title: Characteristics of child dental neglect: a systematic review.
abstract: OBJECTIVE
  Neglect of a child's oral health can lead to pain, poor growth and impaired quality of life. In populations where there is a high prevalence of dental caries, the determination of which children are experiencing dental neglect is challenging. This systematic review aims to identify the features of oral neglect in children.
  
  
  METHODS
  Fifteen databases spanning 1947-2012 were searched; these were supplemented by hand searching of 4 specialist journals, 5 websites and references of full texts. Included: studies of children 0-18 years with confirmed oral neglect undergoing a standardised dental examination; excluded: physical/sexual abuse. All relevant studies underwent two independent reviews (+/- 3rd review) using standardised critical appraisal.
  
  
  RESULTS
  Of 3863 potential studies screened, 83 studies were reviewed and 9 included (representing 1595 children). Features included: failure or delay in seeking dental treatment; failure to comply with/complete treatment; failure to provide basic oral care; co-existent adverse impact on the child e.g. pain and swelling. Two studies developed and implemented 'dental neglect' screening tools with success. The importance of Quality of Life tools to identify impact of neglected dental care are also highlighted.
  
  
  CONCLUSIONS
  A small body of literature addresses this topic, using varying definitions of neglect, and standards of oral examination. While failure/delay in seeking care with adverse dental consequences were highlighted, differentiating dental caries from dental neglect is difficult, and there is a paucity of data on precise clinical features to aid in this distinction.
  
  
  CONCLUSIONS
  Diagnosing dental neglect can be challenging, influencing a reluctance to report cases. Published evidence does exist to support these referrals when conditions as above are described, although further quality case control studies defining distinguishing patterns of dental caries would be welcome.
authors.affiliation: University Dental Hospital, School of Dentistry, Cardiff University, Cardiff, UK. Electronic address: bhatiask@cardiff.ac.uk.
authors.forename: Shannu K
authors.initials: SK
authors.lastname: Bhatia
authors.affiliation: College of Biomedical and Life Sciences, School of Medicine, Cardiff University, Cardiff, UK.
authors.forename: Sabine A
authors.initials: SA
authors.lastname: Maguire
authors.affiliation: College of Biomedical and Life Sciences, School of Dentistry, Cardiff University, Cardiff, UK.
authors.forename: Barbara L
authors.initials: BL
authors.lastname: Chadwick
authors.affiliation: College of Biomedical and Life Sciences, School of Dentistry, Cardiff University, Cardiff, UK.
authors.forename: M Lindsay
authors.initials: ML
authors.lastname: Hunter
authors.affiliation: Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
authors.forename: Jennifer C
authors.initials: JC
authors.lastname: Harris
authors.affiliation: College of Biomedical and Life Sciences, School of Medicine, Cardiff University, Cardiff, UK.
authors.forename: Vanessa
authors.initials: V
authors.lastname: Tempest
authors.affiliation: Support Unit for Research Evidence, Cardiff University, Cardiff, UK.
authors.forename: Mala K
authors.initials: MK
authors.lastname: Mann
authors.affiliation: College of Biomedical and Life Sciences, School of Medicine, Cardiff University, Cardiff, UK.
authors.forename: Alison M
authors.initials: AM
authors.lastname: Kemp
mesh_terms: D000293:Adolescent; D002648:Child; D002649:Child Abuse / Q000175:diagnosis*; D002657:Child Development; D000067576:Child Health; D002675:Child, Preschool; D019140:Dental Care for Children; D003731:Dental Caries / Q000175:diagnosis*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D009909:Oral Health
keywords: Child maltreatment; Dental neglect; Neglect; Oral neglect; Systematic review