Adolescents’ use of an online Q&A service to enhance their oral health literacy: a mixed-methods text mining and thematic analysis

Health literacy is fundamental to healthy behaviour, defined as seeking, processing, and evaluating health information to make informed decisions. Access to health information has historically been linked to socioeconomic status (SES), with disparities in health persisting due to unequal access to new health technologies. Digital technologies offer opportunities for spreading health information but may also increase inequalities through a digital divide. The Norwegian government established the website ung.no in 2003 to provide health information to adolescents. This study aims to investigate what oral health information adolescents seek on the ung.no Q&A service and how they use it to build oral health literacy. The study analysed 1632 questions posted on the ung.no Q&A service and answered by dentists between January 1, 2020, and May 12, 2023. Data included self-reported gender and age of the individuals posting the questions. Descriptive analyses, text mining, manual coding and qualitative thematic analysis were used to assess the four elements of health literacy: finding, processing, evaluating and utilizing health information. The analysis revealed that most questions were posted by girls (65.8%), with the majority coming from the 13–15 age group (55%). Common themes included orthodontic treatment, caries, oral hygiene, finances and the impact of diet and substances on oral health. Adolescents used the Q&A service to seek information, confirm information from other sources, and evaluate options for oral health behaviours and treatments. Many questions reflected concerns about the appearance of teeth, fear of dental procedures and the confidentiality of dental visits. Negative emotions such as stress, fear and shame were prevalent, impacting the adolescents’ ability to process information and make informed decisions. The ung.no Q&A service is a valuable tool for adolescents to increase their oral health literacy. The study highlights the importance of providing clear, accessible information and addressing the emotional factors that influence health behaviours. Dental professionals should focus on building trust, offering empathic communication, and providing proactive guidance to support adolescents in making informed decisions about their oral health.