Equipping the dental workforce to safeguard children from maltreatment and manage dental neglect

Safeguarding children is everybody’s responsibility and a dental team responsibility. Studies were conducted on the theme of equipping the dental workforce to protect children at risk of maltreatment and to manage dental neglect.
Paper 1 is a narrative review with case examples outlining the scope of safeguarding issues in child dental health. It addresses interpretation of oral findings as indicators of abuse and neglect, dental professionals’ contribution to child protection and ways to enhance working with paediatricians.
Papers 2 and 3 report on a 2005 cross-sectional postal survey of UK paediatric dentists’ child protection training, experience and practice. Of 449 participants (62% response rate), 67% had ‘ever suspected’ abuse but only 29% had ‘ever referred’ to children’s services. The commonest self-acknowledged barrier was lack of certainty about the diagnosis (78%). 60% saw children with neglected dentitions daily. Findings informed the design of nationally-distributed guidance, Child protection and the dental team, evaluated in Paper 4. Views of 451 NHS practitioners surveyed (47% response rate) revealed insights on its influence on practice.
In 2016, Paper 5 returned to survey paediatric dentists ‘11-years-on’ from Papers 2 and 3. ‘Ever suspected’ and ‘ever referred’ had increased to 82% and 61%, with a step-change in child protection experience (5 referrals in 5 years up from 0.4% of dentists to 14.6%); barriers to referral had reduced. The proportion seeing dental neglect daily was unchanged.
Papers 6-9 describe and evaluate further initiatives and innovations to support safeguarding practice: a national policy document, a paediatric liaison nursing communication pathway and a ‘was not brought’ pathway.
Conclusion: The UK dental profession has been supported to contribute to safeguarding children at risk of maltreatment and manage dental neglect. Progress is evidenced by substantial change in self-reported knowledge, experience and practice. Scope for further improvement remains and continued support is necessary.