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Dental Neglect

The objective was to answer the following question:


  1. What are the parent/carer characteristics of a child with dental neglect, and what oral features are present in these children?



We performed an all-language literature search across 16 bibliographic databases to identify original articles published since 1947. The initial search strategy was developed across OVID Medline databases using keywords and Medical Subject Headings (MeSH headings) and was modified appropriately to search the remaining bibliographic databases.  The search sensitivity was augmented by the use of a range of supplementary ‘snowballing’ techniques including consultation with subject experts and relevant organisations, and hand searching selected websites, non-indexed journals and the references of all full-text articles.


Identified citations, once scanned for duplicates and relevancy, were transferred to a purpose-built Microsoft Access database to coordinate the review and collate critical appraisal data.  Abstracts and selected full-text papers were scanned by the lead researcher and eligible studies identified for review. Relevant foreign language articles were considered for translation, though none were undertaken. Where applicable, authors were contacted for primary data and additional information. 


A panel of community and pediatric dentists, paediatricians, child protection practitioners, a lecturer in dental public health, social worker and pathologist conducted two independent reviews of each relevant article. Reviews were undertaken using a standardized critical appraisal form based on criteria defined by the National Health Service’s Centre for Reviews and Dissemination 1, and supplemented by systematic review advisory articles 2-6. All reviewers underwent critical appraisal training purposefully designed for this review. A third review was undertaken to resolve disagreement.


  • Definition of dental neglect chosen for the purpose of this review:

Neglect refers to the failure of a parent or guardian to meet a child’s basic oral health needs, such that the child enjoys adequate function and freedom from pain and infection, where reasonable resources are available to the family or caregiver” 7-11


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  1. Centre for Reviews and Dissemination. Systematic Reviews: CRD's Guidance for Undertaking Reviews in Health Care, 2009 Centre for Reviews and Dissemination, University of York. [PDF from York University]
  2. Weaver N, Williams JL, Weightman AL, Kitcher HN, Temple JM, Jones P, Palmer S. Taking STOX: developing a cross disciplinary methodology for systematic reviews of research on the built environment and the health of the public. Journal of Epidemiology and Community Health. 2002;56(1):48-55. [Pubmed]
  3. Critical Appraisal Skills Programme (CASP) [Website]

  4. Polgar A, Thomas SA. Chapter 22. Critical evaluation of published research in Introduction to research in the health sciences. 3rd edition. Melbourne: Churchill Livingstone, 1995.
  5. Weightman AL, Mann MK, Sander L, Turley RL. Health Evidence Bulletins Wales: A systematic approach to identifying the evidence. Project Methodology 5. Cardiff: Information Services UWCM, January 2004. [PDF from Health Evidence Bulletins Wales]
  6. Rychetnik L, Frommer M. A schema for evaluating evidence on public health interventions (version 4). National Public Health Partnership, Melbourne 2002. [PDF from The National Public Health Partnership]
  7. Department for Education. Every child matters;2003. [PDF from Department for Education]
  8. Harris JC, Balmer RC, Sidebotham PD. British Society of Paediatric Dentistry: a policy document on dental neglect in children. International Journal of Paediatric Dentistry. 2009. [Epub ahead of print]. [Early view - 14 May 2009, Wiley Online Library]
  9. American Academy of Pediatric Dentistry Child Abuse Committee & Council on Clinical Affairs. Definition of dental neglect. Definitions. 2010;13. [Definition provided by American Academy of Pediatric Dentistry]
  10. Department of Health. An oral health strategy for England. London; 1994.
  11. Krug EG, Dahlberg LL, Mercy JA, Zwi AB, Lozano R. World report on violence and health. Geneva: World Health Organization; 2002. [PDF from WHO]




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