title: The dilemma of reporting suspicions of child maltreatment in pediatric dentistry.
abstract: This study examined the factors that lead specialists in pediatric dentistry to suspect child abuse or neglect and the considerations that influence the decision to report these suspicions to social services. Focus group discussions were used to identify new aspects of child maltreatment suspicion and reporting. Such discussions illuminate the diversity of informants' experiences, opinions, and reflections. Focus groups included 19 specialists and postgraduate students in pediatric dentistry. We conducted video-recorded focus group discussions at the informants' dental clinics. All sessions lasted approximately 1.5 h. We transcribed the discussions verbatim and studied the transcripts using thematic analysis, a method well-suited to evaluating the experiences discussed and how the informants understand them. The analysis process elicited key concepts and identified one main theme, which we labeled 'the dilemma of reporting child maltreatment'. We found this dilemma to pervade a variety of situations and divided it into three sub-themes: to support or report; differentiating concern for well-being from maltreatment; and the supportive or unhelpful consultation. Reporting a suspicion about child maltreatment seems to be a clinical and ethical dilemma arising from concerns of having contradicting professional roles, difficulties confirming suspicions of maltreatment, and perceived shortcomings in the child-protection system.
authors.affiliation: Division of Pediatric Dentistry, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden.
authors.forename: Therese
authors.initials: T
authors.lastname: Kvist
authors.forename: Anette
authors.initials: A
authors.lastname: Wickström
authors.forename: Isabelle
authors.initials: I
authors.lastname: Miglis
authors.forename: Göran
authors.initials: G
authors.lastname: Dahllöf
mesh_terms: D002648:Child; D002649:Child Abuse / Q000175:diagnosis*; D002651:Child Advocacy; D002669:Child Welfare; D003657:Decision Making; D019140:Dental Care for Children; D003812:Dentist-Patient Relations; D003815:Dentists / Q000941:ethics; D004990:Ethics, Dental; D017144:Focus Groups; D006801:Humans; D019221:Mandatory Reporting; D010290:Parents; D010377:Pediatric Dentistry / Q000941:ethics; D024382:Professional Role; D011368:Professional-Family Relations; D012017:Referral and Consultation; D012947:Social Work; D014741:Video Recording
keywords: child abuse; dentist-patient relations; mandatory reporting; professional practice