{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T19:07:14Z","timestamp":1782846434245,"version":"3.54.5"},"reference-count":40,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Form Res"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec sec-type=\"background\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Dental caries is one of the most prevalent chronic conditions globally. In Japan, fluoride application\u2014mainly via toothpaste, mouth rinses, and professional treatments\u2014is a key preventive measure, as community water fluoridation is not implemented. Despite its proven effectiveness, fluoride use faces opposition from certain groups citing potential health risks. Social media platforms, especially YouTube, have become major sources of health information, but also facilitate the spread of misinformation, which may influence public perceptions and behaviors toward fluoride use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"objective\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to analyze YouTube videos addressing fluoride use for caries prevention, focusing on the types of information presented and comparing the messages shared by proponents and opponents of fluoride use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"methods\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A comprehensive search was conducted on YouTube using fluoride-related keywords in Japanese. The top 50 videos for each keyword were screened, and after excluding irrelevant or duplicate content, 86 videos were analyzed. Videos were categorized as proponent (\u201cpro\u201d), opponent (\u201canti\u201d), or others. The sources, intended audiences, and content themes were assessed. Interrater reliability was confirmed using the Cohen \u03ba coefficient.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"results\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of the 86 analyzed videos, 58% (n=50) were categorized as \u201cpro,\u201d 22% (n=19) as \u201canti,\u201d and 20% (n=17) as others. Proponent videos, mainly produced by dental professionals, emphasized scientific evidence, such as the mechanism of fluoride in preventing caries and guideline-based recommendations. Opponent videos, largely uploaded by laypersons, highlighted potential dangers of fluoride, including health risks and additives, and frequently promoted fluoride-free products. Opponent videos had higher daily viewership and engagement than proponent videos.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"conclusions\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Anti-fluoride content on YouTube appears to reach broader audiences than expert-generated profluoride videos. Opponent messages tend to use emotionally charged communication, whereas proponents focus on scientific information. These differences in style may influence public perceptions of fluoride use. Public health professionals should develop engaging and accessible communication strategies to counter misinformation and promote evidence-based practices.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2196\/82265","type":"journal-article","created":{"date-parts":[[2025,11,14]],"date-time":"2025-11-14T07:40:06Z","timestamp":1763106006000},"page":"e82265-e82265","source":"Crossref","is-referenced-by-count":0,"title":["Pro- and Antifluoride Use Messages on YouTube in Japan: Content Analysis"],"prefix":"10.2196","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-9264-1676","authenticated-orcid":false,"given":"Hikari Sophia","family":"Nagao","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6251-3587","authenticated-orcid":false,"given":"Tsuyoshi","family":"Okuhara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4288-177X","authenticated-orcid":false,"given":"Hiroe","family":"Suzuki-Chiba","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7877-9753","authenticated-orcid":false,"given":"Hiroko","family":"Okada","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5934-0681","authenticated-orcid":false,"given":"Takahiro","family":"Kiuchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2025,12,29]]},"reference":[{"issue":"9555","key":"R1","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1016\/S0140-6736(07)60031-2","article-title":"Dental caries","volume":"369","author":"Selwitz","journal-title":"Lancet"},{"issue":"10482","key":"R2","doi-asserted-by":"publisher","first-page":"897","DOI":"10.1016\/S0140-6736(24)02811-3","article-title":"Trends in the global, regional, and national burden of oral conditions from 1990 to 2021: a systematic analysis for the Global Burden of Disease Study 2021","volume":"405","author":"GBD 2021 Oral Disorders Collaborators","journal-title":"Lancet"},{"issue":"1","key":"R3","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1177\/0022034514557546","article-title":"Socioeconomic inequality and caries: a systematic review and meta-analysis","volume":"94","author":"Schwendicke","journal-title":"J Dent Res"},{"issue":"6","key":"R4","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD010856.pub2","article-title":"Water fluoridation for the prevention of dental caries","volume":"2015","author":"Iheozor-Ejiofor","journal-title":"Cochrane Database Syst Rev"},{"issue":"4","key":"R5","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD002782","article-title":"Topical fluoride (toothpastes, mouthrinses, gels, or varnishes) for preventing dental caries in children and adolescents","volume":"2003","author":"Marinho","journal-title":"Cochrane Database Syst Rev"},{"key":"R6","unstructured":"2022 Survey of Dental Diseases: Ministry of Health, Labour and Welfare. 2022. URL: https:\/\/www.mhlw.go.jp\/content\/10804000\/001112405.pdf [Accessed 27-09-2024]"},{"key":"R7","unstructured":"The British Fluoridation Society. One in a million. The facts about fluoridation. 3rd. 2012. URL: https:\/\/bfsweb.org\/one-in-a-million [Accessed 27-09-2024]"},{"issue":"6","key":"R8","doi-asserted-by":"publisher","first-page":"1141","DOI":"10.1111\/cdoe.12847","article-title":"Tap water natural fluoride and parent-reported experience of child dental caries in Japan: evidence from a nationwide birth cohort survey","volume":"51","author":"Matsuyama","journal-title":"Community Dent Oral Epidemiol"},{"key":"R9","unstructured":"Mittelstaedt M . Why water shouldn\u2019t be fluoridated: an interview with Dr Paul Connett. Fluoride Action Network. URL: http:\/\/fluoridealert.org\/content\/connett_october2010 [Accessed 06-08-2012]"},{"issue":"1","key":"R10","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-021-99688-w","article-title":"A systematic review and meta-analysis of the association between fluoride exposure and neurological disorders","volume":"11","author":"Miranda","journal-title":"Sci Rep"},{"issue":"5","key":"R11","doi-asserted-by":"publisher","first-page":"1375","DOI":"10.1007\/s00204-020-02725-2","article-title":"Toxicity of fluoride: critical evaluation of evidence for human developmental neurotoxicity in epidemiological studies, animal experiments and in vitro analyses","volume":"94","author":"Guth","journal-title":"Arch Toxicol"},{"issue":"8","key":"R12","doi-asserted-by":"publisher","first-page":"837","DOI":"10.1177\/0022034519843495","article-title":"Fluoride revolution and dental caries: evolution of policies for global use","volume":"98","author":"Whelton","journal-title":"J Dent Res"},{"issue":"1","key":"R13","doi-asserted-by":"publisher","first-page":"110","DOI":"10.1186\/s12940-019-0551-x","article-title":"Developmental fluoride neurotoxicity: an updated review","volume":"18","author":"Grandjean","journal-title":"Environ Health"},{"issue":"10","key":"R14","first-page":"267","volume":"1","author":"K. Srinivasan","journal-title":"Sch Bull"},{"issue":"2","key":"R15","first-page":"9","volume":"3","author":"Nidhi Thakur","journal-title":"J Int Oral Health"},{"key":"R16","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2016.12.031","article-title":"Dynamic axes of informed consent in Japan","volume":"174","author":"Specker Sullivan","journal-title":"Soc Sci Med"},{"issue":"3","key":"R17","doi-asserted-by":"publisher","first-page":"426","DOI":"10.1016\/j.pec.2013.06.020","article-title":"Patients\u2019 and health professionals\u2019 use of social media in health care: motives, barriers and expectations","volume":"92","author":"Antheunis","journal-title":"Patient Educ Couns"},{"issue":"6","key":"R18","doi-asserted-by":"publisher","first-page":"1426","DOI":"10.1007\/s00266-017-0937-5","article-title":"Systematic review of quality of patient information on phalloplasty in the internet","volume":"41","author":"Karamitros","journal-title":"Aesthetic Plast Surg"},{"key":"R19","unstructured":"2023 survey on media usage time and information behavior: Ministry of Internal Affairs and Communications [Report in Japanese]. Ministry of Internal Affairs and Communications, Japan; 2023. URL: https:\/\/www.soumu.go.jp\/main_content\/000953019.pdf [Accessed 27-11-2025]"},{"issue":"5","key":"R20","doi-asserted-by":"publisher","first-page":"1336","DOI":"10.1002\/cb.1939","article-title":"To engage or not engage? The features of video content on YouTube affecting digital consumer engagement","volume":"20","author":"Munaro","journal-title":"J Consum Behav"},{"issue":"1","key":"R21","doi-asserted-by":"publisher","first-page":"70","DOI":"10.1016\/j.intmar.2018.11.001","article-title":"It\u2019s not just what you say, but how you say it: the effect of language style matching on perceived quality of consumer reviews","volume":"46","author":"Liu","journal-title":"Journal of Interactive Marketing"},{"issue":"2","key":"R22","doi-asserted-by":"publisher","DOI":"10.3390\/vaccines11020233","article-title":"Associations between vaccination behavior and trust in information sources regarding COVID-19 vaccines under emergency approval in Japan: a cross-sectional study","volume":"11","author":"Okada","journal-title":"Vaccines (Basel)"},{"key":"R23","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2010-1722P","article-title":"Sources and perceived credibility of vaccine-safety information for parents","volume":"127 Suppl 1","author":"Freed","journal-title":"Pediatrics"},{"issue":"2","key":"R24","doi-asserted-by":"publisher","first-page":"88","DOI":"10.1080\/00913367.2015.1018461","article-title":"Reexamining health messages in the digital age: a fresh look at source credibility effects","volume":"44","author":"Kareklas","journal-title":"J Advert"},{"issue":"6","key":"R25","doi-asserted-by":"publisher","DOI":"10.2196\/jmir.4343","article-title":"Associations between exposure to and expression of negative opinions about human papillomavirus vaccines on social media: an observational study","volume":"17","author":"Dunn","journal-title":"J Med Internet Res"},{"issue":"19","key":"R26","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.180543","article-title":"Containing health myths in the age of viral misinformation","volume":"190","author":"Collier","journal-title":"CMAJ"},{"issue":"6","key":"R27","doi-asserted-by":"publisher","DOI":"10.1093\/heapro\/daad153","article-title":"Public perception of the resumption of HPV vaccine recommendation in Japan: Twitter content analysis","volume":"38","author":"Terada","journal-title":"Health Promot Int"},{"issue":"2","key":"R28","first-page":"32","volume":"63","author":"Mertz","journal-title":"J Mass Dent Soc"},{"issue":"3","key":"R29","doi-asserted-by":"publisher","first-page":"517","DOI":"10.2105\/AJPH.2014.302437","article-title":"When advocacy obscures accuracy online: digital pandemics of public health misinformation through an antifluoride case study","volume":"105","author":"Seymour","journal-title":"Am J Public Health"},{"issue":"6","key":"R30","first-page":"47","volume":"92","author":"Basch","journal-title":"J Dent Hyg"},{"issue":"1","key":"R31","doi-asserted-by":"publisher","DOI":"10.1186\/s12903-024-04913-3","article-title":"Content analysis of fluoride-related posts on Instagram","volume":"24","author":"Esmaeilzadeh","journal-title":"BMC Oral Health"},{"issue":"1","key":"R32","doi-asserted-by":"publisher","first-page":"85","DOI":"10.15171\/hpp.2019.11","article-title":"An assessment of fluoride related posts on Instagram","volume":"9","author":"Basch","journal-title":"Health Promot Perspect"},{"issue":"5","key":"R33","doi-asserted-by":"publisher","DOI":"10.2196\/37519","article-title":"Characterization of false or misleading fluoride content on Instagram: infodemiology study","volume":"24","author":"Lotto","journal-title":"J Med Internet Res"},{"issue":"2","key":"R34","doi-asserted-by":"publisher","first-page":"162","DOI":"10.1111\/jphd.12404","article-title":"Social media conversations about community water fluoridation: formative research to guide health communication","volume":"81","author":"Mackert","journal-title":"J Public Health Dent"},{"key":"R35","doi-asserted-by":"publisher","DOI":"10.2196\/44586","article-title":"Analysis of fluoride-free content on Twitter: topic modeling study","volume":"25","author":"Lotto","journal-title":"J Med Internet Res"},{"key":"R36","doi-asserted-by":"publisher","DOI":"10.1016\/j.pmedr.2018.02.014","article-title":"Parents\u2019 attitudes towards topical fluoride and vaccines for children: Are these distinct or overlapping phenomena?","volume":"10","author":"Carpiano","journal-title":"Prev Med Rep"},{"issue":"7","key":"R37","doi-asserted-by":"publisher","first-page":"1327","DOI":"10.2105\/AJPH.2014.301927","article-title":"Caregivers who refuse preventive care for their children: the relationship between immunization and topical fluoride refusal","volume":"104","author":"Chi","journal-title":"Am J Public Health"},{"issue":"3","key":"R38","doi-asserted-by":"publisher","first-page":"314","DOI":"10.1177\/2380084418761846","article-title":"Surveying dentists\u2019 perceptions of caregiver refusal of topical fluoride","volume":"3","author":"Chi","journal-title":"JDR Clin Trans Res"},{"issue":"11","key":"R39","doi-asserted-by":"publisher","first-page":"620","DOI":"10.1111\/nep.14226","article-title":"Evaluating the understandability and actionability of online educational videos on pre-dialysis chronic kidney disease","volume":"28","author":"Furukawa","journal-title":"Nephrology (Carlton)"},{"issue":"12","key":"R40","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD009606.pub2","article-title":"Metal-free materials for fixed prosthodontic restorations","volume":"12","author":"Poggio","journal-title":"Cochrane Database Syst Rev"}],"container-title":["JMIR Formative Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/formative.jmir.org\/2025\/1\/e82265","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T18:16:12Z","timestamp":1782843372000},"score":1,"resource":{"primary":{"URL":"https:\/\/formative.jmir.org\/2025\/1\/e82265"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,29]]},"references-count":40,"URL":"https:\/\/doi.org\/10.2196\/82265","relation":{},"ISSN":["2561-326X"],"issn-type":[{"value":"2561-326X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,29]]},"article-number":"v9i9555e82265"}}