Considerations in identifying pediatric dental neglect and the legal obligation to report

Early predictors of childhood caries among 4-year-old children: a population-based study in north-eastern France

BACKGROUND

Untreated early childhood caries (ECC) can trigger a number of negative consequences, including pain, chewing difficulties, insufficient physical development and low academic performance. Therefore, ECC impacts the oral health-related to quality of life. That is why it is important to assess the ECC prevalence and to determine the associated risk factors.

AIM

The aim of this study was to investigate the relationship between early predictor factors and dental caries among 4-year-old French children, considering the socioeconomic factors, dietary and oral hygiene practices, the access and the follow-up by paediatric dentist.

DESIGN

The study was a cross-sectional observation. A random sample of 4-year-old children was selected among 596 Moselle's public nursery schools in north-eastern France. Data were gathered from clinical dental examinations and a structured questionnaire completed by parents.

RESULTS

In total, 425 subjects with completed questionnaires and clinical examinations were included. The prevalence of ECC and S-ECC (Severe-ECC), including only cavitated lesions, d3mft, were 15.8% and 5.9%, respectively. Multivariable logistic regression modelling identified four main factors associated with a high risk of ECC that were sweet intake (adjusted odds ratio OR_adjusted = 3.43, 95% CI = 1.57-7.53), brushing habits (OR_adjusted = 2.25, 95% CI = 1.23-4.21), childcare arrangement (OR_adjusted = 2.27, 95% CI = 1.23-4.21) and maternal educational level (OR_adjusted = 1.87, 95% CI = 1.06-3.31). These four factors have a cumulative effect. Only 4% of children presented teeth restoration.

CONCLUSIONS

This study highlighted the impact of the family environment on the oral health status of the preschool children. The identification of the risk factors should allow to strengthen preventive measures and initiate oral health education program for children and their family.

Barriers and factors influencing communication between dental professionals and Child Welfare Services in their everyday work

BACKGROUND

Among various health professionals, general dental professionals (GDPs) screen children frequently, giving them a unique opportunity to act upon suspicion of child maltreatment. The dental team has received considerable attention regarding safeguarding children.

AIM

The aims of this study were to explore whether GDPs have mutual collaboration and communication with the Child Welfare Services (CWS), and potential barriers for reporting child maltreatment.

DESIGN

An electronically pre-coded questionnaire was sent to all GDPs (n = 131) in the Public Dental Health Service (PDHS) in Oslo. Frequency distributions and statistical analysis were carried out by chi-squared statistics and multivariate logistic regression analysis.

RESULTS

The response rate was 75%. Ninety per cent of GDPs had received requests from CWS to provide a child's dental chart. General dental professionals reported child maltreatment frequently (71%), but CWS only gave feedback in 55% of the cases. Uncertainty was the most common reason for not reporting and 33% of the GDPs had chosen not to send a report despite suspicion. Using guidelines increased frequency of reporting (OR 3.6).

CONCLUSIONS

Mutual collaboration and communication should be improved in the task of safeguarding children. Uncertainty and lack of guidelines may act as barriers for not reporting to the CWS.