Clinical routines and management of suspected child abuse or neglect in Public Dental Service in Sweden

Mandatory reporting to the social services is required by dental professionals when suspicion of child abuse or neglect occurs. The objective of this study was to analyze the recommendations previously made by the Ombudsman for Children in Sweden. The aim was to study the association between having guidelines and the inclination to report to the social services and also the association between management of multiple missed appointmens and reports to the social service. A web-based questionnaire was sent to the clinical department heads (CDH) of all PDS in Sweden, distributed and authorized by The Ombudsman for Children in Sweden. The response frequency was 95% and all county councils of Sweden were represented. The results showed regional differences regarding management of suspected child abuse, neglect and dental neglect. Clinical department heads that had reported to the social services more often had guidelines on child abuse and neglect (p<0.000). Management of repeated missed appointments varied between clinics. Those who never had made a report to the social services more often stated that the reason for missed appointments was parental negligence (p=0.004) and less often thought it was an actual maltreatment (p=0.003), and they more often rescheduled when a child repeatedly missed an appointment (p=0.013). Sixty-four percent of the clinical department heads requested additional support in this matter. In conclusion, public dental service clinics in Sweden are significantly more likely to report to the social services if guidelines regarding child abuse and neglect are available.