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.