Care for children with dental neglect: identification of problems and approaches to solving them
Dental neglect may have serious consequences for children’s health. Moreover, it may indicate general negligence and it can be associated with child abuse. Therefore, a highly professional case management is of utmost importance, but also poses a great challenge for dentists. In order to develop effective strategies for an optimization of dental care in cases of dental neglect, a better understanding of the situation, and in particular an investigation into the unsolved questions of dentists in these cases, is needed. A prospective clinical examination with ten dentists was carried out to identify their challenges in the treatment of and the care for children facing suspicion of dental neglect. The practice of dental care in the cases of 102 children with suspicion of dental neglect (ages 3–14 years) was analyzed by collecting quantitative data (questionnaires) as well as qualitative data (focus group interviews). Severe and complex challenges in the handling of dental neglect in dental practice were identified. The study revealed that steps towards an optimization of the care for children with suspicion on dental neglect, which is much more than the treatment of caries, are needed. As such steps, we propose (1) the drafting of precise guidelines, (2) the education and training of dental students and dentists in general, (3) mandatory periodical dental health screenings, (4) the establishment of an interdisciplinary cooperation within the public health system, (5) the education of families, and (6) an adequate financial compensation for a professional and optimized case management. The establishment of efficient strategies of prevention and treatment of dental neglect and associated risks for the health of affected children will only be achieved with intense public and governmental support.
KeywordsDental neglect Negligence Child abuse Dentist Treatment
We are grateful to all the participating dentists whose support and comments contributed to the study.
Compliance with ethical standards
The examinations of this study comply with the current German laws. The study protocol was pre-approved by the ethics committee of the University Hospital Düsseldorf.
Conflict of interest
The authors declare that they have no conflict of interest.
- 1.American Academy of Pediatrics Committee on child abuse and neglect (1999) American Academy of pediatric dentistry, ad hoc work group on child abuse and neglect: oral and dental aspects of child abuse and neglect. Pediatrics 104(2):349Google Scholar
- 2.Harris JC, Balmer RC, Sidebotham PD (2009) British Society of Paediatric Dentistry: a policy document on dental neglect in children. Int J Paediatr Dent. https://doi.org/10.1111/j.1365-263X.2009.00996.x
- 3.American Academy of Pediatrics Committee on child abuse and neglect, American Academy of Pediatric Dentistry (2010) Guideline on oral and dental aspects of child abuse and neglect. AAP COCAN, AAPD 37:172–175Google Scholar
- 4.Herrmann B (2014) Kindesmisshandlung und -vernachlässigung. Notf.med. up2date 9:211–230Google Scholar
- 5.Montecchi PP, Di Trani M, Sarzi Amadè D, Bufacchi C, Montecchi F, Polimeni A (2009) The dentist's role in recognizing childhood abuses: study on the dental health of children victims of abuse and witnesses to violence. Eur J Paediatr Dent 10:185–187Google Scholar
- 8.Thyen U (2008) Neglect of neglect. Umgang mit Vernachlässigung von Kindern in der ärztlichen Praxis Monatsschr Kinderheilkd 156, 654–661Google Scholar
- 9.Jessee SA (1995) Orofacial manifestations of child abuse and neglect. Am Fam Physician 52(6):1829–1834Google Scholar
- 10.Fisher-Owens SA, Lukefahr JL, Tate AR, American Academy of Pediatrics, Section on oral health committee on child abuse and neglect, American Academy of Pediatric Dentistry, Council on clinical affairs, Council on scientific affairs, Ad hoc work group on child abuse and neglect (2017) Oral and dental aspects of child abuse and neglect. Pediatrics 140(2):1CrossRefGoogle Scholar
- 13.Mayring P (2008) Qualitative inhaltsanalyse. Grundlagen und Techniken, 10th edn. Beltz, WeinheimGoogle Scholar
- 15.http://www.akfos.com/fileadmin/user_uploads_akfos/PDFs/4_Formulare/Befundbogen_Forensik.pdf (last access 01/18/2018)
- 16.Thomas JE, Straffon L, Inglehart MR (2006) Milieu of dental school and practice - child abuse and neglect: dental and dental hygiene students’ educational experiences and knowledge. J Dent Educ 70:558Google Scholar
- 20.Da Fonseca MA, Feigal RJ, Ten Bensel RW (1992) Dental aspects of 1248 cases of child maltreatment on file at a major county hospital. Pediatr Dent 14:152–157Google Scholar
- 21.Lucks Y, Auras S (2014) Kinderzahnärztliche Behandlung - Voraussetzungen und Herausforderungen. https://www.zmk-aktuell.de/fachgebiete/kinderzahnheilkunde/story/kinderzahnaerztliche-behandlung%2D%2Dvoraussetzungen-und-herausforderungen__1022.html