Many members of staff did not know if their practice had a website or what the website address was.
Items of essential information were frequently absent.
Tooth whitening was promoted on 89% of websites despite legality issues.
Many websites advertised Botox injections despite the illegality of advertising prescription-only medications.
Aims and objectives To investigate the quality and content of dental practice websites by constructing an audit framework based on regulations, guidance and expert advice, and applying this framework to a random sample of UK dental practices websites.
Methods An audit framework was constructed and in-depth data collected from a random sample of 150UK dental practices.
Results Thirty-five percent of dental practices in this study were found to have websites. Compliance with rules and regulations regarding dental practice websites was generally poor. Use of advised content for practice promotion was variable. Many websites were poorly optimised. Eighty-nine percent of the websites advertised tooth whitening, despite the issues surrounding its legality; 25% of the websites advertised Botox even though advertising of prescription only medicines is illegal. Some websites gave misleading information about the specialist status of their dentists.
Conclusions Those responsible for dental practice websites need to be aware of a wide range of regulations and guidance, and are advised to follow expert advice on content and optimisation in order to maximise the potential of their websites.
L. C. Nichols and D. Hassall British Dental Journal 2011; 210: E11
The internet is a technology which has received incredibly widespread and rapid adoption since it first came to public attention in the 1990s. According to Internet World Stats,1 by 30 June 2010 there were an estimated 1.9 billion internet users globally, representing an increase of 444% since the year 2000 alone.
Given this increasing popularity, it is reasonable to assume that a large proportion of dental patients use the internet regularly. Indeed, a previous paper in this Journal found that 67.4% of a sample of patients attending hospital dental clinics were using the internet on a daily basis.2 Anecdotally however, the perception among those providing services to the dental profession is that dentists 'do not use the internet', at least in their professional lives. This perception sounds like, and to some extent almost certainly is, a sweeping generalisation. However, the results of this paper by Nichols and Hassal do seem to suggest that dentists' uptake of the internet for marketing their practices has been slow. It is tempting to conclude that this may be a reflection of a general unfamiliarity with the internet among dentists themselves.
Also of concern is the paper's finding that the practice websites that do exist are frequently do not comply with current regulations. The fact that a quarter of the websites in the study illegally advertised Botox to patients is a worrying statistic. In a world where the burden of regulation and bureaucracy is already at an all-time high, these dentists are unnecessarily leaving themselves open to prosecution.
The article sends an important message to any dentist who has developed or is considering developing a practice website: while such sites are certainly worthwhile, in order to be of maximum benefit, both to patients and practices, regulations and guidelines must be followed and advice sought on website content and optimisation. But there is also a wider message for the profession to take home. The internet is an incredibly useful tool that will only increase further in popularity. It has the potential to be of great benefit to dentists, and patients use it and will continue to use it in increasing numbers. Given the current climate in modern dentistry, it would be shortsighted to dismiss such a potentially powerful resource.
The full paper can be accessed from the BDJ website (www.bdj.co.uk), under 'Research' in the table of contents for Volume 210 issue 7.
Rowena Milan, Managing Editor
Author questions and answers
1. Why did you undertake this research?
As internet usage has and continues to become more widespread, more dental practices have websites. The rules and regulations surrounding these websites are therefore increasingly significant. The use of such websites as a marketing tool also becomes more significant and in order to compete in the dental market it is important that practitioners maximise the marketing potential of their websites.
There has previously been very little research on the compliance of dental practice websites with the relevant rules and regulations, or on the quality of the websites as determined by expert advice on website content. Therefore it was felt that this research would gain much-needed insight of great benefit to all dentists who either have or are considering having a practice website.
2. What would you like to do next in this area to follow on from this work?
This paper has suggested that dental practice websites are of very variable quality. However, to more robustly verify these findings, it would be useful to repeat the study with a much larger sample size.
It would appear that there are many website design firms targeting their skills towards dental practice websites. Research to determine how aware dental practice website designers themselves are of the ideal requirements as determined by this study would also be useful. Dentists often make considerable financial investments with dental website design firms so it is important that they are getting an appropriate level of service.
In an age when information technology is playing such an important and expanding role in so many aspects of clinical practice, this paper, which addresses the use of practice websites, is very timely. The author reviews a random sample of 150 UK dental practices and found that of the 53 practices that had websites, 89% of them advertised tooth whitening, despite the issues surrounding its legality. Twenty-five percent of the websites advertised Botox, even though the advertising of prescription-only medicines is illegal, and some websites gave misleading information about the specialist status of their dentists. These deficiencies and inaccuracies raise important issues that need to be addressed, since they can not only mislead patients but can also place practitioners in conflict with the law.
The authors cite a number of regulatory bodies and guidance that must be considered when developing a practice website, to which can be added the Advertising Standards Authority (ASA) whose online remit as from 1 March 2011 will be extended to cover marketing communications on organisations' own websites.3 The UK Code of non-broadcast advertising, sales promotion and direct marketing (the CAP Code) will apply in full to marketing messages online, including the rules relating to misleading advertising, social responsibility and the protection of children. This could impact on many aspects of advertising including the use of patients' positive testimonials in addition to the problem highlighted in this paper relating to the grey area of patient consent in the use of statements or images online.
It is surprising, when the British Dental Association considers that a practice website is a 'vital marketing tool', that a study undertaken in 2006 found only 12% of UK dentists had a practice website and that in this recent study this had only increased to 35%. The potential benefits of using the internet as a powerful practice promotional tool and an opportunity to give patients valuable oral health advice would appear to be underutilised. This paper provides some useful guidance about the content of a practice website but it is evident from it that practitioners must be much more aware of the regulations that surround this important form of communication.
Internet World Stats. World internet usage and population statistics webpage. http://www.internetworldstats.com/stats.htm (accessed 28 March 2010).
Ni Riordain R, McCreary C . Dental patients' use of the internet. Br Dent J 2009; 207: 583–586.
The Advertising Standards Authority. http://www.asa.org.uk/
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Ireland, R. Summary of: Quality and content of dental practice websites. Br Dent J 210, 314–315 (2011). https://doi.org/10.1038/sj.bdj.2011.265