Oral disease in vulnerable children and the dentist's role in child protection

RK Dentistry

Harris, Christine Marion ; Welbury, Richard

University:University of Glasgow

Department:School of Medicine, Dentistry & Nursing

关键词: Child protection, dentistry, child abuse/ neglect;   

Others  :  http://theses.gla.ac.uk/4150/1/2013harrismsc.pdf.pdf

来源: University of Glasgow

【 摘 要 】

IntroductionIn 2005 Cairns et al examined the role of Scottish general dental practitioners(GDPs) in child protection (Cairns et al., 2005a). In 2006 all UK dental practiceswere sent “Child Protection and the Dental Team” (Harris et al., 2006). Therehas been no published research since 2006 investigating whether the proportionsof GDPs who suspect child abuse/ neglect and those who refer cases haschanged. Additionally there is no published work in the UK on the oral health ofchildren with welfare concerns.AimsTo determine the proportion of Scottish GDPs who suspected child abuse/neglect and the proportion that referred suspected cases, what factorsinfluenced referral and the willingness of Scottish GDPs to be involved indetecting neglect.To establish dental input in comprehensive medical assessments (CMAs) andquantify the oral health of children “with a welfare concern”.Materials and methodsA postal questionnaire was sent to 50% (n=1215) of Scottish GDPs.Children with welfare concerns in NHS Greater Glasgow and Clyde received acomprehensive oral health assessment (COA) as part of a CMA. The child’s age,dmft/dmfs scores, postcode, details of registration with dental services and softtissue abnormalities were recorded.ResultsThe questionnaire response rate was 52% (53% male). 30% and 55% ofrespondents had received undergraduate or postgraduate training in childprotection respectively. 37% had suspected child abuse/neglect but only 11% hadreferred a case. The most common factor that affected referral was “lack ofcertainty of the diagnosis” (74%). 73% of dentists were willing to get involved indetecting neglect.3The age range for children who had a COA was 4 months to 16 years (mean 6years). All resided in areas with SIMD quintiles ≤3. 32% of children ≤9 years and17% of children ≥10 years were caries free. The mean number of decayed,missing and filled teeth (dmft) for children ≤9 years was 2.52 and 5.0 for those≥10 years. For those ≤9 years with evidence of caries experience dmft was 3.7and for those ≥10 years the DMFT was 6. 7.4% had evidence of trauma and 5.4%had enamel defects.