Dental Neglect
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BRIEF REPORT
Dental Neglect Lora Spiller 1
&
James Lukefahr 1 & Nancy Kellogg 1
# Springer Nature Switzerland AG 2019
Abstract Dental neglect can be an indicator of general child neglect. Inadequately treated dental disease may have significant long-term impacts on the physical and psychological well-being of children. Primary care providers play a critical role in the prevention of dental neglect, and should be aware of the manifestations of dental caries and dental trauma. When diagnosing dental neglect, health professionals should ensure the child’s caregivers have demonstrated an understanding of the condition, its consequences, and the recommended treatment and then failed to comply with the treatment. Attempts should be made to eliminate any barriers preventing caretakers from complying with professional advice. Dental neglect is a form of child maltreatment and, if suspected, should be reported to the appropriate child protective agencies. Keywords Child maltreatment . Medical neglect . Physical neglect . Early childhood caries . Untreated dental caries . Untreated dental trauma . Oral hygiene . Child protective services
Dental neglect is the Bwillful failure of a parent or guardian to seek or follow through with treatment necessary to ensure a level of oral health essential for adequate function and freedom from pain and infection,^ as defined by the AAPD (American Academy of Pediatric Dentistry 2010). Higher levels of tooth decay can be found in abused and physically neglected children compared to those in the general population (Valencia-Rojas et al. 2008). Greene et al. (1994) found that children with a history of abuse were eight times more likely to have untreated caries involving permanent teeth compared to non-abused children. Although dental neglect may exist in isolation, inadequately treated dental disease can be an important indicator of broader child neglect (Bradbury-Jones et al. 2013). Dentists and other health professionals are often hesitant to report suspected cases of dental neglect due to a lack of certainty about the diagnosis or fear of consequences from reporting, including potential impact on their practice and possible litigation (Welbury et al. 2003; Al-Habsi et al. 2009). Other factors affecting clinicians’ decisions to not
* Lora Spiller [email protected] 1
Department of Pediatrics, Division of Child Abuse Pediatrics, University of Texas Health San Antonio, Center for Miracles, 315 N. San Saba Street, Suite 201, San Antonio, TX 78207, USA
report suspected cases of maltreatment include concerns for compromising the patient/family-physician relationship and doubts regarding the benefits of reporting to child protective services (Jones et al. 2008). Flaherty et al. (2008) demonstrated that not all suspicions of child maltreatment are reported, even when the level of suspicion is high. This, along with the paucity of studies on dental neglect, raises concern that this important aspect of child maltreatment is often under-detected and under-reported (Bhatia et al. 2014). Re
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