Skip to main content

Advertisement

SpringerLink
Log in

Care for children with dental neglect: identification of problems and approaches to solving them

  • Original Article
  • Published:
International Journal of Legal Medicine Aims and scope Submit manuscript

Abstract

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

References

  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):349

    Google 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 37:172–175

    Google Scholar 

  4. Herrmann B (2014) Kindesmisshandlung und -vernachlässigung. Notf.med. up2date 9:211–230

  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 10:185–187

    CAS  PubMed  Google Scholar 

  6. Paradowski IM, Seifert D, Püschel K, Anders S (2013) Dental neglect. Rechtsmedizin 23:186–190

    Article  Google Scholar 

  7. Bradbury-Jones C, Innes N, Evans D, Ballantyne F, Taylor J (2013) Dental neglect as a marker of broader neglect: a qualitative investigation of public health nurses’ assessments of oral health in preschool children. BMC Public Health 13:370

    Article  Google Scholar 

  8. Thyen U (2008) Neglect of neglect. Umgang mit Vernachlässigung von Kindern in der ärztlichen Praxis Monatsschr Kinderheilkd 156, 654–661

  9. Jessee SA (1995) Orofacial manifestations of child abuse and neglect. Am Fam Physician 52(6):1829–1834

    CAS  PubMed  Google 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):1

    Article  Google Scholar 

  11. Kellog N, Committee on child abuse and neglect (2005) oral and dental aspects of child abuse and neglect; Clinical Report. Pediatrics 116:1565–1567

    Article  Google Scholar 

  12. OECD (2010) Gesundheit auf einen Blick 2009: OECD-Indikatoren. OECD Publishing, Paris. https://doi.org/10.1787/9789264081086-de

    Book  Google Scholar 

  13. Mayring P (2008) Qualitative inhaltsanalyse. Grundlagen und Techniken, 10th edn. Beltz, Weinheim

    Google Scholar 

  14. Harris JC, Elcock C, Sidebotham PD, Welbury RR (2009) Safeguarding children in dentistry: 2. Do paediatric dentists neglect child dental neglect? Br Dent J 206(9):465–470

    Article  CAS  Google 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 70:558

    PubMed  Google Scholar 

  17. Hamp SE, Lindhe J, Fornell J, Johansson LA, Karlsson R (1978) Effect of a field program based on systematic plaque control on caries and gingivitis in schoolchildren after 3 years. Community Dent Oral Epidemiol 6:17–23

    Article  CAS  Google Scholar 

  18. Axelsson P, Lindhe J (1974) The effect of a preventive programme on dental plaque, gingivitis and caries in schoolchildren. Results after one and two years. J Clin Periodontol 1:126–138

    Article  CAS  Google Scholar 

  19. Axelsson P, Nystrom B, Lindhe J (2004) The long-term effect of a plaque control program on tooth mortality, caries and periodontal disease in adults. Results after 30 years of maintenance. J Clin Periodontol 31:749–757

    Article  CAS  Google 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 14:152–157

    PubMed  Google 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

Download references

Acknowledgments

We are grateful to all the participating dentists whose support and comments contributed to the study.

Author information

Author notes

  1. Benno Hartung and Julia Schaper contributed equally to this work.

Authors and Affiliations

  1. Institute of Legal Medicine, University Hospital Düsseldorf, Düsseldorf, Germany

    Benno Hartung & Stefanie Ritz-Timme

  2. Zahnarztpraxis Axel Plümer, Düsseldorf, Germany

    Julia Schaper

  3. Institute of Mathematics, Heinrich-Heine-University, Düsseldorf, Germany

    Katinka Fischer

Authors
  1. Benno Hartung
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Julia Schaper
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Katinka Fischer
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Stefanie Ritz-Timme
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Benno Hartung.

Ethics declarations

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.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Hartung, B., Schaper, J., Fischer, K. et al. Care for children with dental neglect: identification of problems and approaches to solving them. Int J Legal Med 133, 641–650 (2019). https://doi.org/10.1007/s00414-018-1938-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00414-018-1938-x

Keywords

Search

Navigation