Seeking for health-related information on the internet: expert-based toothbrushing recommendations on German websites

Abstract

Background: Toothbrushing is a health behaviour, most people do regularly but ineffective. As there are various toothbrushing techniques and recommendations, people might search the internet for expert-based advice. A previous study comparing different toothbrushing recommendations in different countries revealed that there is a wide diversity in advice by dental associations, companies, dental textbooks and experts. These recommendations also differed for adults and children. As German websites were not included in the initial study, our objective was to assess toothbrushing recommendations by university dental clinics, dental and medical associations and societies, and governmental health institutions. Methods: We navigated through the whole sitemap and relevant links of 127 websites of different organisations to find any toothbrushing recommendations regarding toothbrushing technique, frequency, duration, specification of time, indication, and age group. If the websites had a search function, this was used additionally with the key words toothbrushing and oral hygiene. All types of free accessible information (e.g. documents, videos) on the websites were analysed. Contradictory recommendations in one document were also assessed. Findings: There was a large diversity on different recommendations and even within some organisations one could find some contradictory advice. Discussion: The unacceptable high diversity of toothbrushing recommendations might confuse people seeking for advice. However, a reason for this unreasonably high amount of different recommendations might be that there is not much evidence yet about which toothbrushing method receives the best results regarding oral cleanliness and how often one should brush ones teeth. Those studies are fundamental for developing consistent guidelines.