Higher levels of tooth decay are seen in abused or neglected children. Although dental care is free to all children in the UK, many children are not registered with a dentist. This means in the absence of a dentist the family doctor or GP is often the first point of medical contact for a child. New research now suggests that GPs lack the awareness and training to identify dental neglect in children, and therefore could miss the opportunity to share potential cases of wider abuse or neglect to other health and welfare professionals. The study in The British Dental Journal was led by Sascha Colgan, consultant GP and visiting researcher at the University of Southampton in the UK, and was published by Springer Nature.
Researchers estimate that around one in ten children have been or are being abused or neglected, and that one to two children in the UK die each week as a result of neglect or abuse. Although there is no single standard for identifying neglect, much research shows that dental neglect is an important marker for wider neglect.
In this study, Colgan and colleagues sent a structured survey to all National Health Service (NHS) GPs on the Isle of Wight in the UK (106). Fifty-two per cent of those GPs responded to the survey, which examined how aware GPs are of the role dental health plays in child neglect. The survey also assessed the level of training GPs received in dental pathology.
The results showed that the majority of GPs had never liaised with a dental colleague about a pediatric patient. Ninety-six per cent had never received any formal dental training and some did not perceive dental health to be important. None of the respondents worked in a clinic where the dental registration of a child was noted in medical records, and only five GPs mentioned a link between a child not being registered with a dentist and child neglect.
"This study highlights that GPs lack training in formerly identifying dental pathology and are unaware that dental neglect could be a marker for potential wider child neglect," said Colgan.
Colgan and her colleagues stress that there is a need for further collaboration between dentists and GPs, as well as improved training in dentistry for GPs.
"We know that GPs are not dentists and already have many responsibilities. Ultimately public health policy must be implemented to address the need for greater awareness and investment in improving the prioritization of universal free access to dentistry," said Colgan, who hopes that the study will be scaled up in the future.
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Colgan, S.M et al (2018). 'Bridging the gap' - A survey of medical GPs' awareness of child dental neglect as a marker of potential systemic child neglect, The British Dental Journal, DOI: 10.1038/sj.bdj.2018.349