One in three dentists refrained from reporting suspected child neglect or abuse

Dental Tribune International

四. 17 十一月 2016

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BERGEN, Norway: Owing to its good public health system, 98 per cent of Norwegian children between the ages of 3 and 18 regularly see a dentist. Public dental clinics are thus in the unique position to identify cases of possible neglect or abuse in this vulnerable population and notify the authorities. A nationwide survey among 1,200 public dental hygienists and dentists has now examined how often dental professionals actually reported concerns about child welfare to the Norwegian child protection agency, Barnevernet.

In Norway, public dental health care staff have an obligation to report suspected child maltreatment to child welfare services. However, the current survey results showed that every third staff member had failed to do so, despite his or her suspicions that the children were being neglected or abused. Overall, six out of ten stated that they had submitted reports of their concerns to child protection services throughout their career. The results further showed that notifications were more often from younger dental staff (under 40). Moreover, those working in small municipalities with 10,000 or fewer residents reported less maltreatment than those in larger municipalities did.

Reasons for reporting included children having many cavities and very poor oral hygiene, often in combination with frequent absence from school. In some extreme cases, health staff further suspected physical, psychological and sexual abuse from the injuries they saw, Norwegian newspaper Aftenposten reported. Overall, about 500 notifications were issued per year.

According to Ingfrid Vaksdal Brattabø, who conducted the survey as part of her doctoral thesis at the University of Bergen, the overall number of reports is very low considering that almost every Norwegian child sees a dentist every two years. However, when comparing the results of the survey to other European countries, Norwegian health staff had issued considerably more reports than their foreign counterparts had. Studies in Scotland, the UK and Denmark showed that only 11, 29 and 13 per cent of health staff, respectively, had informed the authorities about suspected neglect or abuse, compared with Norway’s 60 per cent.

Brattabø was not surprised about the finding that one-third of the dentists did not report their suspicions. “One can never be completely sure that one’s suspicions are founded. Dental professionals are afraid to report the error, in case it brings harm to the children or their families. There is also the fear that it may result in the parents not taking their kids to the dental clinic,” she stated. However, although it may be a difficult decision, dental professionals have a duty to protect vulnerable children, Brattabø added.

According to the researcher, dental professionals’ knowledge of child abuse and neglect, the basis on which to report and procedures for reporting must be increased, and collaboration between child welfare and dental services should be improved. Moreover, communication should be bidirectional, she suggested. Lack of feedback from child protection services regarding reports of possible maltreatment may be discouraging for the health staff, she pointed out.

The study, titled “Experience with suspecting child maltreatment in the Norwegian public dental health services, a national survey”, was published online on 20 September ahead of print in the Acta Odontologica Scandinavica journal.