Why Dental Misinformation Spreads: Trust, Influence, and the Anatomy of Myths

(Highlights) With a background in public health. Um, the advice I was getting from my pediatrician to start the childhood vaccination series, I didn't question it. I trusted that guidance and we were following that. Our neighbors were hesitant and we were going through the new parent journey together and having conversations about these experiences as new parents and this is 2013. Uh, that becomes relevant in a moment. And they were, as we hear people say, doing their own research. They were, it's the information age, the age of of information. They were reading um parenting blogs and watching YouTube videos.

Where things really hit home to me, and certainly the late '80s and early '90s, I dealt with a lot of different groups and having different things in terms of focal infection and other things and natural dentistry and that kind of stuff. One of the things we were in New York City and uh, he was talking about all the different toothpaste and I said, "What, what do you mean all the different toothpaste?" You know, I'm thinking Colgate. I'm thinking Crest, right? So, I went over the Sachs right on Fifth Avenue and they had a section of consumable products. They had more than 20 different toothpastes. Uh, almost everyone had no fluoride and more than half are charcoal based.

We live in the you know, communication age and uh, it used to be that before the internet and social media we had silos of information where it was curated and edited. But as we went through the the democratization of information all of a sudden everybody had access to information. So the signal to noise ratio entirely changed. I say this all the time. I think a lot of times it's the blind leading the blind with a lot of subjects across not just healthcare but other industries too. And so, you know, um, sometimes I think half knowledge is more dangerous than no knowledge. And I there are a lot of things that can drive human behavior. Unfortunately, I think it can come down to the attention, the money that might come along with it. I think not everyone is always as well-intentioned as we hope that they would be. We live in the age of uh, communication, but not in the age of good information.

Ready, Annie? Everybody ready. Awesome. All right. Terrific. Welcome to the Paul podcast where we talk about all things dentistry and non-dentistry from a generational perspective. I'm joined uh today again with my co-host Dr. Anne Koch from uh Palm Beach Gardens, Florida and Dr. Parsa Shahidi right here in studio along with our co-host now Dr. Roene Nasr also here and we have a very uh great guest here. We're going to talk about a very important topic that's quite special and close to my heart. Parsa, the topic of misinformation and that information that we should be careful about. So, why don't you introduce our guest?

Well, it's exciting because I get to hear about this when we're off camera all this all the time of Dr. Nasseh. And today we have an expert um in this subject. Um, Dr. Brittany Seymour is joining us. So, we're lucky to have you. She's the Associate Dean at our school at Harvard for faculty affairs. She's an associate professor director of Global Health discipline at the Harvard School of Dental Medicine. She holds a full-time appointment in the department of oral health policy and epidemiology and the office of global and community health. Dr. Seymour earned her DDS from the University of Colorado and her masters of public health from Harvard School of Public Health. And of course, she does a lot of amazing stuff across campus, but she also specifically uh consults for the health communication division at MIT center on civic media and the media cloud project. We are lucky to have you here today to talk about dental misinformation.

Truly, thanks for having me. It's a it's a worthwhile topic.

Totally. It definitely is cuz I mean all of us who've been online, you know, see this uh more of a delusion of misinformation or information that seems to us to be very unfamiliar compared to what we have learned in school and seems to be counterintuitive. You know, some people call these conspiracy theories, some people call it just uh bad information. And so what we want to do today like to see more is to get down to the basics of what causes these types of problems and you know for patients that are listening for people out there that are listening as well as for dentists that are going to face these, what are some of the best ways that we can deal with these questions that come up on daily uh practice.

That sounds good. I I might start with a question for all of you. um, just from your experiences, what do you think causes it and what has been your experience with this?

I have an answer and I say this all the time. I think a lot of times it's the blind leading the blind with a lot of subjects across not just healthcare but other industries too. And so, you know, um, sometimes I think half knowledge is more dangerous than no knowledge. And I know you talked about this the other day or last week, but I don't know. I I feel like sometimes when something propagates across social media specifically, it's almost like, you know, burning uh burning a match in the middle of the woods, it just takes off and there's no stopping it. So, what causes it to me is, you know, people wanting to get views, people want to get attention, and from there, I think it's a little bit too late.

Yeah. I think it's a very slippery slope. I think there are a lot of things that can drive human behavior. Unfortunately, I think it can come down to the attention, the money that might come along with it. I think not everyone is always as well-intentioned as we hope that they would be. I think it's hard to put yourself in that and to be like, "Oh, some people do do things and it could hurt others and sometimes they are aware of it. Sometimes they aren't." I think some people also do it unknowingly. They accidentally hear a story from their neighbor. It comes to them out of maybe not knowing better. They believe it. we believe things that people tell us maybe because we're good-hearted or just confused or not sure. So, yeah, I think also with generative AI and all the things that are coming up recently, it's also hard to know what's real anymore. You open your phone, you're scrolling on TikTok and you get a video of a dolphin flying over the ocean and you're thinking, "Wow, what a beautiful site." And then it's big.

Get me. Yeah, it gets me, too. Yeah. I I I think it's uh social groups and friend networks and I think it's been that way for many years. Um, and it's kind of like even like if you're if you need an electrician, do you go through and look for a real analysis? No, you ask a friend and and I think I don't want to use the term cults, but I think the grouping social grouping things I've seen in the past terms of having let's say a different opinion and I really am concerned and I'm so thrilled to have you here Dr. Seymour because I share wholeheartedly exactly the concern that Rowen just mentioned and that is about um uh generative AI. It's not for people like the three people sitting next to you. It's like for people like me. I'm I'm 76 and for people over 60 years old, certainly over 70, it's very very confusing and it's very tough to differentiate what's real and what's Memorex. Memorex used to be a thing in the past. I had an ad. What's real and what's Memorex? So when I see some of the stuff that's on the internet that's AI generated, I'm able to figure it out. But I have a lot of friends who think, "Oh my god, that's the real thing." That's an enormous concern for me going forward as is the geriatric population in terms of being more susceptible to misinformation.

for for me to add my uh two cents to make it brief. We live in the you know, communication age and uh, it used to be that uh before the internet and social media we had silos of information where it was curated and edited but as we went through the the democratization of information all of a sudden all of you know, everybody had access to information. So the signal to noise ratio entirely changed as people raised the noise. Now we have a cacophony of information and we just are unable to tell the difference. So the problem has become one of who gets first to whoever has you know, it's kind of like the old news cycle thing is becoming shorter and shorter. Whoever gets the information first now you have to unseed that information. So I feel like we live in the age of uh communication but not in the age of good information. It's just whatever is out there.

So, I'd be curious to hear what you think is um the the thing. I'm I'm happy to share what I think, what I've learned. Um, you introduced me as an expert in this area and it feels that the more I learn, the less I know. Um, that's what you expert. So, maybe if you're up for a little bit of story time, I'll start with um may just personally how and why I got into this topic. it it wasn't something I set out to become an expert in. It sort of happened as many life courses do. Um, and then talk a little bit about the a brief history and a little bit about the anatomy of the internet and what we've what we've really learned from that and then we can talk about okay, well then how do we go forward? Where do we go from here?

So back in 2013, which really doesn't feel that long ago, but technology-wise, internet-wise, social media was a different world back then. 10, 15 years ago. It really was. Um, I became a mom. I had my first and only baby. And at the same time, um, my next door neighbor also had her first baby. uh with a background in public health um, the advice I was getting from my pediatrician to start the childhood vaccination series I didn't question it I trusted that guidance and we were following that our neighbors were hesitant um and we were going through the new parent journey together and having conversations about these experiences as new parents and they were hesitant this is 2013 uh that becomes relevant in a moment which this worried me. We share space. Um, vaccinations are important and they were as we hear people say doing their own research. They were it's the information age, the age of of information. They were reading um parenting blogs and watching YouTube videos. And a lot of these sources were not what I would have considered a health expertise source or a scientific source. But for them, these were trusted sources. Um, honestly, at the time going through it, I was judgy, judgmental. Um, and we had some difficult, contentious discussion about this because it almost felt personal as a health expert, a public health expert.

So, this is 2013. By the end of that year, um, 18 states in the US had fallen below protective herd immunity for measles. And early 2014, the United States had the largest measles outbreak in a generation. All of this was right in parallel with what I was experiencing firsthand with my neighbors around vaccine hesitancy. And as time went on through that outbreak, research was showing that not achieving optimal herd immunity was due to unvaccinated individuals by choice because of concerning information they had found online. Wow. So it was a professional interest, but it was personal. This was my baby.

That's what that's what drove you deeper into this field, right? That story.

That's that and that sparked my interest. How does this happen? My neighbors were professional, intelligent, rational, wonderful people and in my opinion were making um poor health decisions. So I wanted to know how does this happen? They they weren't ignorant or uninformed per se, right? And so that sparked an interest. Um, I I took on a very small pet project. I had a fellowship at the time. They asked if I wanted to do an independent project. I said, I think this social media thing might be a problem when it comes to health information or health misinformation and I'd like to learn more about it. U and so what was going to be just a couple months of a a pet project looking at just a couple topics, vaccinations and community water fluidation cuz I'm also a dentist. um turned into a multi-year research initiative. Wow.

Terrific. So, at the seed of it, what did you find? What is the seed of misinformation? Is it just the fact that people have more access to communication means and therefore poor information travels faster than good information.

There are two answers to this question of how did this happen? And at the time, I thought social media was the problem. That is correct and incorrect. It's correct because of the rapidity and the the vast um amount of information that can spread. Right? So by 2015 um 100 hours of content were being uploaded to YouTube per minute. Every half second a new block blog was being created. 700,000 pages of Facebook content were be being created every day. Wow. That is a massive amount of content. Um, and one Facebook post could get around the world faster than anything else at that time. Yeah. So yes, social media was part of the problem. But also this is as old as humans are. This is this is it's gossip. It's how we've always been. Yeah. You know, it was the water well and then the water cooler and then the the social media platforms. So, we are just inherently gossipers and um not in a malicious way or not in I need the tea about my neighbor, but this is how we're wired. We lean into gossip to as a form of cultural learning. We when there's uncertainty um any type of question, how do I behave? Um, what do I do in this situation? We lean into gossip. We learn from stories we hear from neighbors or that work meeting that didn't go well for my colleagues. So, I'm sure not going to do what what she did in that meeting next time. These aren't written rules, but gossip is it's part of human nature.

Dr. Seymour did I mean I know you talk about dental misinformation um behaving like gossip um but I I'm curious because I I wonder you know when you think about gossip you think and misinformation usually comes back to topics that are so inflammatory or so exciting. I wonder what the average person thinks about dental misinformation and gossip because maybe it's not so exciting to a lot of people. But did you feel when this, you know, issue with the neighbors and the the the the measles outbreak was happening, the source of the problem were that was that people simply wanted to talk about something and they found the most inflammatory and out of pocket thing they could talk about was vaccines. What did you think was the source of it?

I think that there's a wide range of reasons and intentions for misinformation online. And there's also a difference between misinformation, which is when something that's, you know, incorrect is is shared knowingly or unknowingly, um, and then disinformation, which is when it is knowingly shared with intent to cause some sort of impact, right? when someone knows this isn't fully true or it's been um altered in some way and they share it for an impact. Um, so, you know, I think generally I tend to um you said something at the beginning around we're just we're all generally good people and empathetic and give people the benefit of the doubt. I think we're we're often dealing with misinformation. Yeah. Particularly with our patients who are really just you know but but that you know to to see the point that Parc is saying as to how things kind of propagate could this be also because of the fact that the structure of social media being organized around the concept of viewing viewership and likes and things like that does it not necessarily mean that things that basically grab attention just like the news headline right you know if it bleeds it leads because that grabs attention, right? So, we're living in an attention economy. So, these are the so so controversial points, points that are beyond It's one of the things I tell my son when watching movies. I'm like, see this kind of behavior? The reason it's on TV is cuz it's not supposed to be that way. Yes. It's like drama going to show good behavior in a drama because it's going to be boring. No one's going to watch it. Right. Right. So it's been historically the case that things that are supposed to be like either incorrect, wrong or bad behavior get promoted first. And the problem is as you can see is like it's certain if you are relatively um kind of uh uh friendly as you said good people that you you want to believe the things that you hear and you're prone to gossip then you will tend to kind of go off track and all of a sudden is is that could that be possible as an explanation?

So as the as the internet was emerging in the 80s 90s and really starting to become the worldwide web, have you heard of that the term the information superhighway? Yeah. We entered into the age of information where you're right those those historic traditional gatekeepers of information um didn't matter in the same way, right? Where there was one nightly news story versus trusted sources. Now we're in the we were in the age of information. um, or information disorder almost depending on how you want to look at it. Yeah.

I have a question. Uh, and again, it's a different generation thing. That's what's kind of fun about our group is the thing that I personally don't understand. I do understand their effect is the whole thing about influences. And how do you think that influences gained the traction that they have achieved? And even furthermore, how have influences become more reliable than science?

That's that is that's a great segue. So when we're thinking about the age of information through our research and our case studies um, our team built a tool where we could visually map out the internet. So this idea of cyberspace they were able to create a visual representation of cyberspace. And what we found was that it's not it's not a network of information. It's a network of social connections and relationships, linkages. So, you have a source of content and then you have people linking in and leaking out. And it became this true web of just social networks um in cyberspace and often around given topics. And so what that really reinforces is that this is not an information era. It's it's the era of social influence and we know that our social networks are the number one influence over health behaviors on or offline. And so that anatomy of the internet has had a major influence in how people seek out, consume, and choose to rely on what they're finding online because it's literally curated for them from their peer and social networks online.

Yeah. Honestly, from a different generational perspective, I feel like we also live in an age of efficiency. And I'm curious to hear your thoughts on this, but I feel like, you know, if I wanted to get information on a topic, life is go go go, my phone's in my hand, Google is up. Typically, if I search something on YouTube, I'm going to just trust the first AI Google search that comes up. Or I'm going to scroll on TikTok, look something up, see someone's experience at a restaurant, and say, "Oh, yep, that looks great. Pictures look great. I'm going to go do it." I also feel like the way that research is put out and published is often not very digestible to many people. And I'm wondering if this topic of access does kind of translate into a lot of these things are boiled down sometimes too much to the point where we lose sight of the true like science behind of things or in this process of boiling down it gets completely like changed in an incorrect way. But as we try and make things more digestible, does that also make us more prone to misinformation? And also, is this kind of the thing that social media propagates? Because people are pumping out videos like this. But to to publish a systematic review, you need to take blank amount of time reading articles, blank amount of time screening, and by the time you're able to publish your systematic review, how many videos have come out in the process, you know, for you to also share your scientific claims? So I'm curious to see those two things and kind of juxtapose in our society.

We were actually able to map out and visualize and see that dynamic at play online. Wow. So when we did um a case study around the topic of community water fluidation online, there was a um cluster or town as we called it of who we would have considered the health or the scientific experts around community water fluidation all in their own little isolated bubble of science. there was a cluster of conspiracy theorists who thought the government was deliberately uh poisoning people or anything. That was a a a fascinating corner of of cyerspace for me to dive into. And back to this idea of the age of influence. Um, you know us and others studying this phenomenon also noticed in these clusters that were really based on our social identities and who we were connecting with around shared norms and values. The type of information that we felt was valid. Each cluster had these norms that were determining the sentiment of the conversation. And there was often almost always, I'd say, a central kind of node. We called them mayors, but today they would be called influencers. Wow. Where the majority of the other folks in that cluster were linking in and following their lead.

Yeah. One thing I want to ask you about and I think this is true of probably a lot of things on earth, but you often have to follow the money and right so we talk about what's going to get specific information out into the world at a faster rate than you know really mundane basic fact that probably people don't care about is attention. And um, you know I think one of our jobs as you know domain experts in the field of dentistry is to be able to find a way to bridge the gap between the people who are kind of working for views and clicks and then the true experts and the expertise that we want to put out there. And so I think it's on us to find a way to actually incentivize those key influencers and people like the way the Huberman's of the world do like Dr. Dr. Nasa does like Peter Tia does in each of their fields to get to the root you know information we want to give across. So I think that's on us to try to find a way but let's just move past the economics for a second. I think just to play devil's advocate you know one thing you talk about is how sometimes an anecdote uh will maybe carry more weight than a systematic review or a CDC report or something like that. Right. And I think the way that the human brain is wired often times all it takes is just maybe one example of something that is close to home, a friend, a family member, a neighbor, and boom, all of a sudden you're you're completely bought into that topic and and that and that ideology and nothing is moving you away from it. So I'm curious, how does everyone here perceive that that notion? What is someone supposed to do when they know somebody or heard about something that affects their way that they think, you know, contrary to the facts that exist?

What do you think? Uh, you know, I mean, for me, I mean, it goes back, I mean, the word trust has come up quite a bit here already, right? So, I feel like we've had a transition from an age in which we had trusted sources and there were institutions and we somehow collectively believed that the institutions were going to be true to us. uh as there was a breakdown through this information age and communication age uh I don't know if you've read Martin Gory's book the revolt of the public that's a very very good book I propon this area you know there was a breakdown in the trust of the institutions and therefore the gravitation towards social media people were the same as as uh Seymour is saying it's the form of a gossip type of situation it's kind of a community of a group a much small relatable group of people that you could trust than some pie in the sky expert out at an institution. So this was really the challenge of what took place. People took the proximal trust far more you know, they took it far more seriously than that. So you know when Fouchi came on and said I am the science a lot of people were triggered you know they were like well I'm far I'm relating far more with my grandma who had like a thing and this happened and that happened you know so these are the challenges that we have to deal with. So I I I think as you said it's like you know it has the answer has to be personal. So you said to use anecdote it has to be relatable to to the patients. They have to kind of they have to emotionally get engaged in the situation. That's part of the reason the most convincing and persuasive forms of argument have always been one that it's been an appeal to emotions even though it doesn't it's not a logical thing and it's in fact a logical fallacy but it works. Yeah. you know it's kind of like politics Annie right negative campaigning works right that's why it's there but it's not a good thing but that's the same thing so I feel like you know we got to work on the emotional component part of it relate to the patients I don't think as you would probably agree you know bringing a uh multic-enter uh study that shows you know how something has been you know randomized controlled trial is not going to work but to me I always say like in my particular case I said well you know I've had this procedure myself like this many years ago and you know I wouldn't telling you to do something that I've done it myself and everybody else I know. It's more valuable. I think that makes a lot of sense. I can also Sorry, Annie. I'll keep this super short. Um I really feel like there is a power in seeing people in front of you and not just words on a page. Especially words with very strong diction that are very difficult to digest. When you hear someone's tone, when you look at someone telling you something with emotion in their voice and real world experience, it is just more believable, easier to take in and more. Yeah, you can just empathize. And I also am wondering if this is mildly a call to action for other health care professionals in that we might also need to start adapting to this new age of influence that you call it and also become influencers in a way too and become versed in this social media language in order for us to communicate our scientific knowledge in a way that's different. We can beat misinformation is with more good information, right? Essentially what it is. That's what we need.

Annie, what were you going to?

Yeah, I was going to say where things really hit home to me and certainly the late 80s and early 90s I dealt with a lot of different groups and having different things in terms of focal infection and other things and natural dentistry and that kind of stuff. But uh late 2018 2019 I was helping a friend with a startup and one of the things we were in New York City and uh he was talking about all the different toothpaste and I said what what do you mean all the different toothpaste? You know, I'm thinking Colgate. I'm thinking Crest, right? So, I went over the Sachs right on Fifth Avenue and they had a section of consumable products. They had more than 20 different toothpastes. Many uh celebritybacked. I'm not going to mention the celebrities. Uh, almost everyone had no fluoride and more than half were charcoal based. And what was interesting to me when I saw them, I kind of fell immediately into the dentist mode like, well, these these you could put everything not going to sell them. So I said ask ask the manager. I asked the manager they couldn't keep them in stock. Uh, and in fact it kind of put us down the wrong pathway in terms of developing one product. But the interesting thing to me was I was stunned at how many different toothpaste there were there. And when I looked at it I it wasn't so much what struck me was a scientific creation or this was the culmination of the years of research. It was kind of all influence generated. Yeah. Yeah. Yep.

I and this is when I just ended up diving into this area of research. I thought I was going to be looking at how Facebook is causing people to make poor health decisions. I learned relatively quickly that this is behavioral economics. This is network science. This is psychology. This is how humans are wired. Um, we are social creatures. Our social networks influence us on a routine basis. And we make decisions based on information that we receive. Not whether it's fact-based or grounded in the evidence, but if it's personal, if we have an emotional response to it. Yeah. if it is socially reinforced across our networks by those we trust and care about and if it's relevant to us, right? No science required.

Do you think the uh susceptibility of influences and and the media thing is a result of the access problem there is in this country to dental care?

I was I was wondering the same thing. Even just mentioning the pediatrician, family medicine, it can be really difficult to get a dental appointment. It can be very difficult to get primary care getting a dental appointment. It's the cost. Okay. For instance, one of the things to me is that you know there are two really serious afflictions the common cold and dental carries. One of which can be controlled and that is dental carries. But the two things that we all know one is fluidation. What's the other thing? probably dental sealants. Have you ever gone around and spoken to different dentists what they're charging per sealant? Um, it's 20 $80 and you know I had a period in my life Dr. to see where I went around to a lot of medical schools talking about cultural competency and other things, other issues. And where I really got focused on this was a number of times I came across generally women who were head of like human resources and and social aspects of the medical school. And a couple of times when they found out that I was a dentist, they mentioned to me that they had sealants placed on their daughter but on their son. It was too expensive. M now these these were people who were assistant professors, associate professors in medical schools and they shared this to me and they they just they weren't complaining to me or picking on me. They were very nice. They were incredibly charming. But they the fact that here are people in the medical school and then when they told me some of the prices of the dental sealants I realized this is outrageous. So it becomes an enormous socioeconomic factor here and that when you overlay it and like for instance I don't know and part of this thing I was doing with my friend we were looking at the edentilist rates in the United States it's gotten better in the last eight years but anybody know what the edentilist rate is totally edentilous in this country for people over 65 25%. Well it was that it was actually now down to 17 to 18%. Okay, that's in this country. That's fully a dentalist. If you want to get into partial edentilist, you know, partial dentures, full dentures, that number's like more than 56%. So when we have that kind of result, you realize somehow there's a disconnection and that's why ruin you're thinking the same way that I'm thinking that there there seems to be a connection here. Totally. Yeah.

So to kind of sum it up, it seems like so it is more proximal. It is more about trust. It is more about connecting. um as a trustworthy source. So how would what would be the message for patients? What would be the message for the dentists out there who face a patient who would be um making a claim that to them sounds like misinformation?

I'll I'll share an analogy. I've I've shared this one several times. Um, it's a dinner table analogy. So we so envision that we are we we're walking into a restaurant peak Friday night Manhattan full all tables are occupied right um what would happen if if you walked in chose a table at random with people sat down and started giving them advice yeah they would hate me especially in New York City they would push me away but why because they don't know who I and what kind of credibility I bring, right? Yeah. Who's this guy? That's a huge norm violation in a in a setting at a restaurant. I can't imagine any of us would go sit down and start giving people advice unsolicited at a restaurant. But that's how the health profession has for too long treated the internet. The internet is a busy restaurant with people at their tables with their friends, and we sit down and think they're going to care about what we have to say. uninvited. We have been broadcasting messages. We've been using older approaches for broadcast diffusion of our message packaged in a way that makes sense to us and expecting that we are welcome to sit down and share that advice at any table we want to because we know it's factual when in fact we need to be rethinking about social diffusion of messages. meaning not how do I get the fact-based information out to everyone but how do I get others to share fact-based information and that is a very different approach and a very different way of using social media and the internet and you know another thing that I have a little bit of an issue with is basically how some of the dental companies are viewing preventive dentistry And uh we know the couple of big ones but a few years ago uh Rowene this was at Penn and it was on a healthcare symposium and I was on a panel and it was a person from the Dallas school a PhD research person and then next to me was uh a woman from the Wharton school and uh during different things there was a conversation with and most of the people were CEOs COO CFOs of dental companies and medical companies mainly mainly dental and he was a COO and when we were talking about preventive of dentistry. He literally said, "We don't think there's any money to be made in preventive dentistry." And the warden lady and myself looked at each other like, "What is this guy talking about? What company does he represent? Because maybe you should short it." Because I thought this guy had an incredibly wrong take on on preventive dentistry. But the reason I'm I'm focusing on preventive dentistry, excuse me, even though I'm an endidonist, is that in conjunction with the promotion of your pre preventive dentistry products, that's the opportunity to disseminate information. And maybe because I don't have kids, maybe because I'm not that age, I just don't see an effort. Obviously the big companies called get crust they have websites you can go on and you can go to it but there's a lot of people who are not going to go on to the websites who I think would maybe I don't it's probably not the right term but let's say susceptible for having some learning about preventive dentistry it's just education I guess that's all educational well and and just like it would be a norm violation if we go just sit at someone's table and offer advice similarly they're not just going to come sit at ours and ask for advice, right? And so when we think about um, you know, approaches for finding this common ground, I think the key is to remember that it's really not about the information. It's about the social aspect of decision making and that comes down to um our identity. So when we're having a conversation with a patient, um, a patient brings in an article they found that article there's an entire social network and identity tied to that article. And when that patient says this article, they're they're they're saying this article means something to me. What they're really saying is someone I trust shared this with me and I value that. So when we correct them, we're not saying to them that article is not factual. We're saying your social identity is wrong and that is dismissive. So when we think about recognizing what's tied to our identities, both we're coming in as identifying as a health care provider, a scientist, um our patients are coming in with their social identity tied to this. Then we think about building that connection, supporting our identities in that conversation. Yeah. Sharing those stories so that we're building in opportunity to personalize the conversation to create connection so that we can sit at the table together in the busy restaurant and become a trusted peer at the table and that then is the opportunity to introduce the evidence.

Yeah, it's a it's a good way to think about it and I think you frame it as I care and I think that's a great you talked about identity connection anecdotes anecdotes and the last two are requests and then evidence so on that point uh Dr. Seymour as we talk about how to get good information across you mentioned something Dr. said which was we have to you know basically beat up the miss and disinformation with good information which means the quantity of output that we're putting out is greater than the the poor information that's out there. um, but your restaurant analogy I feel like when people go to the internet often times they are open and receptive and sort of without explicitly saying so looking for help and advice right so you can imagine the traditional scroller scroller through Twitter uh, you know Instagram Tik Tok those little clips that we watch are sometimes very informative and a really great way to get information across. What would your advice be to dental professionals who are listening to this um who want to do better at educating their patients on the right information? What is the best way for them to get that information across?

I I think what similar to what you're saying, I think information that I'm going to go back feels personal um allows them to build an emotional connection. It feels relevant. They look at that and say that matters to me. that aligns with with who I am. And sometimes that means we are not always the best messengers. It means we build networks um and we can be influencers within those networks, but we rely on the network dynamics to help propagate these messages. And that's how the algorithms online work. They they want people to keep coming back to their platforms and having a great experience. And that relies on these networks and relationship building, right? So I think those of us using these platforms in hoping to share information need to kind of rethink our mindset. It's about relationship building, right?

Totally. Absolutely. And to to the same extent I feel also is that you know when you you have to validate people's fears because their fears are legitimate to themselves. I mean obviously they want health, they want to have safety, they want to make sure that nothing bad is happening as a result of them trusting into some institution that could be wrong and you know in their view could be driven by financial incentives or various different things which is the way people think nowadays is people have lost trust in all institutions. It's always a question as you said follow the money and therefore they make decisions based on some of these uh concepts. So um I think validating is number one and that kind of helps bring down the guard so that you can then probably getting in through an emotional component sharing anecdotes keeping not at the level of a high science you know high brow science type of a thing but at a very kind of basic level of you know I mean for my case I'll always say you know people in my family have done plenty of procedures in my family and this particular thing that you're afraid of and that obviously as you can tell I mean I wouldn't be I've had it myself I've done it on my you family members, parents and stuff like that. So I feel that's much more connecting that's supposed to say according to the association of so and so X and Y is an invalid fear that you have. So it just kind of brings it down to level look to the best of my knowledge I'm doing what I saying right walk. Yeah, I mean, you know, and that that is probably much more helpful. And in that sense, it does help somebody like me with bad teeth. It does help because you can do it all yourself. That's But if you have perfect teeth, it's going to be a tougher cell for But but it also goes back, I think, in some ways. Sorry, I want to hear your thing because I want to know if you this is something you guys are going through in terms of learning. Oh, yeah. Is that you know, we had this discussion with some of the residents the uh actually I think it was yesterday um or a couple days ago. We're talking about the fact that look, we cannot treat everyone the same way. Wow, that was my next point. I don't know how you just read my saying because everybody comes in with their own personal baggages. You said it's psychology. So the best clinicians, the master clinician doesn't walk in with a cookie cutter approach, but it's constantly pivoting based on information that you gain based on the person personality. Right? I know some there's different personalities in these patients and you need to recognize and in some ways you need to thin slice people figure out what they're all about and then you have to you know upload the personality of the doctor that would be best for that particular patient and that would be the uh uh the type of kind of you know, the equivalent of the one minute manager I don't you guys read that book or not you know it's an interesting book like there's no one way to manage you manage different people at different times under different circumstances and a different part of the thing differently and that's the whole customization. It's kind of like precision medicine versus just cookie cutter medicine emotional intelligence, right?

What were you going to say?

This was precisely where I was going with this. I feel like we've talked so much about the positives about sharing and the negatives about sharing information on the internet, but I think we can all agree that it all is generalized to some extent. and all of those people that are listening, even listening to us now, right? We can only speak so much, but everyone has their own experience. And that's why I think we can all agree there is still and will always be so much benefit to sitting in the chair, talking to your doctor, sharing your story, sharing your background, and then getting the advice that is tailored to you because that's really what we're trained to do. And that's something that we'll never really be able to recreate on social media unless it's like tele medicine or something and we have the time and space and HIPPA and all that. um, but yes, I think that as people are consuming this information, it's always good to know that and that's why there's always those disclaimers on the ads you see on TV. Please contact your doctor if you have any of these side like you know, because you never know and not everything is going to be 100% applicable to everyone and I think it's very difficult to make a video on that ever. So I think it's a good point the personalization aspect of it the start listening right I mean it's that's the key part that's what we talk about doctor patient relationship is all about active listening to begin with before we talk but um uh Dr. Seymour before we uh wrap up uh I want to have the audience please comment and let us know what you guys think uh is the best way to get good information across and what have you come across that's really irked you about bad you know disinformation misinformation in the dental space but Dr. Seymour, as we wrap up uh this amazing episode, we want to ask you, what kind of uh parting advice will you leave our our audience today?

It's a that's a good question. There's there's so much I still don't consider myself the expert. There's so much to still learn in this space. I would say maybe to the patients and to the doctors. Yeah. Yeah. I would say for the patients, be patient with us. We are learning. We have been trained in a communication environment that is rapidly evolving. Yeah. And we are not always we don't always default to listening first. We have a we have a reputation for that because we're so excited to share the science with you. I would say for providers to remember when it comes to communication, we are social creatures. We are literally wired to be social for survival. And an engaged patient who brings us a dental myth is better than a patient who is disengaged and isn't Yeah. asking us for advice. And so just when we enter into those discussions, I learned the hard way to reserve judgment. I had to work through that. I would say remember that social proof will always outweigh scientific proof. And so to remember to develop that social validity and that social relationship so that we can really be effective communicators.

That's incredible. That's terrific advice. You know, maybe dental schools should also as well as medical schools focus more on communications, dental communications. I think so. Like media literacy. I think it should be part of the education coming coming out of school. I do.

Annie, you want to take a have a last word?

Well, you know, it's interesting. I think one of the big things is building trust. And I'll use an analogy. Those those are dental phobic patients. uh because of my position at the school, I had the experience to treat many many serious dental phobics who would come into Boston from around the world. And what I mean by phobics was that I would walk into the treatment room and they'd be sitting perpendicular in the dental chair and when I would introduce myself, they would start crying. That's going to be a challenging day, doctor. Okay. And one of the things that I would do, I would spend time that whole first visit re developing a relationship. And and when I would try to do something done very simple by the end of the day when I start to work if you feel anything if anything bothers you raise your hand and I will stop immediately and invariably I would do this because it's a method to the madness and I person would be numb. I take the hand piece I would start to go in the mouth and I would not even be anywhere near the tooth and the person would raise their hand. I know many many dentists maybe this is a generational things that when they try to do that with patients they say I'm not even touching your tooth I'm not and we continue I never did that not once because my agreement with the patient was meaning if if you feel anything raise your hand and I will stop and what I would do with those people they would raise their hand I would stop I'd put the handpiece down and then in a very calm way I would describe to patient. Did you realize you probably don't I wasn't anywhere near touching your tooth. But my agreement with you is that if you have any issues, any pain, any problem, raise your hand and I will stop immediately. I found that helped me get I think really good success with the denophobics. The sad thing is I think I had much better success with dentics than I had with people with preconceived misinformation ideas.

Terrific. So, um, awesome. All right. So, let's come back with the second part of this where we spend this time talking about misinformation, disinformation, and patient management. But in the second segment, we're going to come back and talk about um top 10 dental myths and see if how we can manage it based on this framework that we just established. Yeah, let's do it. Sounds good. Sounds good. Thanks for joining us, Dr. Se. Thanks for having me. We'll see you in the next episode. [music] ... Turning pulp into gold with every word. A show like no other you've ever heard. Health and hearts we craft of mold. Tune into pulp where stories unfold. [Music]