Differences in Emotional and Pain-Related Language in Tweets About Dentists and Medical Doctors: Text Analysis of Twitter Content

Background Social media provides people with easy ways to communicate their attitudes and feelings to a wide audience. Many people, unfortunately, have negative associations and feelings about dental treatment due to former painful experiences. Previous research indicates that there might be a pervasive and negative occupational stereotype related to dentists and that this stereotype is expressed in many different venues, including movies and literature. Objective This study investigates the language used in relation to dentists and medical doctors on the social media platform Twitter. The purpose is to compare the professions in terms of the use of emotional and pain-related words, which might underlie and reflect the pervasive negative stereotype identified in relation to dentists. We hypothesized that (A) tweets about dentists will have more negative emotion-related words than those about medical doctors and (B) pain-related words occur more frequently in tweets about dentists than in those about medical doctors. Methods Twitter content (“tweets”) about dentists and medical doctors was collected using the Twitter application program interface 140Dev over a 4-week period in 2015, scanning the search terms “dentist” and “doctor”. Word content of the selected tweets was analyzed using Linguistic Inquiry and Word Count software. The research hypotheses were investigated using nonparametric Wilcoxon-Mann-Whitney tests. Results Over 2.3 million tweets were collected in total, of which about one-third contained the word “dentist” and about two-thirds contained the word “doctor.” Hypothesis A was supported since a higher proportion of negative words was used in tweets about dentists than in those about medical doctors (z=−10.47; P<.001). Similarly, tests showed a difference in the proportions of anger words (z=−12.54; P<.001), anxiety words (z=−6.96; P<.001), and sadness words (z=−9.58; P<.001), with higher proportions of these words in tweets about dentists than in those about doctors. Also, Hypothesis B was supported since a higher proportion of pain-related words was used in tweets about dentists than in those about doctors (z=−8.02; P<.001). Conclusions The results from this study suggest that stereotypes regarding dentists and dental treatment are spread through social media such as Twitter and that social media also might represent an avenue for improving messaging and disseminating more positive attitudes toward dentists and dental treatment.

[1]  J. King Ethics &law: Consent: the patients' view – a summary of findings from a study of patients' perceptions of their consent to dental care , 2001, British Dental Journal.

[2]  M. Wong,et al.  Patients’ satisfaction with dental care: a qualitative study to develop a satisfaction instrument , 2018, BMC Oral Health.

[3]  G. Kvale,et al.  Factors related to satisfaction with dental care among 23-year olds in Norway. , 2005, Community dentistry and oral epidemiology.

[4]  Cindy K. Chung,et al.  The development and psychometric properties of LIWC2007 , 2007 .

[5]  C. Neil Macrae,et al.  Stereotypes as energy-saving devices: A peek inside the cognitive toolbox. , 1994 .

[6]  K. Hill,et al.  Verifiable CPD paper: National evaluation of personal dental services: a qualitative investigation into patients' perceptions of dental services , 2003, British Dental Journal.

[7]  L. Robinson,et al.  Determining Recommendations for Improvement of Communication Skills Training in Dental Education: A Scoping Review. , 2017, Journal of dental education.

[8]  N. Christakis,et al.  Dynamic spread of happiness in a large social network: longitudinal analysis over 20 years in the Framingham Heart Study , 2008, BMJ : British Medical Journal.

[9]  O. Vassend Anxiety, pain and discomfort associated with dental treatment. , 1993, Behaviour research and therapy.

[10]  Luca Caricati,et al.  Ambivalent stereotypes of nurses and physicians: impact on students' attitude toward interprofessional education. , 2015, Acta bio-medica : Atenei Parmensis.

[11]  G. Wright,et al.  Patient Management: A review of patient satisfaction: 2. Dental patient satisfaction: an appraisal of recent literature , 1999, British Dental Journal.

[12]  E. Nicolas,et al.  A national cross-sectional survey of dental anxiety in the French adult population , 2007, BMC oral health.

[13]  Xiaoli Gao,et al.  Dental Fear and Anxiety in Children and Adolescents: Qualitative Study Using YouTube , 2013, Journal of medical Internet research.

[14]  James M. Leonhardt,et al.  Twitter=quitter? An analysis of Twitter quit smoking social networks , 2011, Tobacco Control.

[15]  Anna Jurek,et al.  Tweet for Behavior Change: Using Social Media for the Dissemination of Public Health Messages , 2017, JMIR public health and surveillance.

[16]  Lars-Göran Öst,et al.  Cognitive behavioral therapy for dental phobia and anxiety , 2013 .

[17]  B. Seymour,et al.  Community water fluoridation online: an analysis of the digital media ecosystem. , 2018, Journal of public health dentistry.

[18]  P. Glick,et al.  Images of occupations: Components of gender and status in occupational stereotypes , 1995 .

[19]  Jan Wacker,et al.  Anger and fear: Separable effects of emotion and motivational direction on somatovisceral responses. , 2007, International journal of psychophysiology : official journal of the International Organization of Psychophysiology.

[20]  Jeong Yeob Han,et al.  Expressing Positive Emotions within Online Support Groups by Women with Breast Cancer , 2008, Journal of health psychology.

[21]  R. M. Tobin,et al.  Measuring emotional expression with the Linguistic Inquiry and Word Count. , 2007, The American journal of psychology.

[22]  C. Macrae,et al.  Social cognition: thinking categorically about others. , 2000, Annual review of psychology.

[23]  G. Bodenhausen,et al.  Categorizing the Social World: Affect, Motivation, and Self-Regulation , 2006 .

[24]  D. Culica,et al.  Medical checkups: who does not get them? , 2002, American journal of public health.

[25]  C. Carver,et al.  Anger is an approach-related affect: evidence and implications. , 2009, Psychological bulletin.

[26]  Jan E Clarkson,et al.  Recall intervals for oral health in primary care patients. , 2007, The Cochrane database of systematic reviews.

[27]  Matthew Purver,et al.  Twitter Language Use Reflects Psychological Differences between Democrats and Republicans , 2015, PloS one.

[28]  R. Fernandes,et al.  Social Media for the Dissemination of Cochrane Child Health Evidence: Evaluation Study , 2017, Journal of medical Internet research.

[29]  T. Willumsen,et al.  Aetiology of Dental Phobia , 2013 .

[30]  K. Vohs,et al.  Case Western Reserve University , 1990 .

[31]  U. Hess,et al.  Competent and Warm but Unemotional: The Influence of Occupational Stereotypes on the Attribution of Emotions , 2013 .

[32]  Dan Cosley,et al.  Managing Impressions and Relationships on Facebook , 2013 .

[33]  G. Slade,et al.  Fluoridation advocacy in referenda where media coverage is balanced yet biased. , 2018, Journal of the American Dental Association.

[34]  M. Cleary,et al.  Nursing and Stereotypes , 2018, Issues in mental health nursing.

[35]  Bertram Gawronski,et al.  Cognitive consistency: a fundamental principle in social cognition , 2012 .

[36]  J. Bridges Literature review on the images of the nurse and nursing in the media. , 1990, Journal of advanced nursing.

[37]  Elia Gabarron,et al.  Ebola, Twitter, and misinformation: a dangerous combination? , 2014, BMJ : British Medical Journal.

[38]  J. King Ethics & law: Consent: the patients' view |[ndash]| a summary of findings from a study of patients' perceptions of their consent to dental care , 2001 .

[39]  G. Humphris,et al.  The prevalence of dental anxiety across previous distressing experiences. , 2011, Journal of anxiety disorders.

[40]  Ara Darzi,et al.  Sentiment Analysis of Health Care Tweets: Review of the Methods Used , 2018, JMIR public health and surveillance.

[41]  Elia Gabarron,et al.  Tweets are not always supportive of patients with mental disorders , 2017 .

[42]  Charles M. Judd,et al.  The Consequences of Communicating Social Stereotypes , 2000 .

[43]  Lisa Gandy,et al.  Characterizing the Discussion of Antibiotics in the Twittersphere: What is the Bigger Picture? , 2015, Journal of medical Internet research.

[44]  J. Carpenter Doctors and Nurses: Stereotypes and Stereotype Change in Interprofessional Education , 1995 .

[45]  Jeffrey T. Hancock,et al.  Experimental evidence of massive-scale emotional contagion through social networks , 2014, Proceedings of the National Academy of Sciences.

[46]  J. Elstad Dental care coverage and income‐related inequalities in foregone dental care in Europe during the great recession , 2017, Community dentistry and oral epidemiology.

[47]  D. Levy,et al.  Stereotypes of professional roles. , 1989, Image--the journal of nursing scholarship.

[48]  J. Ware,et al.  Measuring patient satisfaction with dental care. , 1981, Social science & medicine. Part A, Medical sociology.

[49]  I. Mandel The image of dentistry in contemporary culture. , 1998, Journal of the American Dental Association.

[50]  Ryan C. Martin,et al.  Anger on the Internet: The Perceived Value of Rant-Sites , 2013, Cyberpsychology Behav. Soc. Netw..

[51]  Kevin A Padrez,et al.  Twitter as a Tool for Health Research: A Systematic Review , 2017, American journal of public health.

[52]  D. Locker,et al.  Psychological factors and perceptions of pain associated with dental treatment. , 2002, Community dentistry and oral epidemiology.

[53]  Cognitive vulnerability and the aetiology and maintenance of dental anxiety. , 2012, Community dentistry and oral epidemiology.

[54]  Edward Thibodeau,et al.  Who stole Nemo? , 2007, Journal of the American Dental Association.

[55]  Brian L. Ott The age of Twitter: Donald J. Trump and the politics of debasement , 2017 .

[56]  L. Dundes,et al.  The implications of gender stereotypes for the dentist-patient relationship. , 2008, Journal of dental education.

[57]  J. Pennebaker,et al.  The Psychological Meaning of Words: LIWC and Computerized Text Analysis Methods , 2010 .

[58]  A. Blinkhorn,et al.  Patient care: Marketing dental care to the reluctant patient , 1999, British Dental Journal.

[59]  P. Gopalakrishna,et al.  Influencing satisfaction for dental services. , 1993, Journal of health care marketing.

[60]  R. Gatchel The prevalence of dental fear and avoidance: expanded adult and recent adolescent surveys. , 1989, Journal of the American Dental Association.