141st APHA Annual Meeting

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Dental neglect as a marker of broader neglect: A qualitative investigation of public health nurses' assessments of oral health in preschool children

Tuesday, November 5, 2013 : 10:30 AM - 10:50 AM

Caroline Bradbury-Jones, PhD , School of Nursing & Midwifery, University of Dundee, Dundee, United Kingdom
Julie Taylor, PhD; MSc; BSc(Hons); RN , University of Edinburgh/NSPCC Child Protection Research Centre, University of Edinburgh, Edinburgh, United Kingdom
Dafydd Evans, PhD , Dental School, University of Dundee, Dundee, Scotland
Nicola Innes, PhD , Dental School, University of Dundee, Dundee, Scotland
Fiona Ballantyne, RN, HV , NHS Fife, Scotland, Fife, Scotland
Background: Child neglect is a pernicious child protection issue with adverse consequences that extend to adulthood. Simultaneously, though it remains prevalent, childhood dental caries is a preventable disease (in the presence of appropriate care). Public health nurses play a pivotal role in assessing oral health in children but little is known about how they assess dental neglect. Understanding these factors is important if improvements are to be made in care pathways.

Methods: A qualitative study was conducted in Scotland during 2011/12. Sixteen public health nurses were recruited purposively from one health region. Individual, semi-structured interviews were undertaken and data analyzed inductively using a framework approach. Results: Public health nurses assess oral health through proxy measures, opportunistic observation and discussion with parents. Dental neglect is rarely an isolated issue that leads on its own to child protection referral. It is part of a mosaic of issues associated with child neglect. It is other presenting issues that initiate a response. Barriers to intervention are that dental neglect may be ‘unseen' and ‘unspoken'. The study revealed a communications gap in the care-pathway for children where significant dental problems are identified.

Conclusions: Clear guidance for public health nurses as to what to look for - and how - is required. Improved two way communication between child dental care providers and public health nurses is necessary to close the gap in the care pathway. Public health nurses take their child protection role seriously, but rarely make a prospective link between dental caries and child neglect.

Learning Areas:
Public health or related nursing
Public health or related research

Learning Objectives:
Explain the importance of dental neglect in children as a serious public health issue Identify the means by which public health nurses assess oral health in children Assess the relationships between child dental neglect and broader neglect Disscuss the barriers to child protection intervention in relation to dental neglect.

Keywords: Child Abuse, Oral Health

Presenting author's disclosure statement:

Not Answered