Abstract
Background: Although largely preventable, oral health conditions in children are globally prevalent, particularly among populations with low socio-economic status and marginalized groups. Untreated oral health conditions, such as dental caries, can have severe consequences including unremitting pain, infections, reduced quality of life and lost school days. Neglect of a child’s oral health needs can also be an indicator of dental neglect, a form of child maltreatment associated with broader child neglect. Early detection of dental neglect is essential for initiating prevention activities and referring families to appropriate health and social services to avoid further harm. Dentists, paediatricians, primary care physicians and other professionals play a crucial role in identifying dental neglect and subsequent integrated service provision. This scoping review aims to map the international evidence on screening tools to identify dental neglect and existing integrated models for prevention and care.
Methods: Based on the Population, Concept and Context (PCC) framework, we developed a systematic search strategy for use in three electronic databases (PubMed, PsycInfo, Scopus). Publications in all languages were considered in case an abstract was available in English or German. Two independent reviewers carried out the screening of titles and abstracts using predefined in- and exclusion criteria. Data from included articles were extracted to describe and categorize the available evidence on screening tools, integrated care models (e.g., populations targeted and care pathways described) and characteristics of the included studies (e.g., study design and country). Two reviewers conducted the data extraction using a previously piloted data extraction form. Disagreements were resolved through consensus. To facilitate translation of our findings into practice, this review is conducted in close collaboration with public health professionals conducting dental population screening in children across different age groups and settings.
Results: The literature search resulted in 4763 hits. Of these, we selected 149 papers for full-text assessment. Preliminary findings show that few screening tools to identify dental neglect have been reported so far. We will present key characteristics of the existing tools, including their content, formats and the extent to which they have been tested and validated. Comprehensive integrated models for prevention and care relating to child dental neglect are scarce. The identified models mostly consist of single, not-integrated activities (e.g. standardized procedures for non-attendance at dental appointments). Specific recommendations on the role of dental practices in integrated service pathways are currently lacking.
Lesson learned and next steps:
Methods for the systematic identification of child dental neglect are hardly described and integrated models for prevention and care only to a very limited degree established internationally. More directions on feasible and effective approaches are needed for dentists, other professionals and policy-makers, who seek to strengthen treatment, disease prevention and protection of children from dental neglect. The development of an instrument to systematically identify dental neglect building on a clear operational definition would be an important step towards this goal. It provides the basis for establishing a structured model of prevention and care promoting systematic integration between dentists and other professionals in clinical, community and social service settings.