Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Research
  • Published:

A dentist's dilemma: sharing wellbeing concerns to safeguard Scotland's children

Abstract

Introduction Over a decade ago, Getting it right for every child (GIRFEC) introduced the 'Named Person' as a central contact with whom professionals could share 'wellbeing' concerns in Scotland, aiming to promote inter-agency working to avoid potential child protection issues. The mandatory 'Named Person' scheme has since been repealed but the professional's responsibility to share concerns at wellbeing level remains.

Aims To explore general dental practitioners' (GDPs') understanding of a child's 'wellbeing', along with the investigation of influencing factors on behaviour when sharing concerns at wellbeing level.

Methods Qualitative one-to-one semi-structured telephone interviews with GDPs. Themes arising from transcriptions were organised into the Theoretical Domains Framework.

Results In total, 11 dentists (five men and six women) participated. Risks to wellbeing included only attending in pain and dental neglect. There was good awareness of the 'Named Person' and triggers to sharing suspicions were identified, which were concern severity, multiple concerns and own intuition. Multiple barriers (eg poor knowledge, fear of consequences, environment) and enablers (eg professional responsibility and influences, positive consequences) influenced decisions to refer. GDPs struggled to differentiate between wellbeing and child protection.

Conclusion Barriers and facilitators to sharing wellbeing suspicions are similar to child protection. GDPs may benefit from further training when safeguarding at a wellbeing level.

Key points

  • Dental professionals are now encouraged to share concerns about a child's wellbeing with other health and social care professionals earlier, so that support for the family can be put in place to enable the best outcome for the child.

  • The barriers to sharing concerns at wellbeing level appear to outweigh the facilitators.

  • Training is recommended to help GDPs differentiate concerns at wellbeing level versus those at child protection level.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

References

  1. Scottish Government. A guide for getting it right for every child. 2012. Available at https://ihub.scot/media/1512/a-guide-to-getting-it-right-for-every-child.pdf (accessed December 2016).

  2. Scottish Government. Children and Young People (Scotland) Act 2014. 2014. Available at https://www.legislation.gov.uk/asp/2014/8/pdfs/asp_20140008_en.pdf (accessed December 2016).

  3. Scottish Government. Supreme Court rules on 'named person'. 2016. Available at https://www.gov.scot/news/supreme-court-rules-on-named-person/ (accessed August 2016).

  4. Harris J C, Balmer R C, Sidebotham P D. British Society of Paediatric Dentistry: a policy document on dental neglect in children. Int J Paediatr Dent 2009; DOI: 10.1111/j.1365-263X.2009.00996.x.

  5. Ratnayake N, Ekanayake L. Prevalence and impact of oral pain in 8-year old children in Sri Lanka. Int J Paediatr Dent 2005; 15: 105-112.

  6. Schroth R J, Levi J, Kliewer E, Friel J, Moffatt M E K. Association between iron status, iron deficiency anaemia, and severe early childhod caries: a case control study. BMC Paediatr 2013; DOI: 10.1186/1471-2431-13-22.

  7. Sheiham A. Dental caries affects body weight, growth and quality of life in pre-school children. Br Dent J 2006; 201: 625-626.

  8. British Dental Association. Safeguarding. 2022. Available at https://www.bda.org/advice/Pages/safeguarding.aspx (accessed May 2021).

  9. Harris J C, Elcock C, Sidebotham P D, Welbury R R. Safeguarding children in dentistry: 1. Child protection training, experience and practice of dental professionals with an interest in paediatric dentistry. Br Dent J 2009; 206: 409-414.

  10. Kvist T, Wickström A, Miglis I, Dahllöf G. The dilemma of reporting suspicions of child maltreatment in paediatric dentistry. Eur J Oral Sci 2014; 122: 332-338.

  11. Cairns A M, Mok J Y Q, Welbury R R. The dental practitioner and child protection in Scotland. Br Dent J 2005;199: 517-520.

  12. da Silva R A, Goncalves L M, Rodrigues A C A, da Cruz M C F N. The dentist's role in identifying child abuse: an evaluation about experiences, attitudes and knowledge. Gen Dent 2014;62: 62-66.

  13. Laud A, Gizani S, Maragkou S, Welbury R, Papagiannoulis L. Child protection training, experience, and personal views of dentists in the prefecture of Attica, Greece. Int J Paediatr Dent 2013;23: 64-71.

  14. Uldum B, Christensen H N, Welbury R, Poulsen S. Danish dentists' and dental hygienists' knowledge of and experience with suspicion of child abuse or neglect. Int J Paediatr Dent 2010; 20: 361-365.

  15. Cukovic-Bagic I, Dumancic J, Kujundzic Tiljak M et al. Croatian dentists' knowledge, experience, and attitudes in regard to child abuse and neglect. Int J Paediatr Dent 2015; 25: 444-450.

  16. Harris C M, Welbury R, Cairns A M. The Scottish dental practitioner's role in managing child abuse and neglect. Br Dent J 2013; DOI: 10.1038/sj.bdj.2013.435.

  17. Cane J, O'Connor D, Michie S. Validation of the theoretical domains framework for use in behaviour change and implementation research. Implement Sci 2012; DOI: 10.1186/1748-5908-7-37.

  18. Craig P, Dieppe P, Macintyre S, Michie S, Nazareth I, Petticrew M. Developing and evaluating complex interventions: the new Medical Research Council guidance. BMJ 2008; DOI: 10.1136/bmj.a1655.

  19. Forbes G, Rutherford S, Stirling D, Young L, Clarkson J. Current practice and factors influencing the provision of periodontal healthcare in primary dental care in Scotland: an explorative study. Br Dent J 2015; 218: 387-391.

  20. Gnich W, Bonetti D, Sherriff A, Sharma S, Conway D I, Macpherson L M D. Use of the theoretical domains framework to further understanding of what influences application of fluoride varnish to childrens teeth: a national survey of general dental practitioners in Scotland. Community Dent Oral Epidemiol 2015; 43: 272-281.

  21. Newlands R, Duncan E M, Prior M et al. Barriers and facilitators of evidence-based management of patients with bacterial infections among general dental practitioners: a theory informed interview study. Implement Sci 2016; DOI: 10.1186/s13012-016-0372-z.

  22. Scottish Dental Practice Based Research Network. Get Involved. 2022. Available at http://www.sdpbrn.org.uk/about/get-involved/ (accessed December 2016).

  23. Mitchie S, Johnston M, Abraham C et al. Making psychological theory useful for implementing evidence based practice: a concensus approach. Qual Saf Health Care 2005; 14: 26-33.

  24. Department of Health. Governance arrangements for research ethics committees: a harmonised edition. 2011. Available at https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/979936/WITHDRAWN_dh_133993.pdf (accessed December 2016).

  25. Committee of Postgraduate Dental Deans and Directors. Child protection and the dental team: an introduction to safeguarding children in dental practice. 2009. Available at https://bda.org/childprotection/Resources/Documents/Childprotectionandthedentalteam_v1_4_Nov09.pdf (accessed March 2022).

  26. Olive S, Tuthill D, Hingston E J, Chadwick B, Maguire S. Do you see what I see? Identification of child protection concerns by hospital staff and general dental practitioners. Br Dent J 2016; 220: 451-457.

  27. Welbury R R, MacAskill S G, Murphy J M et al. General dental practitioners' perception of their role within child protection: a qualitative study. Eur J Paediatr Dent 2003;4: 89-95.

  28. Cairns A, Murphy M, Welbury R. An overview and pilot study of the dental practitioner's role in child protection. Child Abuse Rev 2004; 13: 65-72.

  29. Al-Habsi S A, Roberts G J, Attari N, Parekh S. A survey of attitudes, knowledge and practice of dentists in London towards child protection. Are children receiving dental treatment at the Eastman Dental Hospital likely to be on the child protection register? Br Dent J 2009; DOI: 10.1038/sj.bdj.2009.113.

  30. Kaur H, Chaudhary S, Choudhary N, Manuja N, Chaitra T R, Amit S A. Child abuse: Cross-sectional survey of general dentists. J Oral Biol Craniofac Res 2016; 6: 118-123.

  31. Manea S, Favero G A, Stellini E, Romoli L, Mazzucato M, Facchin P. Dentists' perceptions, attitudes, knowledge, and experiences about child abuse and neglect in northeast Italy. J Clin Paediatr Dent 2007;32: 19-25.

  32. Adair S M, Wray I A, Hanes C M, Sams D R, Yasrebi S, Russell C M. Perceptions associated with dentists' decisions to report hypothetical cases of child maltreatment. Paediatr Dent 1997; 19: 461-465.

Download references

Acknowledgements

Thanks to the Scottish Dental Practice Based Research Network (SDPBRN) for their support and the participating dentists.

Author information

Authors and Affiliations

Authors

Contributions

Hannah Collins helped with design, data collection, data analysis, drafting the article and final approval of the article for publication. Gillian Forbes helped with design, data analysis, critical revision and final approval of the article for publication. Elizabeth M. Roebuck helped with idea conception, drafting the article and final approval of the article for publication.

Corresponding author

Correspondence to Hannah Collins.

Ethics declarations

There are no known conflicts of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Collins, H., Forbes, G. & Roebuck, E. A dentist's dilemma: sharing wellbeing concerns to safeguard Scotland's children. Br Dent J (2022). https://doi.org/10.1038/s41415-022-4088-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1038/s41415-022-4088-y

Search

Quick links