INTRODUCTION
Dental patients interact with other users to get and share information on the network in the healthcare system. More than two-thirds of online people in the world use social media platforms. Awareness campaigns and groups formed for social support through social media are increasing. Like many social media sites, Twitter has been quite popular for some time. Approximately 350,000 tweets are shared every minute. Twitter allows users to share photos and videos as well as text posts which could contain up to 280 characters. The unfollowing and being followed relationship in Twitter don’t need to be reciprocal, making it different from some other popular social media platforms. Therefore, it allows patients to examine the ideas and experiences shared by different people. Therefore, Twitter is popular for use in public health research.1-3
Bullying is repetitive and deliberate negative behavior towards an individual who is incapable of defending him or herself. It is a very common occurrence in schoolchildren with a prevalence of 5% to 58% globally. Bullying can occur relationally, verbally, or physically.4,5 In addition to these, online aggressive behavior can be defined as cyberbullying.6 Being bullied has many negative effects on the emotional state of an individual, which could be lifelong. Those who are bullied may experience negative physical, mental, social, and spiritual effects in their lives.7 As students who are being bullied often fear school, their absenteeism and drop-out rates were shown to be increased. The victims often feel anxious, insecure, and lonely and have low self-esteem with a generally negative evaluation of themselves.8 It has been observed that those who are bullied have a high risk of experiencing severe mental health problems.9 Suicidal thoughts and self-harming behaviors have been found to increase in victims who are constantly bullied.10 Therefore, the execution of bullying prevention programs is necessary to break the cycle that causes emotional stress and negative feelings in bullying victims that may continue throughout their lives.
Dentofacial anomalies can lead to an increment in bullying among children and adolescent.7 In the orthodontic literature, the teasing people are exposed to because of their teeth and facial features have been an issue that has been emphasized. Previously, a significant relationship was detected between bullying, malocclusion, and self-esteem in adolescents in the UK.11 Cleft lip and/or palate (CLP) are congenital malformations that can affect the head, lips, and intraoral structures. The incidence of CLP is quite common with 1 in 70012 and varies depending on genetic, and environmental factors. Children with CLP have some functional and aesthetic problems such as trouble in mouth closing, feeding difficulties at birth, hearing problems, speech difficulties, and dental problems.13,14 Due to such difficulties, individuals with CLP are at increased risk of being bullied. A team of medical and dental specialists is required to treat these problems. Delayed treatments may cause potential adverse psychological effects on the child due to CLP-related malocclusions.
Although the relationship between bullying and dentofacial features/orthodontic treatment was previously investigated by analyzing Twitter7, no studies were detected regarding the bullying experienced by individuals with CLP using Twitter data. Therefore, we aimed to evaluate the bullying on Twitter experienced by individuals with CLP.