UK Paediatric Dentists' Child Protection Practice: Improvement Over 11 Years

Objectives: Child maltreatment (CM; abuse and neglect) is a worldwide public health problem. Healthcare professionals must contribute to safeguarding and promoting welfare of children at risk but dentists find this challenging and do not always recognise or report cases appropriately to social services. Over the past decade UK child protection (CP) training, guidance and advice has become more readily available. The objectives were to determine whether paediatric dentists’ rates of CP training, experience and practice have changed over 11 years and to identify predictors of CM recognition and referral.
Methods: A pre-piloted anonymously-completed questionnaire on CP training, experience and practice was mailed to all UK-based British Society of Paediatric Dentistry members in March 2005 (n=789) and May 2016 (n=575). Second mailings were sent to non-responders after 8 weeks. After double data-entry and electronic verification, exclusion criteria were applied. Analysis was conducted for practising UK-dentists using IBM SPSS.
Results: Returned questionnaires (62% response rate in both years), included 448 and 295 practising dentists respectively. Between 2005 and 2016, there were increases in rates of respondents’ postgraduate CP training (87.2% v 99.7%, p<0.001, chi-squared), multi-agency training (27.9% v 49.2%, p<0.001), ever suspected CM (67.9% v 82.3%, p<0.001) and ever referred CM (30.7% v 61.0%, p<0.001). The proportion of those who had suspected CM but had never made a referral reduced from 37.3% to 22.1% (p<0.001). Logistic regression analysis of 2016 data indicated a number of significant predictors for referring CM.
Conclusions: The past decade has seen an improvement in UK paediatric dentists’ CP training and practice but a gap still remains between suspecting and referring CM such that children may be at risk of their needs and welfare not being appropriately assessed. Predictors will inform targeting of intervention strategies to increase referral whenever paediatric dentists suspect CM.