Sharing orthodontic content on social media

The most influential social media platforms currently include Instagram, Facebook, Tiktok and Twitter, all of which engage millions of users daily. The most responsive users on Instagram are a similar age to many of the patients we treat, and they are significantly influenced by content they see online. Social media has thus become a useful tool for both patients and for professionals,¹ especally as these sites can provide users with a useful platform for communication regarding professional advice and support.²

Increasingly, patients are turning to social media for information to support decision-making and improve their awareness of treatment options³. ‘Keep Britain Smiling’ is an example of a nationwide campaign started in 2018 that gained significant momentum. From there, regional campaigns such as ‘Keep Chesterfield Smiling’ among many others were set up to engage users and, most importantly, to promote oral and dental health. Social media can also be used to showcase patients’ journeys through transformation posts and testimonials. ‘Keep Stoke Smiling’ is a well-developed and thriving social media account that regularly reaches between 4K and 8K accounts, and in April 2020, on Facebook alone, it reached 12K individuals, with engagement figures of 7.4K.

However, releasing patient photographs and content exposes the Trust, account holders and patients to plagiarism and unauthorized use of content. Digital images form part of the patient's confidential medical record and must therefore be subject to the same safeguards as any other data, as part of information governance.

This article outlines the key steps needed to set up an orthodontic Instagram page, specifically one that publishes patient information. The authors discuss how to ensure that patient images are protected, and the benefits of watermarking images.

Watermarking a photo means to add or superimpose text or a logo to the image, in order to claim originality as the owner, and to protect against other accounts copying images and claiming them as their own.

The British Orthodontic Society advocates the use of watermarking in their policy document ‘Orthodontic records: collection and management’.⁴ Images being ‘regrammed’ by feature accounts is one of the fastest ways to grow a social media platform, although in most cases, feature accounts will not ‘regram’ watermarked photos. In cases where platforms share patient information and clinical photographs, regramming should be avoided. Hence, watermarking may be worthwhile.

Why watermark images?

• To ensure confidentiality and integrity of the medical images.
• To verify the authenticity of ownership and origin.
• Watermarks can be carefully designed to promote the platform further.

Key steps

• If you work in an NHS hospital, gain approval from the hospital communications or media team.
• Gain verbal and written informed consent from patients or their parent or guardian.
• Get the team on board with the process of creating content.
• Use appropriate ‘hashtags’ to reach the relevant users.
• Watermark photographs.

Watermarking through apps

There are many apps available to make watermarking through your phone easier. Most are free, but require a cost to access additional features. The following step-by-step instruction is through an app called ‘Watermark Studio X’

Key steps

• Upload your photo from your phone to the app.
• Pick your watermark.
• Type your desired text in the box.
• Set the opacity to your liking. This has been set to 20% here (Figure 1).
• Save your watermarked image and upload directly to Instagram.

Watermarking through PowerPoint

The use of PowerPoint is a more lengthy process, but serves as a potential way to watermark clinical patient photographs for social media. This process can also be used to watermark images for lectures and presentations.

Key steps

• Copy and paste photograph (of highest resolution) into a Microsoft Word or PowerPoint document.
• Click on ‘insert’ followed by ‘Wordart’ and select the text you like (Figure 2).
• Type your text in the box and rotate it over your photo, right click and ‘Format Text Effects’ or click on ‘shape format.
• Click ‘text fill’,‘gradient’, ‘more gradient’ and finally ‘solid fill’ at a transparency of your choice, 75% has been used here (Figure 3).
• Use ‘Print screen’ to copy the final photograph with the watermark and send via email to yourself before uploading via your phone to Instagram.