Illegal Orthodontics: A Cross-Sectional Study of Fake Braces Content on TikTok

Abstract Context: Fake braces are defined as orthodontic attachment lookalikes, which are fitted to the teeth by unqualified providers at unregistered premises. Aims: This study aimed to investigate the content and engagement metrics of TikTok videos in relation to fake braces. Settings and Design: TikTok videos were collected via four hashtags: #fakebraces, #bracesmurah, #fashionbraces and #realbraces. Characteristics, content and metadata of each video were extracted, recorded into Microsoft Excel and analysed using SPSS. Statistical Analysis Used: Fisher’s exact test to identify any association between the identity of uploaders and the theme of TikTok videos produced. One-way analysis of variance (ANOVA) used to compare engagement metrics between various groups of uploaders and themes. Results: A total of 1150 videos were screened, and 378 videos were analysed in the study. Videos uploaded since 2020 had 77,500,000 views, 6100,000 likes, 59,255 comments, 355,912 saves and 60,152 shares in total. The majority of videos were uploaded by fake braces sellers (79.9%), health professionals (15.6%) and laypersons (4.5%). Theme with the highest frequency was marketing (66.9%), informational (16.7%), procedural (12.4%), humour (2.4%) and testimonial (1.6%). A significant association was found between the identity of uploaders and the theme of videos uploaded ( P < 0.001). Significantly higher shares were reported for humour-themed videos ( P < 0.05). Conclusions: Fake braces videos on TikTok were uploaded by various groups presenting different themes that could be beneficial or misleading to the public. Oral health literacy in using social media should be strengthened to counteract misinformation online.