Oral Health Conditions and Neglect in Child Care: An Integrative Review Volume 8 - Issue 1

Marília Cleide Tenório Gomes de Aguiar, Amanda Caroline Oliveira Henriques Mendes, Maria da Conceição de Barros Correia, José Victor Leal Alves, Assíria Rebeca de Souza Silva, Zilma Ribeiro do Nascimento, Leonardo Cavalcanti Bezerra dos Santos, Rosa Maria Mariz de Melo Sales Marmhoud Coury, Criseuda Maria Benício Barros, Kátia Maria Gonçalves Marques, Valter Romão de Souza Júnior, Niedje Siqueira de Lima and Luciana de Barros Correia Fontes*

• Department of Clinical and Preventive Dentistry, School of Dentistry, Federal University of Pernambuco (UFPE), Brazil

Received: June 26, 2022;   Published: July 05, 2023

*Corresponding author: Luciana de Barros Correia Fontes, Department of Clinical and Preventive Dentistry, School of Dentistry, Federal University of Pernambuco (UFPE), Avenida Professor Moraes Rego, 1235, Cidade Universitária, Recife, Pernambuco, Brazil

DOI: 10.32474/IPDOAJ.2023.08.000293

Abstract PDF

The objective of this study was to perform an integrative literature review on whether there is scientific evidence linking children’s oral health conditions with caregiver neglect. An integrative literature review based on the PRISMA method was developed. It was based on a guiding question directly related to the proposed objective, adopting the descriptors in health or MesH terms or alternative terms: “oral health,” “child abuse”, and “children”. The virtual portals PubMed and VHL were considered. The Boolean operators “AND” and “OR” were used in the exploratory search, using the pre-defined inclusion and exclusion criteria. There was a time limit for records between January 2018 and December 2022. Two independent researchers participated directly in the collection, which took place between May and June 2023. From 138 records, six studies were included for qualitative analysis. These showed scientific evidence of worse oral health conditions for children who are victims of neglect, necessitating preventive and control approaches.

Keywords: Oral Health; Children; Child Abuse

The physical, mental and social well-being of children and adolescents represents a major challenge to public health worldwide. This, because of the possible impacts on the growth and development of this target population and the condition of dependence on adult individuals for their assistance, their care. Oral health is considered an integral element of overall health and may impact the functional and psychosocial aspects of individuals [1-3]. When it comes to children, there is a greater dependence on such care, related to the development of cognitive and motor skills and related abilities. The World Health Organization (WHO) defines child maltreatment as “all forms of physical and emotional ill-treatment, sexual abuse, neglect, and exploitation that results in actual or potential harm to the child’s health, development or dignity.” There are four main types of abuse: neglect, physical abuse, psychological abuse, and sexual abuse. Abuse is defined as an act of commission and neglect is defined as an act of omission in the care leading to potential or actual harm. Neglect is the most common form of child abuse which includes, in particular, inadequate health care [4]. The aim of this study is to investigate whether there is scientific evidence linking oral health conditions to neglect of care by caregivers.

Integrative literature review based on the PRISMA or Preferred Reporting Items for Systematic Reviews and Meta-Analyses model [5], with the guiding question: - Is there scientific evidence on children’s oral health conditions and negligence on the part of their guardians or caregivers? The following virtual portals were used for data collection PubMed (United States National Library of Medicine service) and VHL (Virtual Health Library) and their databases. The health descriptors or MeSH Medical Subject Headings term were considered: “oral health”, “child abuse”, and “children” in their Portuguese, Spanish and English versions. Also the advanced search form and with the Boolean operators “AND” and “OR”, through the advanced search form.

Inclusion criteria: all scientific articles published between January 2018 and December 2022 that met the guiding question.

Exclusion criteria: opinions, letters to the editor or other works that were not formally characterized as a scientific article were excluded, as well as repeated studies (where only one was counted) and literature reviews. Also those who did not answer the guiding question.

Two independent reviewers carried out the selection of articles, during the months of May and June in 2023, The articles were included by reading the title and the abstract of the records surveyed, according to the inclusion and exclusion criteria adopted. In the case of repeated records, only one was included. The initial selection was made by reading the title and the abstract. Subsequently, the records were chosen to be read in their entirety and, if included, with the summarized presentation of the main information.

From 138 records, the final sample included fivw studies, presented in the form of a summary table (Figure 1).

Figure 1: Distribution of the selected records according to authorship, year of publication, country, database, objective, study design and sample, objective, main results or conclusions.

Dental neglect is the willful failure of parents or guardians to seek and follow through with treatment necessary to ensure a level of oral heath essential for adequate function and freedom from pain and infection [6]. It can be said that inferior health, hygiene, and quality of life conditions were expected for neglected children, which is well documented [7-12] in the selected studies. However, how can the early identification and planning of strategies be carried out in order to establish the child’s well-being in all dimensions that involve his/her growth and development? With many socio-demographic, cultural, and economic variables that need to be considered, it is observed from the selected studies that, amidst a diversity of countries, in terms of characteristics, the problem is recognized and brings negative impacts [7-12]. As for the need for early identification, dental students, the dental surgeon, or the oral health team, in primary care, can be one of the first references in the suspicion of child neglect, particularly when poor oral hygiene occurs and improvement is not observed with positive reinforcement for such and when there is a very large demand for dental treatment, even in early age groups.

Accompanying the situation and seeking the help of the multidisciplinary team, including psychology and social assistance professionals, is unique, so that a positive return can be achieved [13]. The multidisciplinary approach has been utilized extensively by health care professions working with child abuse and neglect families. The multidisciplinary approach has allowed nurses, physicians, social workers, and mental health workers to collaborate in resolving complex problems. Multidisciplinary teams have taken many forms, depending on the demonstrated needs of the clinical setting. The many functions of the team may be summarized as: information-sharing, decision-making, support, and planning. Additional advantages include role clarification and many benefits for patients and families [14,15].

There is scientific evidence between the situation of neglect and the oral health conditions of the child victim. Associations between worse oral conditions, general health, and quality of life have been recorded for children who are victims of neglect. Considering an expected outcome by the context of the topic, there is a need for early identification and supervised interventions over time.

There is no conflict of interest or funding support.

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