Abstract
Aim Service evaluation of our dental hospital paediatric liaison nursing (DH-PLN) service which provides an additional route for information sharing about safeguarding concerns via an agreed pathway for two-way communication with public health nurses.
Method Retrospective analysis of clinical records of all children referred by DH teams to PLN in the three months October-December 2016.
Results One hundred and four children were referred; mean age was 6.2 years, 89.4% from Index of Multiple Deprivation (IMD) quintiles 4 and 5, and 70.2% were attending for dental general anaesthesia. The most common referral reason was dental neglect in 66.3%, followed by missed appointments in 50.0%. The PLN checked child health databases and shared information with health visitors and school nurses (46.2% and 53.8% respectively). Feedback retrieved included known child maltreatment risk factors in 7.7%. This prompted additional child protection referrals to children's social services for seven children (6.7%). Dental outcomes six months later were: treatment complete in 50.0%, treatment ongoing 28.8%, discharged to original referrer with treatment incomplete in 21.1%.
Conclusion This DH-PLN service promotes integrated multidisciplinary working, helping overcome barriers to dentistry's involvement in safeguarding. It facilitates more accurate assessments of risk of harm to children receiving dental care and prompts additional child protection referrals to social services.
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References
National Institute for Health and Care Excellence. Child maltreatment: when to suspect maltreatment in under 18s. 2009. Available at https://www.nice.org.uk/guidance/cg89 (accessed June 2019).
HM Government. Working together to safeguard children. A guide to inter-agency working to safeguard and promote the welfare of children. 2018. Available at https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/779401/Working_Together_to_Safeguard-Children.pdf (accessed June 2019).
Harris C M, Welbury R, Cairns A M. The Scottish dental practitioner's role in managing child abuse and neglect. Br Dent J 2013; 214: E24.
Harris J C. The mouth and maltreatment: safeguarding issues in child dental health. Arch Dis Child 2018; 103: 722-729.
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.
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.
Harris J, Sidebotham P, Welbury R et al. Child protection and the dental team: an introduction to safeguarding children in dental practice. Sheffield: COPDEND, 2006 (updated online 2013). Available at https://bda.org/childprotection/ (accessed June 2019).
Bradbury-Jones C, Innes N, Evans D, Ballantyne F, Taylor J. Dental neglect as a marker of broader neglect: a qualitative investigation of public health nurses' assessments of oral health in pre-school children. BMC Public Health 2013; 13: 370.
Lewney J, Holmes R D, Rankin J, Exley C. Health visitors' views on promoting oral health and supporting clients with dental health problems: a qualitative study. J Public Health (Oxf) 2018; 41: e013-e108.
Harris J C, Elcock C, Sidebotham P D, Welbury R R. Safeguarding children in dentistry: 2. Do paediatric dentists neglect child dental neglect? Br Dent J 2009; 206: 465-470.
Institute of Health Visiting. Local Authority Child Public Health Briefing (2): The health visiting contribution to early help and prevention of child abuse and neglect. 2015. Available at https://ihv.org.uk/wp-content/uploads/2015/06/iHV_public_health_Briefing_2_V3.pdf (accessed June 2019).
Department for Education, Department of Health. Health Visiting and School Nurse Programme: Supporting implementation of the new service offer No. 5: Safeguarding children and young people: enhancing professional practice - working with children and families. 2012. Available at http://media.dh.gov.uk/network/387/files/2012/11/SAFEGUARDING_ENHANCING-PROFESSIONAL-GUIDANCE.pdf (accessed June 2019).
National Perinatal Epidemiology Unit. IMD tool. Available at https://tools.npeu.ox.ac.uk/imd/ (accessed June 2019).
Roe M. Child patients: WNB not DNA. BMJ 2010; 341: c6332.
HM Government. Information sharing: Advice for practitioners providing safeguarding services to children, young people, parents and carers. 2018, p6. Available at https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/721581/Information_sharing_advice_practitioners_safeguarding_services.pdf (accessed June 2019).
Sidebotham P, Brandon M, Bailey S et al. Pathways to harm, pathways to protection: a triennial analysis of serious case reviews 2011 to 2014. London: Department for Education, 2016, pp163-169, p195. Available at https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/533826/Triennial_Analysis_of_SCRs_2011-2014_-__Pathways_to_harm_and_protection.pdf (accessed June 2019).
Fisher-Owens S A, Lukefahr J L, Tate A R, American Academy of Pediatrics, American Academy of Pediatric Dentistry. Oral and Dental Aspects of Child Abuse and Neglect. Paediatrics 2017; 140: e20171487.
Brattabø I V, Bjørknes R, Åstrøm A N. Reasons for reported suspicion of child maltreatment and responses from the child welfare - a cross-sectional study of Norwegian public dental health personnel. BMC Oral Health 2018; 18: 29.
Kvist T, Cocozza M, Annerbäck E M, Dahllöf G. Child maltreatment - prevalence and characteristics of mandatory reports from dental professionals to the social services. Int J Paediatr Dent 2017; 27: 3-10.
Bhatia S K, Maguire S A, Chadwick B L et al. Characteristics of child dental neglect: a systematic review. J Dent 2014; 42: 229-239.
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.
Office of the Chief Dental Officer England. Commissioning Standard for Dental Specialties: Paediatric Dentistry. London: NHS England, 2018, p18. Available at https://www.england.nhs.uk/wp-content/uploads/2018/04/commissioning-standard-for-dental-specialties-paediatric-dentristry.pdf (accessed June 2019).
Olley H, Psaila K, Fowler C, Kruske S, Homer C, Schmied V. 'Being the bridge and the beacon': a qualitative study of the characteristics and functions of the liaison role in child and family health services in Australia. J Clin Nurs 2017; 26: 91-102.
Wild P. A project to improve links between paediatric liaison nurses and school nurse teams. Community Pract 2014; 87: 42-43.
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Spencer, C., Zaitoun, H., White, E. et al. Role of the dental hospital-based paediatric liaison nurse in safeguarding children. Br Dent J 227, 158–163 (2019). https://doi.org/10.1038/s41415-019-0488-z
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DOI: https://doi.org/10.1038/s41415-019-0488-z


