Framing Fluoride Information on Social Media: A Cross-Language and Cross-Platform Analysis.

Abstract

Introduction: Few health topics are as controversial as fluoride, and social media has become a powerful arena where health information and misinformation circulate and compete for attention. This study systematically examined fluoride-related posts across two major platforms (Instagram® and X™) in English and Spanish.

Methods: Using a standardized approach, we identified the first 200 publicly available posts related to fluoride and health on each platform and language (n = 800 total). Posts were analyzed in duplicate, assessing perception (positive, negative, neutral), accuracy (accurate or non-accurate), format, account type, among others.

Results: Results revealed differences across language and platform. Spanish-language content was generally more accurate and conveyed a more positive tone, while English-language posts, particularly on X™, showed a higher prevalence of alarmist narratives. Engagement patterns varied by tone, post format, and account type. Negative posts attracted more likes overall. Post written in Spanish generated lower engagement. Carousel and photo-video formats and professional accounts received substantially greater interaction.

Conclusion: These findings provide empirical evidence that language, source, and format strongly influence the reach and resonance of fluoride posts. They also suggest that multilingual strategies using engaging formats and credible professional voices can enhance the impact of evidence-based fluoride communication and counter misinformation.