In the first of a two-part series, Caroline Holland provides a rundown of the benefits and challenges of social media influencers.

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The mobile phone has changed the way that patients get information about everything, including their teeth. It's estimated1 that 95% of Generation Z, the cohort of children and young people born between 1995 and 2015, own a mobile phone. Of that number, more than 55% are on their phone five hours or more a day. So, if they want to know how to make their teeth whiter or straighter, or why their gums are bleeding, they will use what comes to hand - their phone! - to find answers, whether by looking online or messaging friends. Meanwhile, 93% of millennials - Generation Y (born between 1980-1994) - own and use phones almost as enthusiastically as Generation Z and the Baby Boomers (1944-1964) are also embracing the digital life.

The restorative dentist Aws Alani, speaking at the British Society of Paediatric Dentistry conference in September, said that phones are the biggest threat to patient-dentist relations. Patients are turning to their dentist with unrealistic expectations of what might be achieved.

Dental teams are well-advised to be aware of what is being promoted online so you can be at the ready to provide a counter-balance. A typical example of a potentially risky and damaging product that patients can find online is DIY braces. Another worrying trend is the promotion of charcoal based toothpastes and then there was 'that' Netflix documentary which claimed root canal treatment causes cancer!2

Integral to the addictive qualities of being online 24/7 is the presence of so-called social media influencers. Digital platforms have given influencers a stage. Although largely unquantifiable, their impact on dentistry and patients' wishes and expectations is very real. Sad to say, many patients in all age groups will make up their mind about an issue affecting their oral health as a result of an internet search or the views of an influencer. Obviously it would be preferable if they were to get advice from their dental team, but in many instances you are the last people they consult. Instead, their information might be sourced via a blog, a tweet, a Facebook or Instagram post, or found on a website, in an app, an advertisement or in a forum or an article … the list goes on.

Digital platforms have given influencers a stage. Although largely unquantifiable, their impact on dentistry and patients' wishes and expectations is very real.

Practices which provide cosmetic treatments or orthodontics are already being invited to enter into a partnership with an influencer. On a dental forum recently, a dentist shared his experience of being approached by the agent of a social media influencer with an Instagram following of more than 48,000. The dentist was asked by the agent if he would 'collaborate'. Although it wasn't spelt out in detail, it was clear the influencer wanted veneers in exchange for some positive mentions on Instagram.

Social media influencers are defined3 as 'people who have a large reach across social platforms and have built a lot of trust in a specific industry. Because of this trust, they're often able to persuade (or "influence") their followers to purchase products and services from brands they promote.' Most brands would expect their influencers to have at least 5,000 followers. A post or two about a product on the right platform is often worth a small fee. The more followers, the bigger the fee. Kylie Jenner, probably the best known of all social media influencers currently and a billionaire aged just 21,4 has more than 28 million followers on Twitter and is reported to be paid as much as £960,000 for just one tweet!

Obviously fashion, handbags and cosmetics are the kinds of products most likely to be talked and posted about, but teeth feature too. On Instagram the word teeth has been hashtagged 5 million times.

Among the social media influencers posting about teeth is Ben Black. Aged 21, he is an Invisalign brand advocate. He was at the opening of an Align Technology 'pop-up' in London's Westfield Centre. Ben was there to talk about his experience of Invisalign. With 1.8 million followers and a talent for football and making YouTube videos, Ben's advocacy of the brand has undoubtedly carried influence already.

The dental profession has its own share of influencers, not always on social media, but having a global effect, nonetheless.

Ben Underwood, creator of the app Brush DJ, says that the toothbrushing app has been downloaded in 201 countries - that's nearly every country in the world - to over one third of a million devices.

Ben said: 'We know that the app is often used by families, in children's nurseries and schools, so the reach and positive influence is greater than the number of downloads'.

After several years, Brush DJ is still the only dental app in the NHS Apps Library, a great achievement, and Ben is getting regular engagement from the users - a prerequisite for anyone wanting to be a digital influencer. 'Most of the feedback comes from people leaving reviews in the Apple App Store and Google Play store. All the feedback we get helps to improve the app.'

He is learning to be open-minded about the musical taste of app-users and says he no longer judges a book by its cover! 'We get people who would appear very strait-laced in public requesting Thrash Metal songs. Also, everyone loves ABBA!'

Ben says he is still shocked how ill-informed people are about the basics of oral hygiene.

So a lot of work to be done! In Part 2 of this article you will hear from GDC registrants working as influencers and the impact this has had on their life and career.