Care for children with dental neglect: identification of problems and approaches to solving them.

Dental neglect may have serious consequences for children's health. Moreover, it may indicate general negligence and it can be associated with child abuse. Therefore, a highly professional case management is of utmost importance, but also poses a great challenge for dentists. In order to develop effective strategies for an optimization of dental care in cases of dental neglect, a better understanding of the situation, and in particular an investigation into the unsolved questions of dentists in these cases, is needed. A prospective clinical examination with ten dentists was carried out to identify their challenges in the treatment of and the care for children facing suspicion of dental neglect. The practice of dental care in the cases of 102 children with suspicion of dental neglect (ages 3-14 years) was analyzed by collecting quantitative data (questionnaires) as well as qualitative data (focus group interviews). Severe and complex challenges in the handling of dental neglect in dental practice were identified. The study revealed that steps towards an optimization of the care for children with suspicion on dental neglect, which is much more than the treatment of caries, are needed. As such steps, we propose (1) the drafting of precise guidelines, (2) the education and training of dental students and dentists in general, (3) mandatory periodical dental health screenings, (4) the establishment of an interdisciplinary cooperation within the public health system, (5) the education of families, and (6) an adequate financial compensation for a professional and optimized case management. The establishment of efficient strategies of prevention and treatment of dental neglect and associated risks for the health of affected children will only be achieved with intense public and governmental support.