Abstract
Introduction The dental team play a vital role in ensuring that vulnerable children are followed up and suspected safeguarding concerns are shared, which includes recognising the importance of missed dental appointments. Concerns are less likely to be missed when there are robust pathways in place. This paper aims to discuss the importance of a was not brought (WNB) pathway for children who miss dental appointments and to offer advice on its implementation in practice.
Methods A three-cycle retrospective case note review was carried out to identify follow-up children who WNB to their dental appointments, and the follow-up that had occurred as a result.
Results In cycle one, 16% of children who were not brought were managed according to the audit standards. Therefore, a WNB pathway was developed and audited three months and 12 months following; cycle two showed 32% adherence with the pathway, and 28% in cycle three. The biggest barrier in all cycles seems to be related to the administration of letters.
Discussion Investigators felt that the possible barriers to achieving audit standards were the implementation of a new dictation system, limited time on clinic and a possible anxiety surrounding the management of safeguarding issues.
Conclusion Pathways and resources have been made available for dental professionals to use in their practice to guide management of children who were not brought to dental appointments. As we have shown, there are barriers to implementation of such pathways which service providers must work to overcome, to protect the children that we treat and ensure that they are being kept safe in line with General Dental Council standards.
Key points
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This paper highlights the importance of introducing a 'was not brought' (WNB) pathway for children who are not brought to dental appointments, as missed appointments could play a part in a wider picture of child neglect.
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Results of implementation of a WNB pathway and possible barriers to adherence are discussed.
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Recommendations have been made on how to create and implement a WNB pathway in general dental practice.
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Acknowledgements
The authors would like to acknowledge the BDA implementation guide based on a WNB pathway developed by Jenny Harris and Jen Kirby. We would like to thank members of the dental team in the Paediatric Dental and Child Safeguarding teams at East Surrey Hospital for their involvement with the pathway and auditing.
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Ondhia, A., Marshall, S. & Kandiah, T. Implementation of a 'was not brought' pathway in paediatric dentistry. Br Dent J (2021). https://doi.org/10.1038/s41415-021-3572-0
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DOI: https://doi.org/10.1038/s41415-021-3572-0
