The 'five star' fallacy: an analysis of online reviews and testimonials of dental practices in Northern England.

Aims and objectives To develop a greater understanding of how dental practices in the UK utilise and promote patient reviews and testimonials. To compare and contrast the star ratings, levels of engagement and levels of identifiability by comparing those placed by patients on social media, review websites and search engines, to those placed on providers' own websites. To provide recommendations for future advertising guidance.Materials and methods All practices providing dental services in North East England and Cumbria were identified from the Care Quality Commission database. A web-based Google search for the respective dental practice websites, NHS listings, Facebook pages and Google results page listings was performed. The presence or absence of patient testimonials and reviews was recorded, alongside the total number of testimonials/reviews and the number of non-identifiable testimonials/reviews. Data were analysed using Microsoft Excel and SPSS Statistics.Results Of the 401 practice websites, 19.7% (n = 79) contained at least one graded review, while 40.9% (n = 158) of the 386 NHS listings; 87.2% (n = 272) of the 343 Facebook pages; and 94.4% (n = 442) of the 468 Google listings also contained at least one graded review. All of the 1,798 testimonials observed on practice websites were positive in their sentiment. Further, 22 practices utilised video testimonials. Each of the online review locations showed overall mean scores above 4.5 out of 5 stars.Conclusions Dental practice websites, the NHS website, Facebook and Google utilise testimonials and reviews in distinct and diverse ways. Unlike other jurisdictions around the world, the UK does not have guidance in this area. Electronic word of mouth is often replete with bias, and as such, patients need to be encouraged to seek out multiple sources before decision-making. Facebook and Google may be perceived to be more 'trustworthy' sources of information as they appear less curated and less susceptible to manipulation than practice websites, which the public may feel gives greater credence to the information they provide. In order to achieve the highest standards of integrity and honesty, advertising guidance surrounding reviews and testimonials would benefit from future revision.