Some clarification of trigger signs for dental neglect

ASSIA, EBSCO-CINAHL, Cochrane CENTRAL, EMBASE, ERIC, MEDLINE, SCOPUS, OpenGrey, Proquest-Social Services/Sociological Abstracts, Web of Knowledge-Conference Proceedings Citation Index and ISI Science Citation/ Social Science Citation Index. There were no language restrictions and authors were contacted for primary data and additional information when required.

Studies were considered eligible if they were primary studies of children (0 to 18 years) with confirmed oral neglect and with detail of dental, intra- and extra-oral features. Exclusion criteria included; studies of sexual or physical abuse or those where there was oral neglect suspected but no detail was given. All characteristics associated with dental neglect were considered outcomes.

Each article was independently reviewed by two reviewers from a panel of 22 trained reviewers with a third reviewer resolving any disagreement. A specifically designed tool for quality assessment was used.

Three thousand eight hundred and sixty-three citations and abstracts were scanned, 83 studies were reviewed and nine (with 1595 children aged 0 to 15 years) met the inclusion criteria, including two case control studies. There were not enough data to allow meta-analysis to be carried out.The features most commonly recorded as being characteristics of dental neglect were; failure to seek, or delay in seeking dental treatment, failure to follow advice or complete treatment, and this often co-existed with an adverse impact of dental neglect on the child including pain and swelling. A 'threshold' level of dental caries, that allowed dental neglect to be defined, could not be established from the available literature.

There was limited literature on this topic. The main characteristics of dental neglect highlighted were failure/delay in seeking dental care, with adverse consequences. However, due to a lack of research and additionally, a deficiency in the data on precise clinical features, it was not possible to make the distinction between dental caries and dental neglect.