The Internet can be used as an effective source of health information. This potentiality can lead to an increase in community health literacy, better patient education, and improved public health. According to the available evidence, patients can benefit from using the Internet to enhance their oral and dental health (13).
Results of this study have emphasized that a variety of Iranian users of different ages and genders have used the potentiality of the Internet to seek their oral and dental information. Results also have shown that the majority of the users who asked the questions (1208 people), were searching for their problems, however, 107 people were parents who asked for their children`s problems. These findings can be justified knowing that adults usually seek the related information individually via the Internet and, in their role as a parent, they try to find the solution for their children`s problem applying sophisticated websites. These results are confirmed by Chiu et al. (2016). According to their study, 84% of the dentistry questions were asked by their clients. Meanwhile, the clarity of the users` identity was considered as an important criterion in online consults (2). Other present results have also confirmed that the users asked the questions for their parents, spouses or relatives other than their children and themselves. Hong et al. (2020) have confirmed that web users may ask health-related questions on behalf of their friends or family members (14).
Results of the study regarding the classification of the questions according to ICD-DA, have led to 39 main categories where most of the questions were categorized into: complications of procedures, not elsewhere classified, other diseases of hard tissues of teeth, other disorders of teeth and supporting structures, dentofacial anomalies [including malocclusion] and dental caries. Such results can greatly help the websites` managers to design their websites according to the requests and needs of the users. At the same time, these results have focused on the significance of empowering the role of the Internet in the public`s oral and dental information (7) and, simultaneously, have developed the risk of misinformation or lack of mutual contraction between the users and the virtual dentists. As a recommendation for the latter situation, it is highly recommended to guide the patients to get accurate and timely information via online health communication or validated websites in the scope of their health needs (15).
Other present results have demonstrated the length of the questions and answers. The item of the question`s length is mentioned as one of the effective characteristics in the quality of the question (16). This can be justified as long questions require a lot of time to be read, understood and answered (2). The length of the question can be also affected by the type and severity of complications. For instance, those who suffer from aphthous ulcer or sinusitis tend to give detailed descriptions and expect detailed answers (6). Chiu et al. (2016) have shown the average length of the dentistry questions to be about 172.2 words among consulting websites (2).
Other results about the strategy for communicating chief complaints on the dentistry websites by consultation seekers or inquires have demonstrated that contextual and then the focal strategies are among the patients` interests while only about 7% of the users have preferred to use the emotional strategy to ask their questions or send their message to the dentists. Such a result can be considered from the dentists` viewpoints as a criterion of communication and decision making for the patients. Chiu et al. (2016) have shown that about 76% of the dentistry strategies were related to contextual comparing the only 26% and 12% that were restricted to emotional and focal strategies respectively (2).
The present findings also imply that most of the users aimed to seek a dentistry treatment via searching the websites and posting comments. Searching for causes and reasons, oral and dental health recommendations, and seeking for special dentistry diagnosis, comments and information are among the other purposes of the studied users. Sen et al. (2016) have claimed that, although people may have various purposes in searching the health-related web pages, this process can affect the patients` thinking and lead them to use much more oral health information based on the Internet (17). Similarly, Chiu (2016) has mentioned that the patients have nine different purposes from posting the questions on medical consultation websites. They may seek facts, causes, empathy, advice, diagnosis, emotions, confirmation, explanation or recommendations (2). Some of these aims are similar to those we have found in dentistry questions posted on the related websites. In other words, these various purposes maybe because of the potential tendency of the users for seeking the information before any diagnostic or therapeutic procedure.
At the same time, regarding the purpose of the questions, simply it can be stated that the dentistry and oral and dental health-related information request may appear at any stage of the disease. However, the expected and the received information will likely differ at the different stages of the clinical presentation.
According to the present results, seeking for the treatment, seeking for the information and looking for the experts and dentists` opinion are among three categories that covered most of the proposed questions. In the first category, seeking treatment, 59% of the questions were related to finding treatment solutions for decreasing the pain and problems. This can be supported by the fact that the health information via the Internet can be easily accessed to all the community (18). At the same time, the solutions of online health care are increasingly popular (19). In the user informatics area according to 10 levels of Dr. Ferguson, the first level is related to seeking the information via the Internet, with the possible contact between the users and the clinician occurring at the subsequent stages (20). Furthermore, according to Brockes et al. (2012), in online consulting services about maxillofacial surgery, the users are seeking telediagnosis, cost information, general information about the probable treatments and appropriate specialists (6).
Regarding the dentists` responses to the clients, the present results showed that about 80% of the answers were related to the category of “responding without proposing a physical referral or virtual consult the same as online consults via social networks”. A likely reason for the limited usage of social networks for online consults by the dentists in this study can be the lack of knowledge and skill of the dentists in this area. Considering all the above, it seems that virtual relationships between the patients and the dentists can be applicable for different purposes and may lead to various advantages for the patients and the whole community. In this regard the new areas of attention may be opened for policymakers in the area of oral and dental health, among them the dentistry unmet needs of the community (21), the needs of the less literate part of the population or those less able to afford or access to the Internet should be highly reiterated.