Influence of Social Media towards the Selection of Hollywood Smile among the University Students in Riyadh City.

BACKGROUND: Hollywood smile refers to the aesthetic development of dental appearance inspired by the beauty displayed by the movie actors. Therefore, the present study was conducted to determine the extent of social media effect on the decision making of university students towards selecting Hollywood smile as the choice of their aesthetic treatment.
MATERIALS AND METHODS: This cross-sectional study was conducted by utilizing a self-designed closed-ended questionnaire among under-graduate students from the various public as well as private universities of Riyadh city. The questionnaire was constructed online using Google forms and began with questions related to demographics; questions like Do you notice celebrity's smile on social media? Have you visited a dentist solely after getting inspired by a celebrity's smile? etc., Responses were on a 5-point likert scale ranging from highly dissatisfied or strongly disagree to highly satisfied or strongly agree whenever applicable. Chi-square test was used to compare the differences among the groups with the value of significance kept under 0.05 by using SPSS version 19.
RESULTS: The majority of the female participants reported noticing the celebrity's smile on social media. Influence by the celebrity smiles on social media was found more in the older age group participants. However, the term "Hollywood smile" was slightly more known among the younger aged participants.
CONCLUSION: The overall effect of social media in decision making of opting for Hollywood smile was found to be moderate. More studies should be conducted to investigate how much social medial is effecting the perceptions of youngsters. Copyright:

Introduction

The penetration of internet in Saudi Arabia arrived at 91% and the extent of internet regulars stretched out to be 30 million at the start of 2018 according to the Global Media Sight's statistics, May 2018.[1] It has played a vital role in creating awareness among the general public about various issues. Fields such as business, education, health, etc., have received a significant amount of publicity with the proper utilization of social media. It can easily be inferred that this technology has transformed the overall lifestyle of the public.[23]

People are making the use of the internet for various purposes including for getting health-related information.[4] Its use has definitely changed the entire face of the healthcare system and the overall relationship between healthcare professionals and their patients.[5]

Hollywood smile refers to the aesthetic development of the dental appearance, which has now become a dental terminology.[6] Social media has been a revelation for the dental business in many countries. It has become one of the most common and cheapest ways to promote one's dental business and related products. In recent times, people's choice of dental treatments has vastly included the aesthetics related to dentofacial structures. Improving one's smile has been the most wanted esthetic modality among social media users, which has greatly boosted dental businesses.[78]

When discussing the improvement of a smile, one cannot ignore the significance of Hollywood smile, which has now become an important patients’ demand from their dental health care providers. The use of veneers in esthetic dentistry has evolved into the discovery of this terminology, which is now being used by patients as well as dental practitioners on a regular basis.[9]

The young generation has taken over social media with their majority of the time being spent surfing and discovering the latest updates on several issues including their health. Females tend to be highly attracted to the dental aesthetics and their usage resulting from social media marketing. Their decision making is highly affected by the repeated advertisements being displayed on different social media websites.[1011]

This notion of receiving Hollywood smile has been inspired by the beauty displayed by the movie actors, which has impacted on the lives of the young generation. The major source of this excitement has been none other than the social media. Constant exposure of personal life and constant sharing of photographs on social media has also played an important role in public choosing various aesthetic dental treatments especially Hollywood smile.[1213] It is important to know how much the social media affect the decision making of these young people in Saudi regarding their dental aesthetics. Therefore, the present study was conducted to determine the extent of social media effect on the decision making of university students towards selecting Hollywood smile as the choice of their aesthetic treatment.

Materials and Methods

This cross-sectional study was conducted by utilizing a self-designed closed-ended questionnaire. Ethical clearance to proceed with the study was availed from the institutional ethical committee. The IRB approval number is RC/IRB/2019/29. The participants were undergraduate students from the various public as well as private universities in Riyadh city. All undergraduates from dental specialty were excluded. A total of 1000 students were asked to fill the questionnaire using their smartphones. Convenient sampling was taken place in order to achieve the desired sample size.

The questionnaire was constructed online using Google forms and began with questions related to demographics, including age, gender, name of the university, study field, total hours spent on social media in general, and the type of social media used. Do social media advertisements affect your attention? Do you notice the celebrity's smile on social media? Have you visited a dentist solely after getting inspired by the celebrity's smile? Are you familiar with the term “Hollywood smile?” The responses were on a 5-point likert scale ranging from highly dissatisfied or strongly disagree to highly satisfied or strongly agree whenever applicable. The survey was designed in a way that each respondent will attempt only once using his email account when the survey is sent using social network applications.

Prior to the main survey, the validity of the questionnaire was tested by sending to the experts in research, which included a few faculty members of REU. A pilot study was conducted using 20 online questionnaires filled randomly by university students to assess reliability by calculating Chronbach's coefficient alpha, which was found to be 0.82.

Statistical Analysis: Collected data was transferred from Google sheets to SPSS version 19, where descriptive as well as inferential statistics was conducted. Comparisons among groups were made with the value of significance kept under 0.05 and Chi-square test was used to achieve this.

Results

A total of 1000 university students male and females filled up the online survey, which comprised of 44% males and 56% females.

The participants were grouped on the basis of their specialty, which demonstrated that 46% were health sciences students, 54% were students from other specialties including engineering, business, management, etc., It was demonstrated that 15% of participants used social media for 0–2 h per day and 39% for more than 6 h per day. Among the participants 4% used Facebook, 24% used Instagram, 38% used Twitter, and 34% used Snapchat.

A statistically significant difference was observed among the male and female participants when the majority of the later participants reported noticing the celebrity's smile on social media (P = 0.001). Similar findings were seen when inquired about the familiarity regarding Hollywood smile, which revealed that the females were more knowledgeable than males and this comparison was statistically significant (P = 0.003) [Table 1, Figures 1-3].

Table 1

Comparison of the Study participants on The Basis of Gender

	Item	Gender	HD/SD	D	N	S/A	HS/SA	P
1	How do you rate your own smile?	Male	5%	19%	27%	36%	13%	0.001*
		Female	6%	10%	24%	40%	20%
2	Do social media advertisements affect your attention?	Male	21%	22%	31%	21%	5%	0.001*
		Female	16%	16%	31%	29%	9%
3	Do you notice celebrity's smile on social media?	Male	10%	9%	19%	37%	27%	0.001*
		Female	3%	4%	12%	43%	35%
4	Have you visited a dentist solely after getting inspired by celebrity's smile?	Male	51%	25%	10%	10%	4%	0.426
		Female	45%	27%	10%	13%	5%
5	Are you familiar with the term “Hollywood smile”?	Male	6%	8%	14%	36%	36%	0.003*
		Female	2%	4%	14%	41%	39%
6	Were you exposed to “Hollywood Smile” through social media	Male	13%	12%	20%	35%	20%	0.247
		Female	16%	11%	17%	31%	25%
7	Have you ever ordered esthetic dental products online after watching an advertisement on social media?	Male	61%	22%	7%	9%	1%	0.003*
		Female	52%	22%	8%	15%	4%
8	Do influencers on social media who have Hollywood smile affect your self confidence?	Male	43%	19%	18%	16%	4%	0.034*
		Female	38%	22%	14%	18%	8%
9	Do you find this smile attractive? [Figure 1]	Male	25%	22%	28%	16%	8%	0.001*
		Female	36%	30%	16%	13%	5%
10	Do you find this smile attractive? [Figure 2]	Male	6%	5%	16%	27%	37%	0.080
		Female	4%	5%	11%	38%	43%
11	Pictures before and after results of bleaching (teeth whitening), do you think it requires Hollywood smile? [Figure 3]	Male	46%	22%	14%	13%	4%	0.070
		Female	50%	24%	8%	13%	4%

*HD=Highly Dissatisfied, SD=Strongly Disagree, D=Dissatisfied /Disagree, N=Neutral, S=Satisfied, A=Agree, HS=Highly Satisfied, SA=Strongly Agree. *P<0.05; significant

Figure 1

Do you find this smile attractive?

Figure 3

Pictures before and after results of bleaching (teeth whitening), do you think it requires Hollywood smile?

The comparison among the different fields of education revealed that the health field students tend to be more influenced by social media websites and referring themselves to the dentist as compared to students from other fields (P value = 0.001) [Table 2].

Table 2

Comparison of the Study participants on The Basis of Specialty

Item	Specialty	HD/SD	D	N	S/A	HS/SA	P
1	Health	4%	10%	25%	44%	18%	0.001*
	Others	8%	19%	25%	33%	15%
2	Health	19%	16%	25%	29%	11%	0.001*
	Others	18%	25%	37%	17%	13%
3	Health	6%	6%	12%	39%	38%	0.001*
	Others	9%	8%	16%	43%	24%
4	Health	47%	23%	10%	14%	6%	0.043*
	Others	52%	29%	9%	9%	1%
5	Health	2%	3%	16%	38%	41%	0.001*
	Others	6%	11%	11%	40%	32%
6	Health	12%	7%	14%	35%	31%	0.001*
	Others	18%	19%	22%	28%	13%
7	Health	56%	21%	8%	13%	4%	0.579
	Others	59%	22%	5%	12%	3%
8	Health	39%	20%	14%	20%	8%	0.277
	Others	43%	20%	17%	15%	4%
9	Health	35%	26%	17%	14%	8%	0.004*
	Others	28%	26%	27%	15%	4%
10	Health	4%	5%	14%	34%	43%	0.964
	Others	6%	6%	14%	37%	38%
11	Health	50%	22%	9%	14%	5%	0.094
	Others	48%	25%	11%	13%	3%

*HD=Highly Dissatisfied, SD=Strongly Disagree, D=Dissatisfied /Disagree, N=Neutral, S=Satisfied, A=Agree, HS=Highly Satisfied, SA=Strongly Agree*P<0.05; significant

No significant difference was found among the study groups on the basis of the number of hours spent daily on social media when inquired about ordering online products (P value > 0.05). However, participants spending more time on social media were significantly more aware of the term “Hollywood smile” (P value = 0.001) [Table 3].

Table 3

Comparison on the basis of average time spent on social media (in hours)

Item	Time	HD/SD	D	N	S/A	HS/SA	P
1	0-2	11%	12%	28%	35%	13%	0.007*
	3-5	2%	15%	25%	42%	16%
	≥6	7%	14%	25%	35%	19%
2	0-2	23%	14%	28%	22%	12%	0.367
	3-5	16%	20%	31%	26%	7%
	≥6	18%	20%	31%	25%	6%
3	0-2	9%	7%	15%	35%	34%	0.782
	3-5	5%	8%	17%	40%	30%
	≥6	6%	6%	14%	42%	32%
4	0-2	46%	23%	10%	17%	4%	0.159
	3-5	44%	28%	12%	11%	4%
	≥6	51%	25%	9%	11%	4%
5	0-2	1%	3%	28%	37%	31%	0.001*
	3-5	3%	6%	11%	40%	39%
	≥6	6%	7%	13%	37%	38%
6	0-2	12%	6%	18%	29%	36%	0.037
	3-5	15%	11%	17%	34%	22%
	≥6	15%	14%	20%	33%	18%
7	0-2	51%	21%	6%	16%	5%	0.134
	3-5	55%	22%	8%	11%	3%
	≥6	60%	22%	5%	12%	2%
8	0-2	36%	14%	18%	15%	16%	0.001*
	3-5	39%	23%	16%	17%	4%
	≥6	43%	20%	14%	17%	5%
9	0-2	27%	22%	21%	17%	14%	0.007*
	3-5	31%	29%	20%	15%	5%
	≥6	34%	25%	24%	12%	5%
10	0-2	4%	5%	17%	34%	41%	0.001*
	3-5	4%	5%	14%	37%	40%
	≥6	6%	6%	11%	36%	41%
11	0-2	41%	18%	9%	24%	7%	0.001*
	3-5	48%	23%	10%	15%	4%
	≥6	53%	25%	12%	7%	3%

*HD=Highly Dissatisfied, SD=Strongly Disagree, D=Dissatisfied /Disagree, N=Neutral, S=Satisfied, A=Agree, HS=Highly Satisfied, SA=Strongly Agree. *P<0.05; significant

Older age group participants were found to be highly influenced by the celebrity smiles on social media and referring themselves to the dentist to receive aesthetic dental treatment (P value: 0.001) [Table 4]

Table 4

Comparison on the basis of age (in years)

Item	Age	HD/SD	D	N	S/A	HS/SA	P
1	18-21	8%	14%	28%	33%	17%	0.005*
	22-25	3%	12%	24%	42%	18%
	≥25	11%	12%	22%	44%	10%
2	18-21	15%	22%	29%	25%	9%	0.022*
	22-25	22%	17%	30%	25%	6%
	≥25	10%	11%	33%	40%	7%
3	18-21	7%	5%	15%	46%	33%	0.182
	22-25	6%	8%	16%	38%	32%
	≥25	7%	13%	17%	43%	20%
4	18-21	56%	23%	6%	10%	5%	0.001*
	22-25	47%	26%	11%	12%	4%
	≥25	26%	30%	21%	17%	6%
5	18-21	4%	5%	15%	40%	37%	0.082
	22-25	3%	6%	13%	36%	42%
	≥25	6%	10%	20%	46%	18%
6	18-21	12%	11%	21%	30%	25%	0.006*
	22-25	17%	11%	15%	33%	23%
	≥25	7%	16%	31%	37%	9%
7	18-21	58%	22%	4%	13%	4%	0.001*
	22-25	60%	18%	9%	11%	2%
	≥25	33%	40%	6%	17%	4%
8	18-21	42%	20%	15%	17%	7%	0.861
	22-25	41%	20%	16%	16%	7%
	≥25	33%	27%	14%	17%	9%
9	18-21	31%	23%	23%	17%	6%	0.202
	22-25	33%	28%	20%	12%	7%
	≥25	27%	33%	26%	11%	2%
10	18-21	6%	3%	12%	37%	43%	0.017*
	22-25	4%	6%	14%	34%	41%
	≥25	10%	6%	21%	32%	31%
11	18-21	50%	22%	9%	13%	5%	0.031*
	22-25	52%	22%	10%	13%	3%
	≥25	33%	28%	20%	11%	7%

*HD=Highly Dissatisfied, SD=Strongly Disagree, D=Dissatisfied /Disagree, N=Neutral, S=Satisfied, A=Agree, HS=Highly Satisfied, SA=Strongly Agree. *P < 0.05; significant

Discussion

This study aimed to assess the effect of social media use on the selection of Hollywood smile among the young college-going people in Saudi. The responses were compared on the basis of gender, the field of study, and the number of hours spent on social media on daily basis.

Our analysis showed that the young female participants noticed more celebrity's smile on social media, which affected their decision of improving their dental aesthetics than the males with the difference being statistically significant, and similar findings were recorded by Dunlop et al.[14] Previous literature shows that social media utilization was more in females than males owing to their emotional behavior.[15]

Comparison on the basis of age group suggested that the younger participants were more satisfied with their dental appearance as compared to the older individuals. Similar findings were observed by Aldaij et al.[16], when they investigated the Saudi population about their satisfaction level of dental aesthetics. Influence by the celebrity smiles on social media was found more in older age group participants. However, contrasting findings were revealed when inquired about the term “Hollywood smile”, which was known slightly more among the younger aged participants.

Health filed students had more knowledge about Hollywood smile in our study. This was in accord with the study conducted by Aldaij M et al.[17] who also concluded that overall health- related students show better knowledge and attitudes towards their aesthetic dental treatments and needs.

The concept of dissatisfied smile and aesthetics from own's smile has a negative impact on one's psychology. It can affect general health also. The contribution of dental aesthetics towards the overall appearance of a person cannot be ignored. The cosmetic enhancement may help to improve the financial status of a person as the probability of getting into payroll increases. It may render a person more productive at work and can also contribute to the productivity and development of the nation.

Limitations

Since it was a questionnaire study, the actual influence of social media on respondents may or may not be predicted, reflecting the inbuilt shortcomings of such studies. This can be attributed to the fact that in questionnaire-based studies, there is a likelihood of social allure of faking high-quality bias.[18]

Conclusions

The overall effect of social media in decision making of opting for Hollywood smile was found to be moderate. Females were more dissatisfied with their smiles and needed aesthetic enhancement as compared to males. The use of the internet was also more by females as compared to males. In the current era, the use of the internet is worldwide for numerous areas including dentistry. This information digital media is expanding our knowledge faster than any other source. More studies should be conducted to investigate how much social medial is effecting the perceptions of youngsters.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.