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The voice of the child in dental care plans: a service evaluation


Introduction The voice of the child (VOC) is vitally important in the dental setting as 'patient participation' is a key clinical governance pillar. A recent Care Quality Commission review of Bradford District Care NHS Foundation Trust identified 'the voice of the patient was not always clear in the care plans stored on the electronic system'.

Aims To determine if Bradford District Care NHS Foundation Trust's Community Dental Service was recording and acting upon the voice of children and young people (CYP) regarding their dental care.

Methods Retrospective case note analysis of CYP who had completed a course of treatment between January and March 2019. Patient notes were reviewed to determine if key indicators of the VOC were included. Verbal communication, communication barriers and evidence treatment options were discussed with CYP wherever feasible and whether comments by CYP were used to tailor their care.

Results Review of 200 patients aged 4-16 years old found that no CYP notes recorded all key VOC indicators. In total, 36% of dentists recorded if the CYP had verbal communication or otherwise; 26% of notes evidenced treatment options had been discussed; and 11% of notes evidenced that CYP comments were used to tailor their care.

Discussion Presentation of results to clinicians locally highlighted the importance of the VOC and the need to improve documentation. Subsequently, implementation of a modified clinical note pro forma has taken place which includes VOC indicators, thus providing evidence that CYP are being listened to and, where feasible, their opinions used to tailor care.

Conclusion The VOC was not routinely being documented in clinical notes, thus it was difficult to prove/disprove if the VOC was being listened to.

Key points

  • This paper highlights the importance of listening to the voice of the patient and ensuring this is portrayed in dental notes for the dental team.

  • This quality improvement project highlights this lesser-known standard to all dental care professionals to help ensure this aspect of care and communication; ie the voice of any patient is heard and visible in contemporaneous dental records.

  • This aspect of care is a key clinical governance pillar, which can be assessed by care quality commission inspections, and is crucial to ensure steps are taken to measure if current practices meet standards.

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  1. UNICEF. A Summary of the UN Convention on the Rights of the Child. 2010. Available at (accessed March 2020).

  2. Royal College of Paediatrics and Child Health. Engagement legislation. 2017. Available at (accessed March 2020).

  3. Royal College of Paediatrics and Child Health. What do young people want in the NHS Long Term Plan? 2019. Available at (accessed March 2020).

  4. Royal College of Paediatrics and Child Health. Not just a phase: A Guide to the Participation of Children and Young People in Health Services. 2010. Available at (accessed March 2020).

  5. Patel K, Jenkyn I. An introduction to clinical governance in dentistry. Br Dent J 2021; 230: 539-543.

  6. Chawdhary I R. Clinical governance for the dental team. BDJ Team 2020; 7: 20-22.

  7. Europe Economics. Risk in Dentistry: Report for the General Dental Council. 2014. Available at (accessed January 2021).

  8. Marshman Z, Gibson B J, Owens J et al. Seen but not heard: a systematic review of the place of the child in 21st-century dental research. Int J Paediatr Dent 2007; 17: 320-327.

  9. Rodd H D, Abdul-Karim A, Yesudian G, O'Mahony J, Marshman Z. Seeking children's perspectives in the management of visible enamel defects. Int J Paediatr Dent 2011; 21: 89-95.

  10. Tsichlaki A, O'Brien K. Do orthodontic research outcomes reflect patient values? A systematic review of randomized controlled trials involving children. Am J Orthod Dentofacial Orthop 2014; 146: 279-285.

  11. El-Yousfi S, Innes N P T, Holmes R D et al. Children and parents' perspectives on the acceptability of three management strategies for dental caries in primary teeth within the 'Filling Children's Teeth: Indicated or Not' (FiCTION) randomised controlled trial - a qualitative study. BMC Oral Health 2020 20: 69.

  12. Marshman Z, Campbell C. A Child-Centred Service: The Voice of the Child. In Campbell C (ed) Dental Fear and Anxiety in Paediatric Patients. pp 241-252. Switzerland: Springer, 2017.

  13. Marshman Z. Guest Editorial: 'The voice of the child in oral health research'. Int J Paediatr Dent 2015; 25: 309.

  14. Care Quality Commission. Bradford District Care NHS Foundation Trust Inspection report. 2018. Available at (accessed March 2020).

  15. Ware E B, Drummond B, Gross J, Hayne H. Giving Children a Voice About Their Dental Care. J Dent Child (Chic) 2020; 87: 116-119.

  16. Bhatti A, Vinall-Collier K, Duara R, Owen J, Grey-Burrows K A, Day P F. Recommendations for delivering oral health advice: a qualitative supplementary analysis of dental teams, parents' and children's experiences. BMC Oral Health 2021; 21: 210.

  17. Yuan S, Humphris G, Ross A, MacPherson L, Freeman R. Recording communication in primary dental practice: an exploratory study of interactions between dental health professionals, children and parents. Br Dent J 2019; 227: 887-892.

  18. Freeman R. Communicating with children and parents: recommendations for a child-parent-centred approach for paediatric dentistry. Eur Arch Paediatr Dent 2008; DOI: 10.1007/BF03262651.

  19. NICE. Babies, children and young people's experience of healthcare. 2021. Available at (accessed April 2022).

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Authors and Affiliations



Annabelle Carter conducted the project work, collected data, analysed data and drafted the manuscript. Francesca Soldani conceived the project, supervised the project and revised the manuscript.

Corresponding author

Correspondence to Annabelle Carter.

Ethics declarations

The authors declare no conflicts of interest.

This project was a service evaluation with the trust, thus no ethical approval was required.

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Carter, A., Soldani, F. The voice of the child in dental care plans: a service evaluation. Br Dent J (2022).

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