GPs failing to spot dental tell-tale signs of child abuse
A new study shows that GPs are ill-equipped to detect dental neglect in children.
Family doctors could better detect child neglect with increased dental health training.
But currently, they could be missing 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 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 prioritisation of universal free access to dentistry,' said Colgan, who hopes that the study will be scaled up in the future.
The BDA’s Chair of General Dental Practice Henrik Overgaard-Nielsen said: 'Tooth decay can be a tell-tale sign of abuse or neglect, and many children are falling through the cracks in a siloed health service. GPs bear an enormous burden and it cannot fall to them to "multitask", when government is failing to deal with the problem.
'Tooth decay is the number one reason for child hospital admissions, but dentists are not seeing those at most risk early enough to make a difference. Poverty, neglect or ignorance can be huge barriers to good oral health, and we desperately need joined-up policymaking to tackle them.
'Oral health has such a low profile that it is not surprising that awareness of its importance is low in other parts of the NHS. When we face an epidemic of decay, dentistry can’t be left in a corner. Without meaningful engagement in education, in media and across the health service we simply cannot expect progress.'
Author: Julie Bissett