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

Information sharing between the dental healthcare and child welfare services regarding child maltreatment-A repeated cross-sectional study in Norway

BACKGROUND

Little is known about dental healthcare workers reported suspected child maltreatment to and received inquiry from the child welfare services (CWS).

AIM

Assess time lag differences in public dental healthcare workers' information sharing with CWS and identify sociodemographic and attitudinal covariates of information sharing with CWS in 2014 and 2019.

DESIGN

In 2014 and 2019, a national census of 1542 and 1791 Norwegian dental health care workers, respectively, were invited to participate in an electronic survey. Of them, 1200 (77.8%) and 1270 (70.9%) replied to the questionnaires. Time trends of reported child maltreatment and received inquiries were estimated and adjusted for sociodemographics, attitudes, trust, and collaborative routines in logistic regression analyses.

RESULTS

The likelihood of reported child maltreatment to and received inquiry from CWS was higher in 2019 than in 2014 (OR 1.4 [95% CI 1.2-1.7] and OR 1.1 [95% CI 0.9-1.4]). Significant associations occurred with sociodemographic characteristics, attitudes, and collaborative routines. The likelihood of receiving inquiry about whether being employed long versus short term was higher in 2019 than in 2014.

CONCLUSION

Information sharing between dental healthcare workers and CWS improved across time and might promote beneficial outcomes.

Oral health history in children referred to a child advocacy center in Norway

BACKGROUND

Some suspected child victims of physical or sexual abuse undergo dental forensic examinations at child advocacy centers (CACs) in Norway. Their oral health history has not previously been studied.

OBJECTIVE

This study aimed to compare oral health history of CAC children to matched children. Additionally, the oral health history of children exposed to sexual abuse was compared to children exposed to physical abuse.

PARTICIPANTS AND SETTING

The CAC cohort included 100 children, 3-16 years. The matched cohort, with no known history of abuse, included 63 children.

METHODS

The retrospective study analyzed registered data in the children's dental records.

RESULTS

CAC children were more likely than matched children to have caries experience in both primary and permanent teeth, with incidence rate ratio (IRR) 1.50 (95 % CI 1.01-2.25) and 1.92 (1.11-3.30). "Was Not Brought" to dental appointments was more than twice as likely, IRR 2.25 (1.31-3.86), in the CAC cohort. There were no significant differences in reports to the Child Protection Services or dental traumas. Suspected victims of sexual abuse had more caries, IRR 4.28 (2.36-7.77), and fillings, IRR 4.83 (2.55-9.16), in permanent teeth compared to suspected victims of physical abuse.

CONCLUSIONS

CAC children were more likely to have caries experience and not show up for dental appointments than the matched children. Sexual abuse suspected had four times more caries experience than physical abuse suspected. This study supports the need for addressing oral health in risk evaluations concerning child abuse, and provides valuable information to dental professionals and prosecuting authorities.

Paediatric dentists' role in child protection practice: Progress over time?

BACKGROUND

Child maltreatment (abuse and neglect) is a global public health problem. Healthcare professionals must contribute to safeguarding and promoting the welfare of children at risk.

AIM

To determine whether paediatric dentists' rates of child protection training, experience and practice have changed and to identify factors currently associated with maltreatment recognition and referral.

DESIGN

A pre-piloted anonymous questionnaire was mailed to the UK-based British Society of Paediatric Dentistry members in 2005 (n = 789) and 2016 (n = 575). Analysis was conducted for practising dentists.

RESULTS

Response rates were 66.3% in 2005 and 62.4% in 2016. Increases were observed in respondents' postgraduate child protection training (87.2% vs. 99.7%), multi-agency training (27.9% vs. 49.2%), ever suspected (67.9% vs. 82.3%) and ever referred child maltreatment (30.7% vs. 61.0%). The proportion who had suspected maltreatment but never referred a child reduced from 37.2% to 21.3%. Having referred more than five times in the preceding five years rose from 0.4% to 14.6% of respondents, yet those seeing children with neglected dentitions daily or more frequently remained unchanged.

CONCLUSION

This repeated cross-sectional survey demonstrates a substantial improvement in UK paediatric dentists' training and practice, but a gap remains between suspecting and referring maltreatment concerns such that some children remain at risk.

Dental health personnel's experience with receiving inquiries from child welfare services: a national cross-sectional study

OBJECTIVES

To assess if and to what extent public dental health personnel (PDHP) receive inquiries from child welfare services (CWS), and to assess whether PDHP's experience of receiving inquiries is associated with PDHP's characteristics and whether the associations are influenced by PDHP's experience of reporting to CWS.

MATERIAL AND METHODS

Questionnaires were distributed to 1542 PDHP in Norway. Descriptive statistics were used for analysis. Negative-binominal-regression analyses with incidence rate ratios (IRRs) and confidence intervals (CIs) were used to estimate the association between received inquiries from CWS and PDHP characteristics.

RESULTS

From a total of 1074 respondents, 52.4% had received inquiries from CWS (2012-2014) with a mean number of 3.9 (SD = 4.5). PDHP's likelihood of receiving inquiries was significantly associated with having many patients, working in small municipalities, working in eastern Norway, having good knowledge of the Health Personnel Act, and having experience reporting to CWS. Regional differences were the only association that varied according to PDHP reporting activity.

CONCLUSIONS

PDHP receive inquiries from the CWS. The likelihood of receiving inquiries is associated with several characteristics of PDHP. To increase PDHP's likelihood of receiving inquiries, it is important to establish contact between the CWS and PDHS and ensure that the PDHP has good knowledge of the Health Personnel Act.

Of babies and bathwater: balancing support and challenge in a 'was not brought' approach to children's missed dental appointments

Prompted by a recent Letter to the Editor describing another team's experience of implementing the Sheffield 'was not brought' pathway for children and young people's missed dental appointments (WNB-CYP), its author reflects on the reasoning behind certain deliberate features of the pathway and the place of the WNB approach within the wider context of dentistry's involvement in safeguarding children.

Encourages adoption of a 'was not brought' (WNB) approach to children's missed dental appointments, putting the child's right to healthcare centre stage.

Explains the in-built features of a published WNB pathway which help to avoid unresolved cases or disguised compliance.

Advises that managing dental neglect and missed appointments requires a balance of providing support to families together with appropriate challenge.