Quality and accuracy of patient-oriented web-based information on tooth avulsion

Background/Aim Tooth avulsion (TA) is a severe form of traumatic dental injury. Treatment outcome depends on the immediate measures taken. Usually, first responders are laypeople and internet has become a favored platform for them to access health-related information. The aim of this study was to evaluate the accuracy, quality, readability and popularity of patient-oriented web information on emergency management of TA. Methods Three search engines (Google, Bing and Yahoo.com) were browsed with six VPNs using ‘knocked out tooth’, ‘fallen out tooth’ and ‘tooth avulsion’ as keywords. Top 20 results for each were evaluated. Webpages were included if they had information oriented to caregivers. They were analyzed for accuracy (cut-off ≥ 95%). Quality of the web pages was assessed using DISCERN and Journal of the American Medical Association (JAMA) benchmark. Readability was evaluated using: Flesch-Kincaid Grade Level (FKGL), Gunning Fog (FOG), Simple Measure of Gobbledygook (SMOG), and Coleman-Liau Index (CLI). Popularity was assessed by Alexa Popularity Rank (APR). Accurate and inaccurate webpages were compared using Chi-square analysis and Mann-Whitney U test. Spearman's correlation between accuracy and popularity was established. p Results Seventy-two webpages were included. 23 (32%) were accurate (k = 0.94). Median DISCERN rating for accurate and inaccurate webpages was 3.0 [2.5–3.0] and 3.0 [2.0–3.0] respectively (p= 0.331). 10(44%) of accurate and 12(24.5%) of the inaccurate webpages had high-quality JAMA (p=0.089). Median readability scores for accurate: FKGL (8[6.75-9.2]), FOG (10.6 [9.55-12.3]), CLI (7[6-7]), SMOG (6.7 [6.15-7.5]); and inaccurate webpages: FKGL (7.85 [6.275-8.525]), FOG (10.55 [8.875-11.425]), CLI (7 [7-8.25]), SMOG (7 [6.2-7.925]). 68(94.5%) and 4(5.5%) webpages had average and difficult readability, respectively with a significantly higher CLI score in inaccurate webpages (p=.0035). Median APR was 1,02,538 [26852-1443755] for accurate and 7,63,190 [219799-2992067] for inaccurate webpages (p=0.163), with no correlation between accuracy and APR, Spearman rho = -0.241, p (2-tailed) = 0.0704. Conclusion Relevant webpages were limited and had low accuracy. This can impact the emergency management by laypeople and adversely affect the outcome of TA.