Figure 1.
Figure 2.
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Figure 4.
Descriptive statistics of assessed videos_ The cumulative results from each video assessment are expressed as the number (n) of videos or as a percentage of the total number of videos
| Variables |
n videos | Percentage |
|---|---|---|
| Author | ||
| Layperson | 3 | 2% |
| Layperson and user | 90 | 73% |
| DIY aligner company | 21 | 17% |
| Dentist or Orthodontist | 5 | 4% |
| News channel | 4 | 3% |
| Dental professional body | 0 | 0 |
| Authors with sponsorship or financial interest | ||
| Yes | 67 | 54% |
| No | 52 | 42% |
| Unsure | 2 | 2% |
| N/A | 2 | 2% |
| Authors that recommended DIY aligners | ||
| Yes | 35 | 28% |
| No | 12 | 10% |
| Proceed with caution | 7 | 6% |
| N/A | 69 | 56% |
| Global Quality Score | ||
| Score 1: Poor quality | 15 | 12% |
| Score 2: Generally poor quality | 85 | 69% |
| Score 3: Moderate quality | 19 | 15% |
| Score 4: Good quality | 4 | 3% |
| Score 5: Excellent quality | 0 | 0% |
| DISCERN reliability tool criteria | ||
| 1. Are the aims clear and achieved? | 101 | 82% |
| 2. Are reliable sources of info used ? | 16 | 13% |
| 3. Is the info presented balanced & unbiased? | 8 | 7% |
| 4. Are additional sources of info listed for patient reference? | 5 | 4% |
| 5. Are areas of uncertainty mentioned? | 3 | 2% |
| Total DISCERN reliability scores | ||
| Score 0 | 16 | 13% |
| Score 1 | 89 | 72% |
| Score 2 | 11 | 9% |
| Score 3 | 3 | 2% |
| Score 4 | 4 | 3% |
| Score 5 | 0 | 0% |
Author Recommendation classification
| Author recommendation | |
|---|---|
| Yes | The author outwardly recommended DIY aligners. However, if they did not outwardly recommend DIY aligners but had a positive sentiment, this was only a positive sentiment and not a recommendation. |
| Proceed with caution | The author recommended the aligners but with a caveat, e.g. “I’d recommend SmileDirectClub if you have mild problems or have had braces before but if your problems are more severe, then speak to your Dentist or Orthodontist”. |
| No | The author did not recommend DIY aligners. |
| N/A | There was no recommendation. e.g., if the video was instructional only. |
Video popularity criteria
| Criteria | Calculation (if applicable) |
|---|---|
| The total number of views | N/A |
| The total number of comments | N/A |
| The interaction index | Likes – dislikes/Total number of viewings x 100% |
| Viewing rating | Number of Views/Number of Days since Upload × 100% |
P-value matrix (LOG10 data used for likes, views, subscribers, author views)
| Variables | Likes | Views | Subscribers | Author views | Interaction index | Viewing rate | Content score | Reliability score | GQS score |
|---|---|---|---|---|---|---|---|---|---|
| Likes | 1 | ||||||||
| Views | p < 0.001* | 1 | |||||||
| Subscribers | p < 0.001* | p < 0.001* | 1 | ||||||
| Author views | p < 0.001* | p < 0.001* | p < 0.001* | 1 | |||||
| Interaction index | 0.014** | p < 0.001** | p < 0.001** | p < 0.001* | 1 | ||||
| Viewing rate | p < 0.001* | p < 0.001* | p < 0.001* | p < 0.001* | p < 0.001** | 1 | |||
| Content score | 0.040* | 0.693 | 0.010** | 0.011* | 0.011* | 0.554 | 1 | ||
| Reliability score | 0.001* | 0.001* | 0.206 | 0.305 | 0.168 | p < 0.001* | 0.317 | 1 | |
| GQS score | p < 0.001* | 0.012* | 0.984 | 0.652 | 0.857 | 0.005* | p < 0.001* | p < 0.001* | 1 |
| *P < 0.05 | |||||||||
| **P < 0.05 and negative relationship |
Reasons for Excluding Videos
| Reason for exclusion | No. of videos |
|---|---|
| Duplicate | 27 |
| Video length > 15 min | 27 |
| Not related to the subject | 19 |
| Comments disabled | 11 |
| Likes/Dislikes hidden | 2 |
| Total exclusions | 86 |
Descriptive statistics of content assessment_ The cumulative results from each video assessment are expressed as the number (n) of videos or as a percentage of the total number of videos
| Content assessment variables |
n videos | Percentage |
|---|---|---|
| Definition of DIY Clear Aligners | 2 | 2% |
| Procedure for DIY Clear Aligner Therapy | 94 | 76% |
| Usage instructions for DIY Clear Aligners | 75 | 61% |
| Comparison of treatment options | 34 | 28% |
| Biomechanics of Aligner Therapy | 2 | 2% |
| Pain | 58 | 47% |
| Oral hygiene | 20 | 16% |
| Soft tissue soreness | 14 | 11% |
| Speech performance | 29 | 24% |
| Psychosocial aspects (e.g. social life, effect on confidence) | 35 | 28% |
| Cost of treatment | 54 | 44% |
| Treatment success | 60 | 49% |
| Complications | 26 | 21% |
| Treatment time | 61 | 50% |
| Comparison between DIY and doctor directed aligner therapy | 30 | 24% |
| Content assessment | ||
| Content poor (0–7) | 106 | 86% |
| Content rich (8–15) | 17 | 14% |
| Sentiment | ||
| Positive | 104 | 84% |
| Neutral | 7 | 6% |
| Negative | 12 | 10% |
| Complications/disadvantages | ||
| Poor results | 15 | 12% |
| Change in bite | 19 | 15% |
| Pain | 56 | 46% |
| Difficulty taking impressions | 13 | 11% |
| Poor customer service | 12 | 10% |
| Results may be inferior to doctor directed | 5 | 4% |
| Lack of fixed retention | 2 | 2% |
| Appeal of DIY Aligners Criteria | ||
| Reduced cost | 51 | 41% |
| Convenience | 32 | 26% |
| Ease of use | 25 | 20% |
| Same as doctor directed | 22 | 18% |
| Lack of contact with doctors office | 17 | 14% |