Public Perception of Fluoride: An Infodemiological Analysis of YouTube Videos and Comments

Abstract

Objective:

This study aimed to analyze the public’s perception of fluoride by investigating the most-viewed YouTube videos and their associated comments addressing fluoride in dental/public health contexts.

Methods:

Metadata and comments of YouTube videos were retrieved using the YouTube Data application programming interface (YouTube Data API) via Python. The top 100 most-viewed YouTube videos related to fluoride and their comments were analyzed. Sentiment analysis, Latent Dirichlet Allocation (LDA) topic modeling, word co-occurrence analysis, and word frequency analysis were performed. Statistical analyses including Spearman’s correlation, Kruskal–Wallis tests, and Mann–Whitney U tests were conducted to assess potential associations.

Result:

A total of 76 eligible videos and 88,126 comments were analyzed. Approximately half (45%) of the retrieved videos were uploaded in 2024 and 2025. The mean (±standard deviation) and median sentiment scores were 9.5 ± 15.9 and 5.4, respectively. Significant negative correlations were observed between sentiment scores and both video views (r = −0.247, P = 0.032) and the number of comments (r = −0.486, P < 0.001). Among professional uploaders, videos by dental hygienists had a higher sentiment score compared with those by dentists (17.5 vs. −0.5). Topic modeling revealed that the term “poison” appeared 6 times more frequently in negative comments than in positive comments, followed by “conspiracy” and “bad,” whereas “love,” “care,” and “safe” were predominant in positive comments.

Conclusion:

Fluoride has emerged as a controversial societal topic. The terms “poison” and “conspiracy” reflect prominent public concerns. Dental hygienists play a critical role in disseminating online information on fluoride, highlighting the need for targeted strategies to mitigate public anxiety and promote the appropriate use of fluoride in dental care.

Knowledge Transfer Statement:

The present study provides insights into public health communication. First, empowering professionals and optimizing video formats (eg, tutorials, skills-based demonstration, and short dramas) could enhance the reach and acceptance of evidence-based fluoride advocacy. Second, policymakers should address societal and historical factors shaping public distrust, rather than relying solely on scientific dissemination. Finally, due to contagion of negative emotions, there is a need to monitor and alleviate negative sentiments.