conducted by Yavuz et al. [48] and Kurian et al. [49], dental professionals mainly uploaded the videos. The quality of the videos on accelerated orthodontic treatment in the study by Yavuz et al. [48] was "good," probably because the videos uploaded by dental professionals were mainly educational and the study did not exclude videos of long duration. However, the results of Kurian et al. [49] showed that videos on fixed implant-supported prostheses were poor quality because dental professionals uploaded these videos with a marketing bias rather than providing purely educational information. Most of the videos in our analysis were also posted by dental clinicians. Fourteen of the videos uploaded by dental clinicians classified as "good" contained comprehensive, high-quality, and mainly educational content. However, most of the videos on bleeding gums were not comprehensive. This may be related to the exclusion of videos >15 min, which may contain more comprehensive content. Some of the evaluated videos were uploaded by nonprofessional users, which also affected the overall quality of the evaluated videos. Videos uploaded by businesses were mainly marketing, and videos uploaded by others were of poor quality due to their limited medical knowledge.

The content evaluation process revealed only a few videos that described the systemic etiology and prognosis, none of which provided a detailed prognosis. Only six of the videos contained all the content, indicating that the content of YouTube videos on bleeding gums is not comprehensive. A thorough understanding of the systemic etiology and prognosis is essential to treat bleeding gums. Bleeding gums can be caused by local and systemic factors. Therefore, it is essential to pay attention not only to the local etiology but also to understand the patient’s systemic situation, clarify the etiology, and treat it promptly to avoid misdiagnosis. Depending on the individual and the degree of periodontal disease, the periodontal prognosis involves making a "forecast" of periodontal disease. The maintenance programs and treatment designs used differ. Increased intervention efforts and identification of high-risk teeth or individuals promote disease improvement.

In the present study, the average length of videos rated as "good" was significantly greater than that of the other groups. Video length was moderately correlated with GQS, the usefulness score, the total score, and the DISCERN score. This may be because the longer a video is, the more content can be explained and the higher the quality of the video. The length of the video not only has an impact on the quality of the video but also plays a significant role in the viewer’s attention. On the YouTube platform, a user-selectable filter is available for video length, i.e., videos less than 4 min and greater than 4 min (if the video is less than 4 min, YouTube will mark it as a short video). Therefore, in this study, we divided the videos into two groups of less than 4 min and more than 4 min for analysis. Videos longer than 4 min had a higher average DISCERN, usefulness score, GQS, and total score but a lower average number of views, indicating that longer videos may reduce viewers’ attention levels, while videos longer than 4 min have better quality and reliability. However, videos less than 4 min in length tend to be watched heavily and have poorer video quality and reliability. A previous study by Ajumobi et al. [50] showed that videos under 4 min were more succinct and captured the attention of a broader audience. In comparison, videos longer than 4 min were of better quality, consistent with the results of our study. In a previous study by Delli et al. [51], the duration of videos that were found to be beneficial to viewers was approximately 7 min. For this reason, it is crucial to consider both the content and the duration when producing videos so that they are educational and engaging for the audience.

Incorrect and inadequate content in YouTube videos about bleeding gums can significantly influence patients’ attitudes and medical decisions. Therefore, it is imperative to monitor health information on YouTube. To avoid inaccurate health-related material on social media platforms, it is advised that relevant medical experts and government organizations monitor social networks or use other valid methods to evaluate video content. However, no such implementation has been developed to date [52, 53]. Therefore, we believe that the video quality of the YouTube platform can be improved by involving more dental professionals and organizations in producing high-quality videos related to dental problems. Furthermore, YouTube can offer a certification feature that assesses the quality of videos uploaded by dentists and professional institutions. This evaluation will be conducted using advanced Deep Learning models [54], which rely on sophisticated architecture and a meticulously organized YouTube dataset. Videos that meet the certification standards can be awarded an official mark, ensuring users that they are reliable and trustworthy resources for information on dental-related topics. When users search for bleeding gum-related problems, officially certified videos will be highlighted. Additionally, dentists may recommend videos of higher quality and reliability to their patients based on information they find on YouTube. YouTube should continue to serve as a reliable source of dental information.

The current study has some limitations. First, YouTube search results change as recent videos are added or removed. Therefore, new video additions or modifications may have occurred after the date the included videos were analyzed, resulting in slight differences. Second, patients may type different search phrases and receive different results. To minimize this limitation, we used Google Trends to select our audience’s most frequently searched terms. Third, YouTube recently removed the ability to view the number of video dislikes. Therefore, dislike data and interaction indices cannot be displayed. Fourth, we excluded several videos that were >15 min in length, which might have offered excellent content. Finally, the videos we filtered with our translation software were somewhat skewed in scope but covered most of the YouTube videos.

Supporting information

S1 Table

(XLSX)

pone.0298597.s001.xlsx^{(37.6KB, xlsx)}

S2 Table

(XLSX)

pone.0298597.s002.xlsx^{(28.7KB, xlsx)}

Acknowledgments

We thank Dr. Weijun Zheng (Department of Medical Statistics, Zhejiang Chinese Medicine University, China) for providing professional instructions in statistical analyses.

Data Availability

All relevant data are within the manuscript and its Supporting Information files.

Funding Statement

The author(s) received no specific funding for this work.

References

1.Almas K, Al-Hawish A, Al-Khamis W. Oral hygiene practices, smoking habit, and self-perceived oral malodor among dental students. Journal of Contemporary Dental Practice. 2003; 4(4): 77–90. [PubMed] [Google Scholar]
2.Newbrun E. Indices to measure gingival bleeding. Journal of periodontology. 1996; 67(6): 555–561. doi: 10.1902/jop.1996.67.6.555 [DOI] [PubMed] [Google Scholar]
3.Darby I. Drugs and gingival bleeding. Australian Prescriber. 2006; 29: 154–155. [Google Scholar]
4.Bui FQ, Almeida-da-Silva CLC, Huynh B, Trinh A, Liu J, Woodward J, et al. Association between periodontal pathogens and systemic disease. Biomedical journal. 2019; 42(1): 27–35. doi: 10.1016/j.bj.2018.12.001 [DOI] [PMC free article] [PubMed] [Google Scholar]
5.Rokaya D, Srimaneepong V, Wisitrasameewon W, Humagain M, Thunyakitpisal P. Peri-implantitis Update: Risk Indicators, Diagnosis, and Treatment. European journal of dentistry. 2020; 14(4): 672–682. [DOI] [PMC free article] [PubMed] [Google Scholar]
6.Heboyan A, Syed AUY, Rokaya D, Cooper PR, Manrikyan M, Markaryan M. Cytomorphometric Analysis of Inflammation Dynamics in the Periodontium Following the Use of Fixed Dental Prostheses. Molecules. 2020; 25(20): 4650. doi: 10.3390/molecules25204650 [DOI] [PMC free article] [PubMed] [Google Scholar]
7.Elani HW, Starr JR, Da Silva JD, Gallucci GO. Trends in Dental Implant Use in the U.S., 1999–2016, and Projections to 2026. Journal of dental research. 2018; 97(13): 1424–1430. doi: 10.1177/0022034518792567 [DOI] [PMC free article] [PubMed] [Google Scholar]
8.Lee CT, Huang YW, Zhu L, Weltman R. Prevalences of peri-implantitis and peri-implant mucositis: systematic review and meta-analysis. Journal of dentistry. 2017; 62: 1–12. doi: 10.1016/j.jdent.2017.04.011 [DOI] [PubMed] [Google Scholar]
9.Achoki T, Miller-Petrie MK, Glenn SD, Kalra N, Lesego A, Gathecha GK, et al. Health disparities across the counties of Kenya and implications for policy makers, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Glob Health. 2019; 7(1): e81–e95. doi: 10.1016/S2214-109X(18)30472-8 [DOI] [PMC free article] [PubMed] [Google Scholar]
10.Pihlstrom BL, Michalowicz BS, Johnson NW. Periodontal diseases. Lancet. 2005;366(9499):1809–1820. doi: 10.1016/S0140-6736(05)67728-8 [DOI] [PubMed] [Google Scholar]
11.Veynachter T, Orti V, Moulis E, Rousseau H, Thilly N, Anagnostou F, et al. Prevalence and associated factors of self-reported gingival bleeding: a multicenter study in France. International Journal of Environmental Research and Public Health. 2020; 17(22): 8563. [DOI] [PMC free article] [PubMed] [Google Scholar]
12.Caton JG, Armitage G, Berglundh T, Chapple IL, Jepsen S, Kornman KS, et al. A new classification scheme for periodontal and peri‐implant diseases and conditions–Introduction and key changes from the 1999 classification. Journal of clinical periodontology. 2018; 45 Suppl 20: S1–S8. [DOI] [PubMed] [Google Scholar]
13.Kinane DF, Stathopoulou PG, Papapanou PN. Periodontal diseases. Nature Reviews Disease Primers. 2017; 3: 17038. doi: 10.1038/nrdp.2017.38 [DOI] [PubMed] [Google Scholar]
14.Kassebaum N, Bernabé E, Dahiya M, Bhandari B, Murray C, Marcenes W. Global burden of severe periodontitis in 1990–2010: a systematic review and meta-regression. Journal of dental research. 2014; 93(11): 1045–1053. doi: 10.1177/0022034514552491 [DOI] [PMC free article] [PubMed] [Google Scholar]
15.Peres MA, Macpherson LM, Weyant RJ, Daly B, Venturelli R, Mathur MR, et al. Oral diseases: a global public health challenge. The Lancet. 2019; 394(10194): 249–660. doi: 10.1016/S0140-6736(19)31146-8 [DOI] [PubMed] [Google Scholar]
16.Tonetti MS, Jepsen S, Jin L, Otomo‐Corgel J. Impact of the global burden of periodontal diseases on health, nutrition and wellbeing of mankind: A call for global action. Journal of Clinical Periodontology. 2017; 44(5): 456–462. doi: 10.1111/jcpe.12732 [DOI] [PubMed] [Google Scholar]
17.Brennan D, Spencer A, Roberts-Thomson K. Quality of life and disability weights associated with periodontal disease. Journal of dental research. 2007; 86(8): 713–717. doi: 10.1177/154405910708600805 [DOI] [PubMed] [Google Scholar]
18.Taani DQ. Periodontal awareness and knowledge, and pattern of dental attendance among adults in Jordan. International Dental Journal. 2002; 52(2): 94–98. [DOI] [PubMed] [Google Scholar]
19.Ikemba CM, Kozinetz CA, Feltes TF, Fraser CD Jr, McKenzie ED, Shah N, et al. Internet use in families with children requiring cardiac surgery for congenital heart disease. Pediatrics. 2002; 109(3): 419–22. doi: 10.1542/peds.109.3.419 [DOI] [PubMed] [Google Scholar]
20.Wainstein BK, Sterling‐Levis K, Baker SA, Taitz J, Brydon M. Use of the Internet by parents of paediatric patients. J Paediatr Child Health. 2006; 42(9): 528–332. doi: 10.1111/j.1440-1754.2006.00916.x [DOI] [PubMed] [Google Scholar]
21.Boston M, Ruwe E, Duggins A, Willging JP. Internet use by parents of children undergoing outpatient otolaryngology procedures. Arch Otolaryngol Head Neck Surg. 2005; 131(8): 719–722. doi: 10.1001/archotol.131.8.719 [DOI] [PubMed] [Google Scholar]
22.Hassona Y, Taimeh D, Marahleh A, Scully C. YouTube as a source of information on mouth (oral) cancer. Oral Dis. 2016; 22(3): 202–208. doi: 10.1111/odi.12434 [DOI] [PubMed] [Google Scholar]
23.Bezner SK, Hodgman EI, Diesen DL, Clayton JT, Minkes RK, Langer JC, et al. Pediatric surgery on YouTube™: is the truth out there? Journal of Pediatric Surgery. 2014; 49(4): 586–589. [DOI] [PubMed] [Google Scholar]
24.Gao X, Hamzah S, Yiu C, McGrath C, King N. Dental fear and anxiety in children and adolescents-A qualitative study using social media. Journal of Medical Internet Research. 2013; 15(2): e29. [DOI] [PMC free article] [PubMed] [Google Scholar]
25.Kaval ME, Demirci GK, Atesci AA, Sarsar F, Dindaroğlu F, Güneri P, et al. YouTube™ as an information source for regenerative endodontic treatment procedures: Quality and content analysis. International Journal of Medical Informatics. 2022; 161: 104732. [DOI] [PubMed] [Google Scholar]
26.Nason K, Donnelly A, Duncan H. YouTube as a patient‐information source for root canal treatment. International Endodontic Journal. 2016; 49(12): 1194–200. doi: 10.1111/iej.12575 [DOI] [PubMed] [Google Scholar]
27.Google Trends[Internet]. America: Google; c2022[cited 2022 Aug 28]. Available from: https://trends.google.com.tr/trends/?geo=TR.
28.Eysenbach G, Köhler C. How do consumers search for and appraise health information on the world wide web? Qualitative study using focus groups, usability tests, and in-depth interviews. British Medical Journal. 2002; 324(7337): 573–577. doi: 10.1136/bmj.324.7337.573 [DOI] [PMC free article] [PubMed] [Google Scholar]
29.Peterson G, Aslani P, Williams KA. How do consumers search for and appraise information on medicines on the Internet? A qualitative study using focus groups. Journal of Medical Internet Research. 2003; 5(4): e3. doi: 10.2196/jmir.5.4.e33 [DOI] [PMC free article] [PubMed] [Google Scholar]
30.Desai T, Shariff A, Dhingra V, Minhas D, Eure M, Kats M. Is content really king? An objective analysis of the public’s response to medical videos on YouTube. PLoS One. 2013; 8(12): e82469. [DOI] [PMC free article] [PubMed] [Google Scholar]
31.YouTube Creators: How YouTube Search Works[Internet]. America: YouTube; c2022[cited 2022 Aug 28]. Available from: https://www.youtube.com/watch?v=gTrLniP5tSQ.
32.Maganur PC, Hakami Z, Raghunath RG, Vundavalli S, Jeevanandan G, Almugla YM, et al. Reliability of Educational Content Videos in YouTubeTM about Stainless Steel Crowns. Children (Basel). 2022; 9(4): 571. doi: 10.3390/children9040571 [DOI] [PMC free article] [PubMed] [Google Scholar]
33.Sezici YL, Gediz M, Dindaroğlu F. Is YouTube an adequate patient resource about orthodontic retention? A cross-sectional analysis of content and quality. American journal of orthodontics and dentofacial orthopedics. 2022; 161(1): e72–e79. [DOI] [PubMed] [Google Scholar]
34.Topsakal KG, Duran GS, Görgülü S, Eser Misir S. Is YouTubeTM an adequate source of oral hygiene education for orthodontic patients? International journal of dental hygiene. 2022; 20(3): 504–511. doi: 10.1111/idh.12557 [DOI] [PubMed] [Google Scholar]
35.ElKarmi R, Hassona Y, Taimeh D, Scully C. YouTube as a source for parents’ education on early childhood caries. International Journal of Paediatric Dentistry. 2017; 27(6): 437–443. doi: 10.1111/ipd.12277 [DOI] [PubMed] [Google Scholar]
36.Bernard A, Langille M, Hughes S, Rose C, Leddin D, Van Zanten SV. A systematic review of patient inflammatory bowel disease information resources on the World Wide Web. Official journal of the American College of Gastroenterology| ACG. 2007; 102(9): 2070–2077. doi: 10.1111/j.1572-0241.2007.01325.x [DOI] [PubMed] [Google Scholar]
37.Charnock D, Shepperd S, Needham G, Gann R. DISCERN: an instrument for judging the quality of written consumer health information on treatment choices. Journal of Epidemiology and Community Health. 1999; 53(2): 105–111. doi: 10.1136/jech.53.2.105 [DOI] [PMC free article] [PubMed] [Google Scholar]
38.Ng JY, Ahmed S, Zhang CJ. Dietary and herbal supplements for weight loss: Assessing the quality of patient information online. Nutrition Journal. 2021; 20: 1–13. [DOI] [PMC free article] [PubMed] [Google Scholar]
39.Aksoy M, Topsakal KG. YouTube™ for information on paediatric oral health instructions. International Journal of Dental Hygiene. 2022; 20(3): 496–503. [DOI] [PubMed] [Google Scholar]
40.Loch C, Kuan IB, Elsalem L, Schwass D, Brunton PA, Jum’ah A. COVID‐19 and dental clinical practice: Students and clinical staff perceptions of health risks and educational impact. Journal of Dental Education. 2021; 85(1): 44–52. doi: 10.1002/jdd.12402 [DOI] [PubMed] [Google Scholar]
41.Haridy R, Abdalla MA, Kaisarly D, Gezawi ME. A cross‐sectional multicenter survey on the future of dental education in the era of COVID‐19: Alternatives and implications. Journal of Dental Education. 2021; 85(4): 483–493. doi: 10.1002/jdd.12498 [DOI] [PMC free article] [PubMed] [Google Scholar]
42.Iyer P, Aziz K, Ojcius DM. Impact of COVID‐19 on dental education in the United States. Journal of Dental Education. 2020; 84(6): 718–722. doi: 10.1002/jdd.12163 [DOI] [PubMed] [Google Scholar]
43.Marouf N, Cai W, Said KN, Daas H, Diab H, Chinta VR, et al. Association between periodontitis and severity of COVID‐19 infection: A case–control study. Journal of Clinical Periodontology. 2021; 48(4): 483–491. doi: 10.1111/jcpe.13435 [DOI] [PMC free article] [PubMed] [Google Scholar]
44.Chang MC, Park D, editors. YouTube as a source of patient information regarding exercises and compensated maneuvers for dysphagia. Healthcare (Basel). 2021; 9(8): 1084. doi: 10.3390/healthcare9081084 [DOI] [PMC free article] [PubMed] [Google Scholar]
45.Romano A, Lauritano D, Fiori F, Di Petrillo M, Hasan I, Lucchese A, et al. Cross‐sectional study on the quality of oral lichen planus videos on YouTube™. Journal of Oral Pathology & Medicine. 2021; 50(2): 220–228. doi: 10.1111/jop.13128 [DOI] [PubMed] [Google Scholar]
46.Ramadhani A, Zettira Z, Rachmawati YL, Hariyani N, Maharani DA. Quality and Reliability of Halitosis Videos on YouTube as a Source of Information. Dentistry Journal (Basel). 2021; 9(10): 120. doi: 10.3390/dj9100120 [DOI] [PMC free article] [PubMed] [Google Scholar]
47.Chaurasia A, Katheriya G. Prevalence of halitosis and related factors in North Indian population- A hospital based cross-sectional study. Journal of Oral Medicine, Oral Surgery, Oral Pathology and Oral Radiology. 2018; 4(2):79–84. [Google Scholar]
48.Buyuk SK, Genc E, Yavuz MC. Does YouTube (TM) offer high quality information? Evaluation of accelerated orthodontics videos. 2020; 189(2): 505–509. [DOI] [PubMed] [Google Scholar]
49.Kurian N, Varghese KG, Daniel S, Varghese VS, Kaur T, Verma R. Are YouTube videos on complete arch fixed implant-supported prostheses useful for patient education? The Journal of prosthetic dentistry. 2022; S0022-3913(22)00138-X. doi: 10.1016/j.prosdent.2022.02.013 [DOI] [PubMed] [Google Scholar]
50.Ajumobi AB, Malakouti M, Bullen A, Ahaneku H, Lunsford TN. YouTube™ as a source of instructional videos on bowel preparation: a content analysis. Journal of Cancer Education. 2016; 31: 755–759. [DOI] [PubMed] [Google Scholar]
51.Delli K, Livas C, Vissink A, Spijkervet FK. Is YouTube useful as a source of information for Sjögren’s syndrome? Oral Diseases. 2016; 22(3): 196–201. [DOI] [PubMed] [Google Scholar]
52.Bhola S, Hellyer P. The risks and benefits of social media in dental foundation training. British Dental Journal. 2016; 221(10): 609–613. doi: 10.1038/sj.bdj.2016.854 [DOI] [PubMed] [Google Scholar]
53.Lavorgna L, De Stefano M, Sparaco M, Moccia M, Abbadessa G, Montella P, et al. Fake news, influencers and health-related professional participation on the Web: A pilot study on a social-network of people with Multiple Sclerosis. Multiple sclerosis and related disorders. 2018; 25: 175–178. doi: 10.1016/j.msard.2018.07.046 [DOI] [PubMed] [Google Scholar]
54.Chaurasia A, Namachivayam A, Koca-Ünsal RB, Lee JH. Deep-learning performance in identifying and classifying dental implant systems from dental imaging: a systematic review and meta-analysis. Journal of Periodontal and Implant Science. 2023; 53(3):e12. doi: 10.5051/jpis.2300160008 [DOI] [PMC free article] [PubMed] [Google Scholar]

PLoS One. doi: 10.1371/journal.pone.0298597.r001

Decision Letter 0

Anand Marya

1 Aug 2023

PONE-D-23-16369YouTube as an information source for bleeding gums: a quantitative and qualitative analysisPLOS ONE

Dear Dr. Lin,

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Reviewer #1: No

Reviewer #2: Yes

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Reviewer #1: I Don't Know

Reviewer #2: Yes

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Reviewer #1: Dear Author,

What is novelty of your research ?? the methodology seems vague particularly study design?? Clarify it. the inclusion and exclusion criteria also needs to be clarified. How you accessed the video quality?? is there any gold standrad??

Reviewer #2: This is an interesting study where the researchers conducted a quantitative and qualitative analysis of YouTube videos related to bleeding gums.

Introduction

“According to the new classification of periodontal and peri-implant diseases and conditions for 2017.” Please find the latest classification.

Gingivitis, Periodontitis and peri-implantitis are common diseases. Peri-implantitis also can result in bleeding gums. Please add this.

https://pubmed.ncbi.nlm.nih.gov/32882741/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7587339/

Method

“A YouTube search for "bleeding gums" was conducted on 28 August 2022”. Is the search done only one day or for a specific duration? Please elaborate.

“The duration of the video was limited to 15 min (longer videos were less likely to capture the attention of online viewers, according to a previous study, so the video was restricted to 15 min).” This is not really true. Some patient having bleeding gum if wants to know more may want to know more about it can see or listen the longer and detail videos.

How many researchers did the search. Needs to add.

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PLoS One. 2024 Mar 6;19(3):e0298597. doi: 10.1371/journal.pone.0298597.r002

Author response to Decision Letter 0

14 Sep 2023

Dear Editor:

We would like to express our sincere gratitude to Dr. Anand Marya for accepting the role of editor for our submitted manuscript titled "YouTube as an information source for bleeding gums: a quantitative and qualitative analysis" (PLOS ONE manuscript number: PONE-D-23-16369). Furthermore, we truly appreciate that you had assigned such qualified reviewers to our manuscript, whose insightful comments and constructive suggestions greatly assisted us in the revision process. We extend our heartfelt thanks for their invaluable contribution. Our point-by-point responses to the comments are provided as a separate file labeled 'Response to Reviewers'.

Thank you for your consideration. I look forward to hearing from you.

Best Regards.

Prof. Minkui Lin

Email address: linmk105@sina.com.

Attachment

Submitted filename: Response to Reviewers.docx

pone.0298597.s003.docx^{(361.5KB, docx)}

PLoS One. doi: 10.1371/journal.pone.0298597.r003

Decision Letter 1

Tanay Chaubal

21 Nov 2023

PONE-D-23-16369R1YouTube as an information source for bleeding gums: a quantitative and qualitative analysisPLOS ONE

Dear Dr. Lin,

I congratulate you on submitting the revised manuscript. However, there are still glaring deficiencies which need to be addressed. I am hoping that you address those.

Please submit your revised manuscript by Jan 05 2024 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file.

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We look forward to receiving your revised manuscript.

Kind regards,

Tanay Chaubal

Academic Editor

PLOS ONE

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Reviewer #1: (No Response)

Reviewer #3: (No Response)

**********

2. Is the manuscript technically sound, and do the data support the conclusions?

Reviewer #1: Partly

Reviewer #3: Yes

**********

3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: I Don't Know

Reviewer #3: Yes

**********

4. Have the authors made all data underlying the findings in their manuscript fully available?

Reviewer #1: No

Reviewer #3: Yes

**********

5. Is the manuscript presented in an intelligible fashion and written in standard English?

Reviewer #1: No

Reviewer #3: Yes

**********

6. Review Comments to the Author

Reviewer #1: Dear Author,

The rebuttal against the raised queries are not satisfactory and not addressed as expected.

Reviewer #3: introduction line 29- its not explanatory, patients frequently present to the dental clinic with bleeding gums while brushing their teeth or noticing blood in their mouth in the morning after waking up.

line 33- classification is 2017 not 2018

what were your keywords for search?

**********

7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy.

Reviewer #1: No

Reviewer #3: No

**********

PLoS One. 2024 Mar 6;19(3):e0298597. doi: 10.1371/journal.pone.0298597.r004

Author response to Decision Letter 1

5 Jan 2024

Dear Editor:

Thank you for giving us the opportunity to submit a revised version of “YouTube as a Source of Information on Bleeding Gums: A Quantitative and Qualitative Analysis” (PLOS ONE manuscript number: PONE-D-23-16369) for potential publication in PLOS ONE. We appreciate your and the reviewers’ time and effort in providing feedback on our article. Your views, as well as the reviewers’, are valuable and have been instrumental in improving our research papers. We have carefully reviewed all of the suggestions and have made our best efforts to incorporate them into the text in order to meet the acceptance criteria. The following is our peer-to-peer response to these comments (Detailed response is provided as a separate document labeled "Responses to Reviewers." ):

Reviewer Comments and Responses:

1.If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.

Reviewer #1: (No Response)

Reviewer #3: (No Response)

Our response: None .

2.Is the manuscript technically sound, and do the data support the conclusions?

Reviewer #1: Partly

Reviewer #3: Yes

Our response: We appreciate the reviewer’s acknowledgement of our efforts to improve the manuscript based on the comments. However, there are still some areas that require clarification.

Firstly, we would like to point out that our choice of viewing and reviewing the top 200 videos was based on a study [1] indicating that the majority of YouTube viewers search within this range. This allowed us to have a suitable sample size for analysis.

Furthermore, the analytical techniques employed in our study are well-established. For instance, we utilized the global quality score (GQS) [2,3], usefulness score [4], and DISCERN [5], all of which have been extensively used in peer-reviewed studies and serve to strengthen and enhance our conclusions.

Finally, we agree with the reviewer that collecting high-quality data is a critical initial step in establishing the validity of the findings. To ensure this, we had two researchers independently examine and rate each video, and the reliability of the raters was assessed before commencing the analysis of the videos. In light of the reviewer’s recommendation regarding the manuscript data, we have re-evaluated our statistical methods and experimental data.

To sum up, we tried our best to study the topic using classical methods from numerous literatures, and have obtained the data and information to reach the conclusions of this manuscript.

References

1.Desai T, Shariff A, Dhingra V, et al. Is content really king? An objective analysis of the public's response to medical videos on YouTube. PLoS One. 2013; 8(12): e82469.

2.Sezici YL, Gediz M, Dindaroğlu F. Is YouTube an adequate patient resource about orthodontic retention? A cross-sectional analysis of content and quality. Am J Orthod Dentofacial Orthop. 2022; 161(1): e72-e79.

3.Ustdal G, Guney AU. YouTube as a source of information about orthodontic clear aligners. Angle Orthod. 2020; 90(3): 419-424.

4.Çapan BŞ. YouTube as a source of information on space maintainers for parents and patients. PLoS One. 2021; 16(2): e0246431.

5.Charnock D, Shepperd S, Needham G, et al. DISCERN: an instrument for judging the quality of written consumer health information on treatment choices. J Epidemiol Community Health. 1999; 53(2): 105-111.

Revised text: not applicable. (The statistical methods and the revised text related are seen in our third response)

3.Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: I Don't Know

Reviewer #3: Yes

Our response: We sincerely apologize for not providing sufficient clarity regarding the appropriateness of our statistical analysis in our previous response letter. Prior to evaluating the videos, we consulted with statistical experts and carefully reviewed pertinent literature [1-4]. To ensure reliability among raters, we calculated Kappa coefficients of correlation. The Shapiro-Wilk test was employed to determine whether our data conformed to a normal distribution. For datasets that deviated from normality, we utilized non-parametric tests: specifically, the Kruskal-Wallis test for comparing more than two samples, the Mann-Whitney test for comparing two independent samples, and Spearman's correlation coefficient to assess relationships between variables.

In our revised manuscript, we have included extensive details on our statistical methodologies, elucidating the specific tests employed and the rationales behind their selection. Furthermore, to enhance transparency and readability, we have clearly indicated which statistical tests were used within each chart legend. This added clarity aims to facilitate a thorough understanding of our analytical approach and the robustness of our findings.

References

1.Lena Y, Dindaroğlu F. Lingual orthodontic treatment: A YouTube™ video analysis. Angle Orthod. 2018; 88(2): 208-214.

2.Kaval ME, Demirci GK, Atesci AA, et al. YouTube™ as an information source for regenerative endodontic treatment procedures: Quality and content analysis. Int J Med Inform. 2022; 161: 104732.

3.Sezici YL, Gediz M, Dindaroğlu F. Is YouTube an adequate patient resource about orthodontic retention? A cross-sectional analysis of content and quality. Am J Orthod Dentofacial Orthop. 2022; 161(1): e72-e79.

4.Fortuna G, Schiavo JH, Aria M, et al. The usefulness of YouTube™ videos as a source of information on burning mouth syndrome.J Oral Rehabil. 2019; 46(7): 657-665.

4.Have the authors made all data underlying the findings in their manuscript fully available?

Reviewer #1: No

Reviewer #3: Yes

Our response: We are immensely grateful for your thoughtful reminder, as we recognize that due to space constraints, it is not always possible to include all relevant information in the main manuscript. We strive to provide any previously omitted information wherever feasible. Unfortunately, the size of the 200 videos in this study, amounting to 2.78GB, exceeded the file upload limit of PLOS ONE, preventing us from uploading them. Therefore, we have included comprehensive details of the 107 included videos in the S1 Table and provided reasons for the exclusion of 93 videos in the S2 Table.

5.Is the manuscript presented in an intelligible fashion and written in standard English?

Reviewer #1: No

Reviewer #3: Yes

Our response: Thank you for your thoughtful suggestion. Based on your recommendation, we have re-engaged a professional editorial team (AJE editorial team) to assist us in polishing the manuscript. We have thoroughly revised the entire manuscript to ensure that it is easy to understand and written in standard English. We sincerely hope that the revised manuscript will meet your satisfaction.

6.Review Comments to the Author

Reviewer #1: Dear Author,

The rebuttal against the raised queries are not satisfactory and not addressed as expected.

We have carefully reconsidered the 1st round queries from Reviewer #1 and aim to ensure the following updated responses fully satisfies your needs.

(1) What is novelty of your research ?

Our response: We appreciate the opportunity to explain the novelty of our research and to make revisions. We noted that our previous abstract did not highlight the novelty of this paper, so we revised the abstract to highlight what is novel about our study.

In short, bleeding gums present a prevalent dental issue in individuals' everyday lives [1-3]. The heightened risk of COVID-19 infection arises from the close proximity between dental practitioners and patients, as well as the generation of aerosols within dental settings [4-6]. Consequently, individuals have refrained from visiting dental clinics amidst the COVID-19 pandemic [4]. In this context, the utilization of the internet can effectively mitigate transmission rates by minimizing physical contact, The utilization of the YouTube platform for the purpose of seeking health-related information has become prevalent among individuals, and it is important to note that YouTube operates on an open-access model, wherein user-generated content lacks the scrutiny of peer review. While YouTube effectively provides valuable health education resources, it is imperative to acknowledge the potential prevalence of misinformation and inaccuracies [7]. Dental professionals have acknowledged the significance of YouTube as a source of patient information, consequently, numerous studies have evaluated the informational quality of YouTube videos on oral-related topics such as burning mouth syndrome, root canal treatment, lingual orthodontic treatment, regenerative endodontic treatment et al [8-11]. According to our knowledge, no recent study has looked into bleeding gums-related content on YouTube. Incorrect and inadequate content in YouTube videos about bleeding gums can significantly influence patients' attitudes and medical decisions. Consequently, the objective of this study is to perform both quantitative and qualitative analyses of YouTube videos pertaining to bleeding gums.

In our revision, we have directly stated the novelty of our research in the abstract (lines 11-13), introduction (lines 61-64), and discussion (lines 248-249).

References

1.Lawal FB, Dosumu EB. Self-reported and clinically evident gingival bleeding and impact on oral health-related quality of life in young adolescents: a comparative study. Malawi Med J. 2021; 33(2): 121-126.

2.Molina GF, Faulks D, Mazzola I, et al. Three-year survival of ART high-viscosity glass-ionomer and resin composite restorations in people with disability. Clin Oral Investig. 2018; 22(1): 461-467.

3.Chen H, Zhang R, Cheng R, et al. Gingival bleeding and calculus among 12-year-old Chinese adolescents: a multilevel analysis. BMC Oral Health. 2020; 20(1): 147.

4.Loch C, Kuan IB, Elsalem L, et al. COVID‐19 and dental clinical practice: Students and clinical staff perceptions of health risks and educational impact. J Dent Educ. 2021; 85(1): 44-52.

5.Haridy R, Abdalla MA, Kaisarly D, et al. A cross‐sectional multicenter survey on the future of dental education in the era of COVID‐19: Alternatives and implications. J Dent Educ. 2021; 85(4): 483-493.

6.Iyer P, Aziz K, Ojcius DM. Impact of COVID‐19 on dental education in the United States. J Dent Educ. 2020; 84(6): 718-722.

7.Hassona Y, Taimeh D, Marahleh A, et al. YouTube as a source of information on mouth (oral) cancer. Oral Dis. 2016; 22(3): 202-208.

8.Fortuna G, Schiavo JH, Aria M, et al. The usefulness of YouTube™ videos as a source of information on burning mouth syndrome. J Oral Rehabil. 2019; 46(7): 657-665.

9.Nason K, Donnelly A, Duncan HF. YouTube as a patient-information source for root canal treatment. Int Endod J. 2016; 49(12): 1194-1200.

10.Lena Y, Dindaroğlu F. Lingual orthodontic treatment: A YouTube™ video analysis. Angle Orthod. 2018; 88(2): 208-214.

11.Kaval ME, Demirci GK, Atesci AA, et al. YouTube™ as an information source for regenerative endodontic treatment procedures: Quality and content analysis. Int J Med Inform. 2022; 161: 104732.

(2) Concern of the reviewer: the methodology seems vague particularly study design? Clarify it.

Our response: We are sorry that our research method, especially the study design, was not well explained in the previous response letter. Our study was aimed at a cross-sectional study of YouTube videos related to bleeding gums, as the initial portrayal of the study design section may potentially perplex readers, in light of this, we have made appropriate revisions (lines 68-71), referring to the previous study conducted by Antonio et al [1-3]. Our research design is as follows (The detailed research methods are included in the Materials and Methods section of our manuscript) :

1. Conducted a search on YouTube using the keyword "bleeding gums" from Google Trends, and collected samples using inclusion and exclusion criteria;

2. The descriptive statistics for the videos included the time since upload, the video length, and the number of likes, views, comments, subscribers, and viewing rates;

3. The global quality score (GQS), usefulness score, and DISCERN were used to evaluate the video quality;

4. Statistical analysis was performed using the Kruskal–Wallis test, Mann–Whitney test, and Spearman correlation analysis.

References

1.Romano A, Lauritano D, Fiori F, et al. Cross-sectional study on the quality of oral lichen planus videos on YouTube™. J Oral Pathol Med. 2021; 50(2): 220-228.

3.Uzel İ, Ghabchi B, Akalın A, et al. YouTube as an information source in paediatric dentistry education: Reliability and quality analysis. PLoS One. 2023; 18(3): e0283300.

(3). Concern of the reviewer: the inclusion and exclusion criteria also needs to be clarified.

Our response: We are sorry that our previous response letter did not clearly explain the inclusion and exclusion criteria of our study, and the updated explanation is as follows:

1. Because the results may be heavily influenced by inclusion and exclusion criteria, therefore, our study referred to research on information quality analysis of YouTube videos on oral related topics [1-4], which will undoubtedly make the conclusions more solid and reliable. More details on inclusion and exclusion criteria can be found in the manuscript Methods section (lines 97-106).

2. Based on the inclusion and exclusion criteria, we excluded 93 videos. A total of 107 videos were included in further assessments. We mentioned this in the Results section (lines 169-171).

3. We have included comprehensive information about 107 included videos in the S1 Table, and we have also supplemented the exclusion reasons for 93 excluded videos in the S2 Table.

References

1.Maganur PC, Hakami Z, Raghunath RG, et al. Reliability of Educational Content Videos in YouTubeTM about Stainless Steel Crowns. Children (Basel). 2022; 9(4): 571.

2.Nason K, Donnelly A, Duncan HF. YouTube as a patient-information source for root canal treatment. Int Endod J. 2016; 49(12): 1194-1200.

4.Topsakal KG, Duran GS, Görgülü S, et al. Is YouTubeTM an adequate source of oral hygiene education for orthodontic patients? Int J Dent Hyg. 2022; 20(3): 504-511.

(4) Concern of the reviewer: How you accessed the video quality? is there any gold standard?

Our response: We are sorry that we did not explain clearly how we accessed the video quality in our previous response letter. As there is still no gold standard for evaluating video quality, therefore, our study referred to several recent studies on information quality analysis of YouTube videos on oral related topics using the global quality score (GQS) [1,2] and usefulness score [3] to evaluate video quality. While video reliability was assessed using DISCERN [4] (A full explanation of the methods used to access video quality analysis can be found in the manuscript Methods section (lines 121-148)). While these are mature standards, we look forward to a gold standard to be developed for evaluating video quality in the future that will help improve video quality by monitoring health information on YouTube and other social networks.

References

1.Sezici YL, Gediz M, Dindaroğlu F. Is YouTube an adequate patient resource about orthodontic retention? A cross-sectional analysis of content and quality. Am J Orthod Dentofacial Orthop. 2022; 161(1): e72-e79.

2.Ustdal G, Guney AU. YouTube as a source of information about orthodontic clear aligners. Angle Orthod. 2020; 90(3): 419-424.

3.Çapan BŞ. YouTube as a source of information on space maintainers for parents and patients. PLoS One. 2021; 16(2): e0246431.

4.Charnock D, Shepperd S, Needham G, et al. DISCERN: an instrument for judging the quality of written consumer health information on treatment choices. J Epidemiol Community Health. 1999; 53(2): 105-111.

Reviewer 3:

(1)introduction line 29- its not explanatory, patients frequently present to the dental clinic with bleeding gums while brushing their teeth or noticing blood in their mouth in the morning after waking up.

Our response: We would like to express our gratitude to the reviewer for pointing out this error, as it will enhance the precision of the sentence. We have revised it (introduction, lines 29-31) , and have appropriately cited the corresponding literature in the reference list (References 1).

(2) line 33- classification is 2017 not 2018.

Our response: We thank the reviewer for pointing out this error and we have revised the year for the new classification of periodontal and peri-implant diseases and conditions (introduction, lines 35), which was proposed in 2017 as said by the reviewer [1].

References

1.Caton JG, Armitage G, Berglundh T, Chapple IL, Jepsen S, Kornman KS, et al. A new classification scheme for periodontal and peri‐implant diseases and conditions–Introduction and key changes from the 1999 classification. Journal of clinical periodontology. 2018; 45 Suppl 20: S1-S8.

(3) what were your keywords for search?

Our response: We are grateful to the reviewer for bringing this matter to our attention, referring to the information quality analysis study of YouTube videos on oral related topics [1-3], we were performed on YouTube using the keyword "bleeding gums" from Google Trends (details about the search strategies are included in the Materials and Methods section of our article (lines 73-84)).

References

1.Maganur PC, Hakami Z, Raghunath RG, Vundavalli S, Jeevanandan G, Almugla YM, et al. Reliability of Educational Content Videos in YouTubeTM about Stainless Steel Crowns. Children (Basel). 2022; 9(4): 571.

3.Topsakal KG, Duran GS, Görgülü S, et al. Is YouTubeTM an adequate source of oral hygiene education for orthodontic patients? Int J Dent Hyg. 2022; 20(3): 504-511.

Thank you for your consideration. I look forward to hearing from you.

Best regards,

Prof. Minkui Lin

(Fujian Key Laboratory of Oral Diseases&Fujian Provincial Engineering Research Center of Oral Biomaterial&Stomatological Key Lab of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University)

Email address: linmk105@ sina.com

Attachment

Submitted filename: Response to Reviewers.docx

pone.0298597.s004.docx^{(427.6KB, docx)}

PLoS One. doi: 10.1371/journal.pone.0298597.r005

Decision Letter 2

Tanay Chaubal

15 Jan 2024

PONE-D-23-16369R2YouTube as an information source for bleeding gums: A quantitative and qualitative analysisPLOS ONE

Dear Dr. Lin,

==============================Thank you for addressing the reviewers' comments. However, the manuscript needs further improvements. Kindly address all the comments made by the reviewers.==============================

Please submit your revised manuscript by Feb 29 2024 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file.

Please include the following items when submitting your revised manuscript:

A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'.
A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'.
An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'.

We look forward to receiving your revised manuscript.

Kind regards,

Tanay Chaubal

Academic Editor

PLOS ONE

[Note: HTML markup is below. Please do not edit.]

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

Reviewer #1: All comments have been addressed

Reviewer #3: All comments have been addressed

**********

2. Is the manuscript technically sound, and do the data support the conclusions?

Reviewer #1: Yes

Reviewer #3: Yes

**********

3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #3: Yes

**********

4. Have the authors made all data underlying the findings in their manuscript fully available?

Reviewer #1: Yes

Reviewer #3: Yes

**********

5. Is the manuscript presented in an intelligible fashion and written in standard English?

Reviewer #1: Yes

Reviewer #3: Yes

**********

6. Review Comments to the Author

Reviewer #1: Dear Author,

Rebuttal against the queries are not addressed satisfactorily. The manuscript is not acceptable in current form

Reviewer #3: All the queries and references are well explained and addressed to in proper systematic manner. all required questions have been answered and that all responses meet formatting specifications.

**********

7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy.

Reviewer #1: Yes: Akhilanand Chaurasia

Reviewer #3: No

**********

PLoS One. 2024 Mar 6;19(3):e0298597. doi: 10.1371/journal.pone.0298597.r006

Author response to Decision Letter 2

22 Jan 2024

Dear Editor:

Reviewer Comments and Responses:

1.If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.

Reviewer #1: All comments have been addressed

Reviewer #3: All comments have been addressed

Our response: We express our gratitude to the reviewers for their endorsement.

2.Is the manuscript technically sound, and do the data support the conclusions?

Reviewer #1: Yes

Reviewer #3: Yes

Our response: None.

3.Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #3: Yes

Our response: None.

4.Have the authors made all data underlying the findings in their manuscript fully available?

Reviewer #1: Yes

Reviewer #3: Yes

Our response: None.

5.Is the manuscript presented in an intelligible fashion and written in standard English?

Reviewer #1: Yes

Reviewer #3: Yes

Our response: None.

6.Review Comments to the Author

Reviewer #1: Dear Author,

Rebuttal against the queries are not addressed satisfactorily. The manuscript is not acceptable in current form.

We appreciate Dr. Akhilanand Chaurasia’s acknowledgement of our efforts to improve the manuscript based on the comments in the first round of review. However, there are still several areas that require further clarification. We have tried our best to review the manuscript and made sure that the updated responses below fully meet your requirements.

(1) What is novelty of your research ?

Our response: According to our knowledge, no recent study has evaluated content related to bleeding gums on YouTube. However, study on YouTube video relevant to bleeding gums is required, as bleeding gums present a prevalent dental issue in individuals' everyday lives [1-3]. Bleeding gums are mainly triggered by periodontal disease and occasionally by peri-implant diseases, direct trauma, viruses, fungal or bacterial infections, medications, pregnancy, dermatoses, and systemic disorders [4-12], patients' quality of life suffers as a result [13-15].

The utilization of the YouTube platform for the purpose of seeking health-related information has become prevalent among individuals [16], and it is important to note that YouTube is open access, which means that user-generated content is not peer reviewed; while it offers effective health education resources, there may also be a great deal of misinformation and inaccuracy [17]. Incorrect and inadequate content in YouTube videos about bleeding gums can significantly influence patients' attitudes and medical decisions. Consequently, the objective of this study is to perform both quantitative and qualitative analyses of YouTube videos pertaining to bleeding gums.

In our article, we have directly stated the novelty of our research in the abstract (lines 11-13), introduction (lines 61-64), and discussion (lines 248-249). In addition, we added relevant references to the discussion, highlighting studies with both intra-oral and extra-oral causes, such as bad breath [18], with similar results [19], reinforcing our conclusions. At the same time, in order to better evaluate YouTube videos, we also refer to the literature of Chaurasia et al. [20], and add the possible role of Deep Learning model related content in YouTube video evaluation. Although it has not been realized in our study, Deep Learning model provides an important direction for future application.

References

2.Molina GF, Faulks D, Mazzola I, et al. Three-year survival of ART high-viscosity glass-ionomer and resin composite restorations in people with disability. Clin Oral Investig. 2018; 22(1): 461-467.

3.Chen H, Zhang R, Cheng R, et al. Gingival bleeding and calculus among 12-year-old Chinese adolescents: a multilevel analysis. BMC Oral Health. 2020; 20(1): 147.

4.Newbrun E. Indices to measure gingival bleeding. Journal of periodontology. 1996; 67(6): 555-561.

5.Darby I. Drugs and gingival bleeding. Australian Prescriber. 2006; 29: 154-155.

6.Bui FQ, Almeida-da-Silva CLC, Huynh B, Trinh A, Liu J, Woodward J, et al. Association between periodontal pathogens and systemic disease. Biomedical journal. 2019; 42(1): 27-35.

7.Rokaya D, Srimaneepong V, Wisitrasameewon W, Humagain M, Thunyakitpisal P. Peri-implantitis Update: Risk Indicators, Diagnosis, and Treatment. European journal of dentistry. 2020; 14(4): 672-682.

8.Heboyan A, Syed AUY, Rokaya D, Cooper PR, Manrikyan M, Markaryan M. Cytomorphometric Analysis of Inflammation Dynamics in the Periodontium Following the Use of Fixed Dental Prostheses. Molecules. 2020; 25(20): 4650.

9.Elani HW, Starr JR, Da Silva JD, Gallucci GO. Trends in Dental Implant Use in the U.S., 1999-2016, and Projections to 2026. Journal of dental research. 2018; 97(13): 1424-1430.

10.Lee CT, Huang YW, Zhu L, Weltman R. Prevalences of peri-implantitis and peri-implant mucositis: systematic review and meta-analysis. Journal of dentistry. 2017; 62: 1-12.

11.Achoki T, Miller-Petrie MK, Glenn SD, Kalra N, Lesego A, Gathecha GK, et al. Health disparities across the counties of Kenya and implications for policy makers, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Glob Health. 2019; 7(1): e81-e95.

12.Pihlstrom BL, Michalowicz BS, Johnson NW. Periodontal diseases. Lancet. 2005;366(9499):1809-1820.

13.Santonocito S, Palazzo G, Indelicato F, Chaurasia A, Isola G. Effects induced by periodontal disease on overall quality of life and self-esteem. Mediterranean Journal of Clinical Psychology. 2022; 10(1).

14.Slots J. Periodontology: past, present, perspectives. Periodontol 2000. 2013;62(1):7–19.

15.Frencken JE, Sharma P, Stenhouse L, Green D, Laverty D, Dietrich T. Global epidemiology of dental caries and severe periodontitis—a comprehensive review. Journal Of Clinical Periodontology. 2017;44(Suppl 18):S94-s105.

16.Bezner SK, Hodgman EI, Diesen DL, Clayton JT, Minkes RK, Langer JC, et al. Pediatric surgery on YouTube™: is the truth out there? Journal of Pediatric Surgery. 2014; 49(4): 586-589.

17.Hassona Y, Taimeh D, Marahleh A, Scully C. YouTube as a source of information on mouth (oral) cancer. Oral Dis. 2016; 22(3): 202-208.

18.Chaurasia A, Katheriya G. Prevalence of halitosis and related factors in North Indian population- A hospital based cross-sectional study. Journal of Oral Medicine, Oral Surgery, Oral Pathology and Oral Radiology. 2018; 4(2):79-84.

19.Ramadhani A, Zettira Z, Rachmawati YL, Hariyani N, Maharani DA. Quality and Reliability of Halitosis Videos on YouTube as a Source of Information. Dentistry Journal (Basel). 2021; 9(10): 120.

20.Chaurasia A, Namachivayam A, Koca-Ünsal RB, Lee JH. Deep-learning performance in identifying and classifying dental implant systems from dental imaging: a systematic review and meta-analysis. Journal of Periodontal and Implant Science. 2023; 53(3):e12.

(2) Concern of the reviewer: the methodology seems vague particularly study design? Clarify it.

Our response: We appreciate the opportunity to explain our research method (especially the study design). Our research design is a cross-sectional study that quantitatively and qualitatively analyzes videos related to bleeding gums on YouTube. Within the framework of this research design, referring to the previous study conducted by Antonio et al [1-3], we provide a detailed description of the specific techniques and procedures used to collect, analyze, and interpret data in the Materials and Methods section. Our research method is as follows (The detailed research methods are included in the Materials and Methods section of our manuscript):

1. Conducted a search on YouTube using the keyword "bleeding gums" from Google Trends, select the top 200 videos, and further analyze 107 of them based on the inclusion and exclusion criteria;

2.Descriptive statistics on 107 videos, including the time since upload, the video length, and the number of likes, views, comments, subscribers, and viewing rates, and categorize these videos according to their sources;

3.Use global quality score (GQS), usefulness score, and total score to evaluate video quality, and use DISCERN to evaluate video reliability;

4.IBM SPSS Statistics 27 software was used for statistical tests. The normality of the data was determined using the Shapiro‒Wilk test. Non-parametric tests were used for data that did not adhere to the normal distribution: the Kruskal-Wallis test (for more than two samples), the Mann-Whitney test (for two independent samples), and Spearman's correlation coefficient. Kappa coefficients of correlation were calculated to assess interrater reliability. The significance level was set at p <0.05.

References

1.Romano A, Lauritano D, Fiori F, et al. Cross-sectional study on the quality of oral lichen planus videos on YouTube™. J Oral Pathol Med. 2021; 50(2): 220-228.

3.Uzel İ, Ghabchi B, Akalın A, et al. YouTube as an information source in paediatric dentistry education: Reliability and quality analysis. PLoS One. 2023; 18(3): e0283300.

(3) Concern of the reviewer: the inclusion and exclusion criteria also needs to be clarified.

Our response: We are sorry that our previous response letter did not clearly explain the inclusion and exclusion criteria of our study, and the updated explanation is as follows:

1.Since the results may be heavily influenced by the inclusion and exclusion criteria, we referred to research on information quality analysis of YouTube videos on oral related topics [1-4] when formulating the inclusion and exclusion criteria, aiming to select research objects with common characteristics from complex videos and exclude the influence of some non-research factors. Ensuring the reasonableness and completeness of the inclusion and exclusion criteria will undoubtedly make the conclusions more solid and reliable. Detailed information on the inclusion and exclusion criteria can be found in the manuscript Methods section (lines 97-106).

2. Based on the inclusion and exclusion criteria, we excluded 93 videos. A total of 107 videos were included in further assessments. We mentioned this in the Results section (lines 169-171).

3. We have included comprehensive information about 107 included videos in the S1 Table, and we have also supplemented the exclusion reasons for 93 excluded videos in the S2 Table.

References

1.Maganur PC, Hakami Z, Raghunath RG, et al. Reliability of Educational Content Videos in YouTubeTM about Stainless Steel Crowns. Children (Basel). 2022; 9(4): 571.

2.Nason K, Donnelly A, Duncan HF. YouTube as a patient-information source for root canal treatment. Int Endod J. 2016; 49(12): 1194-1200.

4.Topsakal KG, Duran GS, Görgülü S, et al. Is YouTubeTM an adequate source of oral hygiene education for orthodontic patients? Int J Dent Hyg. 2022; 20(3): 504-511.

(4) Concern of the reviewer: How you accessed the video quality? is there any gold standard?

Our response: We are sorry that we did not explain clearly how we accessed the video quality in our previous response letter. As there is still no gold standard for evaluating video quality, therefore, our study referred to several recent studies on information quality analysis of YouTube videos on oral related topics. Global quality score (GQS) [1,2] and usefulness score [3] were respectively used to evaluate the quality of YouTube video information to improve the accuracy of quality analysis results. The results showed that the quality scores of videos using GQS and usefulness scores were consistent, respectively (A full explanation of the methods used to access video quality analysis can be found in the manuscript Methods section (lines 121-148)). While these are mature standards, we look forward to a gold standard to be developed for evaluating video quality in the future that will help improve video quality by monitoring health information on YouTube and other social networks.

References

2.Ustdal G, Guney AU. YouTube as a source of information about orthodontic clear aligners. Angle Orthod. 2020; 90(3): 419-424.

3.Çapan BŞ. YouTube as a source of information on space maintainers for parents and patients. PLoS One. 2021; 16(2): e0246431.

Reviewer #3:

All the queries and references are well explained and addressed to in proper systematic manner. all required questions have been answered and that all responses meet formatting specifications.

Our response: We thank Reviewer #3 for recognition of our revised manuscript.

Thank you for your consideration. I look forward to hearing from you.

Best regards,

Prof. Minkui Lin

Email address: linmk105@ sina.com

Attachment

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PLoS One. doi: 10.1371/journal.pone.0298597.r007

Decision Letter 3

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29 Jan 2024

YouTube as an information source for bleeding gums: A quantitative and qualitative analysis

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PLoS One. doi: 10.1371/journal.pone.0298597.r008

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[pone.0298597.ref001] 1.Almas K, Al-Hawish A, Al-Khamis W. Oral hygiene practices, smoking habit, and self-perceived oral malodor among dental students. Journal of Contemporary Dental Practice. 2003; 4(4): 77–90. [PubMed] [Google Scholar]

[pone.0298597.ref002] 2.Newbrun E. Indices to measure gingival bleeding. Journal of periodontology. 1996; 67(6): 555–561. doi: 10.1902/jop.1996.67.6.555 [DOI] [PubMed] [Google Scholar]

[pone.0298597.ref003] 3.Darby I. Drugs and gingival bleeding. Australian Prescriber. 2006; 29: 154–155. [Google Scholar]

[pone.0298597.ref004] 4.Bui FQ, Almeida-da-Silva CLC, Huynh B, Trinh A, Liu J, Woodward J, et al. Association between periodontal pathogens and systemic disease. Biomedical journal. 2019; 42(1): 27–35. doi: 10.1016/j.bj.2018.12.001 [DOI] [PMC free article] [PubMed] [Google Scholar]

[pone.0298597.ref005] 5.Rokaya D, Srimaneepong V, Wisitrasameewon W, Humagain M, Thunyakitpisal P. Peri-implantitis Update: Risk Indicators, Diagnosis, and Treatment. European journal of dentistry. 2020; 14(4): 672–682. [DOI] [PMC free article] [PubMed] [Google Scholar]

[pone.0298597.ref006] 6.Heboyan A, Syed AUY, Rokaya D, Cooper PR, Manrikyan M, Markaryan M. Cytomorphometric Analysis of Inflammation Dynamics in the Periodontium Following the Use of Fixed Dental Prostheses. Molecules. 2020; 25(20): 4650. doi: 10.3390/molecules25204650 [DOI] [PMC free article] [PubMed] [Google Scholar]

[pone.0298597.ref007] 7.Elani HW, Starr JR, Da Silva JD, Gallucci GO. Trends in Dental Implant Use in the U.S., 1999–2016, and Projections to 2026. Journal of dental research. 2018; 97(13): 1424–1430. doi: 10.1177/0022034518792567 [DOI] [PMC free article] [PubMed] [Google Scholar]

[pone.0298597.ref008] 8.Lee CT, Huang YW, Zhu L, Weltman R. Prevalences of peri-implantitis and peri-implant mucositis: systematic review and meta-analysis. Journal of dentistry. 2017; 62: 1–12. doi: 10.1016/j.jdent.2017.04.011 [DOI] [PubMed] [Google Scholar]

[pone.0298597.ref009] 9.Achoki T, Miller-Petrie MK, Glenn SD, Kalra N, Lesego A, Gathecha GK, et al. Health disparities across the counties of Kenya and implications for policy makers, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Glob Health. 2019; 7(1): e81–e95. doi: 10.1016/S2214-109X(18)30472-8 [DOI] [PMC free article] [PubMed] [Google Scholar]

[pone.0298597.ref010] 10.Pihlstrom BL, Michalowicz BS, Johnson NW. Periodontal diseases. Lancet. 2005;366(9499):1809–1820. doi: 10.1016/S0140-6736(05)67728-8 [DOI] [PubMed] [Google Scholar]

[pone.0298597.ref011] 11.Veynachter T, Orti V, Moulis E, Rousseau H, Thilly N, Anagnostou F, et al. Prevalence and associated factors of self-reported gingival bleeding: a multicenter study in France. International Journal of Environmental Research and Public Health. 2020; 17(22): 8563. [DOI] [PMC free article] [PubMed] [Google Scholar]

[pone.0298597.ref012] 12.Caton JG, Armitage G, Berglundh T, Chapple IL, Jepsen S, Kornman KS, et al. A new classification scheme for periodontal and peri‐implant diseases and conditions–Introduction and key changes from the 1999 classification. Journal of clinical periodontology. 2018; 45 Suppl 20: S1–S8. [DOI] [PubMed] [Google Scholar]

[pone.0298597.ref013] 13.Kinane DF, Stathopoulou PG, Papapanou PN. Periodontal diseases. Nature Reviews Disease Primers. 2017; 3: 17038. doi: 10.1038/nrdp.2017.38 [DOI] [PubMed] [Google Scholar]

[pone.0298597.ref014] 14.Kassebaum N, Bernabé E, Dahiya M, Bhandari B, Murray C, Marcenes W. Global burden of severe periodontitis in 1990–2010: a systematic review and meta-regression. Journal of dental research. 2014; 93(11): 1045–1053. doi: 10.1177/0022034514552491 [DOI] [PMC free article] [PubMed] [Google Scholar]

[pone.0298597.ref015] 15.Peres MA, Macpherson LM, Weyant RJ, Daly B, Venturelli R, Mathur MR, et al. Oral diseases: a global public health challenge. The Lancet. 2019; 394(10194): 249–660. doi: 10.1016/S0140-6736(19)31146-8 [DOI] [PubMed] [Google Scholar]

[pone.0298597.ref016] 16.Tonetti MS, Jepsen S, Jin L, Otomo‐Corgel J. Impact of the global burden of periodontal diseases on health, nutrition and wellbeing of mankind: A call for global action. Journal of Clinical Periodontology. 2017; 44(5): 456–462. doi: 10.1111/jcpe.12732 [DOI] [PubMed] [Google Scholar]

[pone.0298597.ref017] 17.Brennan D, Spencer A, Roberts-Thomson K. Quality of life and disability weights associated with periodontal disease. Journal of dental research. 2007; 86(8): 713–717. doi: 10.1177/154405910708600805 [DOI] [PubMed] [Google Scholar]

[pone.0298597.ref018] 18.Taani DQ. Periodontal awareness and knowledge, and pattern of dental attendance among adults in Jordan. International Dental Journal. 2002; 52(2): 94–98. [DOI] [PubMed] [Google Scholar]

[pone.0298597.ref019] 19.Ikemba CM, Kozinetz CA, Feltes TF, Fraser CD Jr, McKenzie ED, Shah N, et al. Internet use in families with children requiring cardiac surgery for congenital heart disease. Pediatrics. 2002; 109(3): 419–22. doi: 10.1542/peds.109.3.419 [DOI] [PubMed] [Google Scholar]

[pone.0298597.ref020] 20.Wainstein BK, Sterling‐Levis K, Baker SA, Taitz J, Brydon M. Use of the Internet by parents of paediatric patients. J Paediatr Child Health. 2006; 42(9): 528–332. doi: 10.1111/j.1440-1754.2006.00916.x [DOI] [PubMed] [Google Scholar]

[pone.0298597.ref021] 21.Boston M, Ruwe E, Duggins A, Willging JP. Internet use by parents of children undergoing outpatient otolaryngology procedures. Arch Otolaryngol Head Neck Surg. 2005; 131(8): 719–722. doi: 10.1001/archotol.131.8.719 [DOI] [PubMed] [Google Scholar]

[pone.0298597.ref022] 22.Hassona Y, Taimeh D, Marahleh A, Scully C. YouTube as a source of information on mouth (oral) cancer. Oral Dis. 2016; 22(3): 202–208. doi: 10.1111/odi.12434 [DOI] [PubMed] [Google Scholar]

[pone.0298597.ref023] 23.Bezner SK, Hodgman EI, Diesen DL, Clayton JT, Minkes RK, Langer JC, et al. Pediatric surgery on YouTube™: is the truth out there? Journal of Pediatric Surgery. 2014; 49(4): 586–589. [DOI] [PubMed] [Google Scholar]

[pone.0298597.ref024] 24.Gao X, Hamzah S, Yiu C, McGrath C, King N. Dental fear and anxiety in children and adolescents-A qualitative study using social media. Journal of Medical Internet Research. 2013; 15(2): e29. [DOI] [PMC free article] [PubMed] [Google Scholar]

[pone.0298597.ref025] 25.Kaval ME, Demirci GK, Atesci AA, Sarsar F, Dindaroğlu F, Güneri P, et al. YouTube™ as an information source for regenerative endodontic treatment procedures: Quality and content analysis. International Journal of Medical Informatics. 2022; 161: 104732. [DOI] [PubMed] [Google Scholar]

[pone.0298597.ref026] 26.Nason K, Donnelly A, Duncan H. YouTube as a patient‐information source for root canal treatment. International Endodontic Journal. 2016; 49(12): 1194–200. doi: 10.1111/iej.12575 [DOI] [PubMed] [Google Scholar]

[pone.0298597.ref027] 27.Google Trends[Internet]. America: Google; c2022[cited 2022 Aug 28]. Available from: https://trends.google.com.tr/trends/?geo=TR.

[pone.0298597.ref028] 28.Eysenbach G, Köhler C. How do consumers search for and appraise health information on the world wide web? Qualitative study using focus groups, usability tests, and in-depth interviews. British Medical Journal. 2002; 324(7337): 573–577. doi: 10.1136/bmj.324.7337.573 [DOI] [PMC free article] [PubMed] [Google Scholar]

[pone.0298597.ref029] 29.Peterson G, Aslani P, Williams KA. How do consumers search for and appraise information on medicines on the Internet? A qualitative study using focus groups. Journal of Medical Internet Research. 2003; 5(4): e3. doi: 10.2196/jmir.5.4.e33 [DOI] [PMC free article] [PubMed] [Google Scholar]

[pone.0298597.ref030] 30.Desai T, Shariff A, Dhingra V, Minhas D, Eure M, Kats M. Is content really king? An objective analysis of the public’s response to medical videos on YouTube. PLoS One. 2013; 8(12): e82469. [DOI] [PMC free article] [PubMed] [Google Scholar]

[pone.0298597.ref031] 31.YouTube Creators: How YouTube Search Works[Internet]. America: YouTube; c2022[cited 2022 Aug 28]. Available from: https://www.youtube.com/watch?v=gTrLniP5tSQ.

[pone.0298597.ref032] 32.Maganur PC, Hakami Z, Raghunath RG, Vundavalli S, Jeevanandan G, Almugla YM, et al. Reliability of Educational Content Videos in YouTubeTM about Stainless Steel Crowns. Children (Basel). 2022; 9(4): 571. doi: 10.3390/children9040571 [DOI] [PMC free article] [PubMed] [Google Scholar]

[pone.0298597.ref033] 33.Sezici YL, Gediz M, Dindaroğlu F. Is YouTube an adequate patient resource about orthodontic retention? A cross-sectional analysis of content and quality. American journal of orthodontics and dentofacial orthopedics. 2022; 161(1): e72–e79. [DOI] [PubMed] [Google Scholar]

[pone.0298597.ref034] 34.Topsakal KG, Duran GS, Görgülü S, Eser Misir S. Is YouTubeTM an adequate source of oral hygiene education for orthodontic patients? International journal of dental hygiene. 2022; 20(3): 504–511. doi: 10.1111/idh.12557 [DOI] [PubMed] [Google Scholar]

[pone.0298597.ref035] 35.ElKarmi R, Hassona Y, Taimeh D, Scully C. YouTube as a source for parents’ education on early childhood caries. International Journal of Paediatric Dentistry. 2017; 27(6): 437–443. doi: 10.1111/ipd.12277 [DOI] [PubMed] [Google Scholar]

[pone.0298597.ref036] 36.Bernard A, Langille M, Hughes S, Rose C, Leddin D, Van Zanten SV. A systematic review of patient inflammatory bowel disease information resources on the World Wide Web. Official journal of the American College of Gastroenterology| ACG. 2007; 102(9): 2070–2077. doi: 10.1111/j.1572-0241.2007.01325.x [DOI] [PubMed] [Google Scholar]

[pone.0298597.ref037] 37.Charnock D, Shepperd S, Needham G, Gann R. DISCERN: an instrument for judging the quality of written consumer health information on treatment choices. Journal of Epidemiology and Community Health. 1999; 53(2): 105–111. doi: 10.1136/jech.53.2.105 [DOI] [PMC free article] [PubMed] [Google Scholar]

[pone.0298597.ref038] 38.Ng JY, Ahmed S, Zhang CJ. Dietary and herbal supplements for weight loss: Assessing the quality of patient information online. Nutrition Journal. 2021; 20: 1–13. [DOI] [PMC free article] [PubMed] [Google Scholar]

[pone.0298597.ref039] 39.Aksoy M, Topsakal KG. YouTube™ for information on paediatric oral health instructions. International Journal of Dental Hygiene. 2022; 20(3): 496–503. [DOI] [PubMed] [Google Scholar]

[pone.0298597.ref040] 40.Loch C, Kuan IB, Elsalem L, Schwass D, Brunton PA, Jum’ah A. COVID‐19 and dental clinical practice: Students and clinical staff perceptions of health risks and educational impact. Journal of Dental Education. 2021; 85(1): 44–52. doi: 10.1002/jdd.12402 [DOI] [PubMed] [Google Scholar]

[pone.0298597.ref041] 41.Haridy R, Abdalla MA, Kaisarly D, Gezawi ME. A cross‐sectional multicenter survey on the future of dental education in the era of COVID‐19: Alternatives and implications. Journal of Dental Education. 2021; 85(4): 483–493. doi: 10.1002/jdd.12498 [DOI] [PMC free article] [PubMed] [Google Scholar]

[pone.0298597.ref042] 42.Iyer P, Aziz K, Ojcius DM. Impact of COVID‐19 on dental education in the United States. Journal of Dental Education. 2020; 84(6): 718–722. doi: 10.1002/jdd.12163 [DOI] [PubMed] [Google Scholar]

[pone.0298597.ref043] 43.Marouf N, Cai W, Said KN, Daas H, Diab H, Chinta VR, et al. Association between periodontitis and severity of COVID‐19 infection: A case–control study. Journal of Clinical Periodontology. 2021; 48(4): 483–491. doi: 10.1111/jcpe.13435 [DOI] [PMC free article] [PubMed] [Google Scholar]

[pone.0298597.ref044] 44.Chang MC, Park D, editors. YouTube as a source of patient information regarding exercises and compensated maneuvers for dysphagia. Healthcare (Basel). 2021; 9(8): 1084. doi: 10.3390/healthcare9081084 [DOI] [PMC free article] [PubMed] [Google Scholar]

[pone.0298597.ref045] 45.Romano A, Lauritano D, Fiori F, Di Petrillo M, Hasan I, Lucchese A, et al. Cross‐sectional study on the quality of oral lichen planus videos on YouTube™. Journal of Oral Pathology & Medicine. 2021; 50(2): 220–228. doi: 10.1111/jop.13128 [DOI] [PubMed] [Google Scholar]

[pone.0298597.ref046] 46.Ramadhani A, Zettira Z, Rachmawati YL, Hariyani N, Maharani DA. Quality and Reliability of Halitosis Videos on YouTube as a Source of Information. Dentistry Journal (Basel). 2021; 9(10): 120. doi: 10.3390/dj9100120 [DOI] [PMC free article] [PubMed] [Google Scholar]

[pone.0298597.ref047] 47.Chaurasia A, Katheriya G. Prevalence of halitosis and related factors in North Indian population- A hospital based cross-sectional study. Journal of Oral Medicine, Oral Surgery, Oral Pathology and Oral Radiology. 2018; 4(2):79–84. [Google Scholar]

[pone.0298597.ref048] 48.Buyuk SK, Genc E, Yavuz MC. Does YouTube (TM) offer high quality information? Evaluation of accelerated orthodontics videos. 2020; 189(2): 505–509. [DOI] [PubMed] [Google Scholar]

[pone.0298597.ref049] 49.Kurian N, Varghese KG, Daniel S, Varghese VS, Kaur T, Verma R. Are YouTube videos on complete arch fixed implant-supported prostheses useful for patient education? The Journal of prosthetic dentistry. 2022; S0022-3913(22)00138-X. doi: 10.1016/j.prosdent.2022.02.013 [DOI] [PubMed] [Google Scholar]

[pone.0298597.ref050] 50.Ajumobi AB, Malakouti M, Bullen A, Ahaneku H, Lunsford TN. YouTube™ as a source of instructional videos on bowel preparation: a content analysis. Journal of Cancer Education. 2016; 31: 755–759. [DOI] [PubMed] [Google Scholar]

[pone.0298597.ref051] 51.Delli K, Livas C, Vissink A, Spijkervet FK. Is YouTube useful as a source of information for Sjögren’s syndrome? Oral Diseases. 2016; 22(3): 196–201. [DOI] [PubMed] [Google Scholar]

[pone.0298597.ref052] 52.Bhola S, Hellyer P. The risks and benefits of social media in dental foundation training. British Dental Journal. 2016; 221(10): 609–613. doi: 10.1038/sj.bdj.2016.854 [DOI] [PubMed] [Google Scholar]

[pone.0298597.ref053] 53.Lavorgna L, De Stefano M, Sparaco M, Moccia M, Abbadessa G, Montella P, et al. Fake news, influencers and health-related professional participation on the Web: A pilot study on a social-network of people with Multiple Sclerosis. Multiple sclerosis and related disorders. 2018; 25: 175–178. doi: 10.1016/j.msard.2018.07.046 [DOI] [PubMed] [Google Scholar]

[pone.0298597.ref054] 54.Chaurasia A, Namachivayam A, Koca-Ünsal RB, Lee JH. Deep-learning performance in identifying and classifying dental implant systems from dental imaging: a systematic review and meta-analysis. Journal of Periodontal and Implant Science. 2023; 53(3):e12. doi: 10.5051/jpis.2300160008 [DOI] [PMC free article] [PubMed] [Google Scholar]

PERMALINK

YouTube as an information source for bleeding gums: A quantitative and qualitative analysis

Jiali Wu

Danlin Li

Minkui Lin

Roles

Abstract

1. Introduction

2. Materials and methods

2.1. Research design

2.2. Search strategy

Fig 1. Interest rates in different phrases over time in Google Trends.

2.3. Inclusion and exclusion criteria (Fig 2)

Fig 2. A flow chart showing the screening process for YouTube™ videos.

2.4. Video parameters

2.5. Sources of the videos

2.6. Assessment of quality

Table 1. Global quality score (GQS) criteria.

Table 2. Usefulness score.

Table 3. Total score.

2.7. Assessment of reliability

Table 4. DISCERN reliability tool (1 point per question for yes answers).

2.8. Statistical analysis

2.9. Ethics statement

3. Results

Table 5. Reasons for excluding videos for each search term.

Table 6. Descriptive variables of the YouTube™ videos.

Table 7. Frequency and percentage of the global quality scale score.

Table 8. Distribution of the usefulness score items.

Table 9. Comparison of YouTube™ video uploaders between poor, moderate, and good informational videos about bleeding gums.

Table 10. Comparison of video parameters among poor, moderate, and good informational videos about bleeding gums.

Table 11. Correlation of the data.

Table 12. Comparison between video length and viewing rate of YouTube™ videos on bleeding gums.

Table 13. Comparison of video variables based on duration.

4. Discussion

Supporting information

Acknowledgments

Data Availability

Funding Statement

References

Decision Letter 0

Anand Marya

Roles

Author response to Decision Letter 0

Decision Letter 1

Tanay Chaubal

Roles

Author response to Decision Letter 1

Decision Letter 2

Tanay Chaubal

Roles

Author response to Decision Letter 2

Decision Letter 3

Tanay Chaubal

Roles

Acceptance letter

Tanay Chaubal

Roles

Associated Data

Supplementary Materials

Data Availability Statement

ACTIONS

PERMALINK

RESOURCES

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