Unpacking X (formerly Twitter) discourse on fluoride and related topics during the 2024 US presidential election.

BACKGROUND

Fluoride is a cornerstone of caries prevention, yet public trust in fluoride has become increasingly contested, particularly on social media platforms where health misinformation and political narratives intersect. Understanding how fluoride is discussed online may inform strategies to improve communication and public confidence in oral health interventions.

METHODS

The authors analyzed publicly available posts from X (formerly Twitter) (X Corp) during the 2024 US presidential election that referenced fluoride and related topics. Natural language processing techniques were used to classify post sentiment and emotional tone and to identify dominant discussion themes. Comparisons were made between fluoride-related posts and general posts by the same users to assess differences in sentiment distribution and emotional expression.

RESULTS

Fluoride-related discourse was considerably more negative than general discourse on the platform. Negative sentiment toward fluoride was frequently associated with distrust in government and public health institutions, political polarization, and perceived health risks. Positive discourse emphasized caries prevention, dental products, and evidence-based public health benefits. Users expressing negative sentiments toward fluoride were also more likely to express negative sentiments in non-fluoride-related posts.

CONCLUSIONS

Online discussions about fluoride during a politically charged period reflected broader sociopolitical beliefs and emotional responses rather than isolated concerns about dental science.

PRACTICAL IMPLICATIONS: Dental care professionals should recognize that patient concerns about fluoride may stem from emotionally driven narratives encountered online. Communication strategies that acknowledge concerns while clearly explaining the safety and benefits of fluoride may support effective patient counseling and public engagement.