Knowledge, Attitudes, and Intention to Report Child Abuse and Neglect, Including Dental Neglect, Among Dental...

Dentists are uniquely positioned to detect child abuse and neglect (CAN), including dental neglect, yet reporting rates remain low and Bulgarian data are scarce. This study assessed the knowledge, attitudes, and self-reported intention to report CAN, including dental neglect, among clinical dental students in Plovdiv, Bulgaria, and their views on further education. We additionally tested whether recognition and attitudes differed by sex, stage of training, and prior CAN education, and identified independent correlates of the intention to report.

A single-centre, analytical cross-sectional survey (Microsoft Forms) was conducted among 4th-, 5th-, and 6th-year (intern) dental students at the Medical University of Plovdiv (March-May 2025). The 17-item questionnaire covered demographics, knowledge, attitudes, the perceived role of the dentist, and interest in further training. An indicator-recognition score (0-24) was derived from four "select-all-that-apply" items. Group differences were examined with Mann-Whitney U and χ²/Fisher tests; independent correlates were identified with a general linear model (recognition score) and binary logistic regression (reporting intention; dentist's role), with effect sizes reported.

Of 200 invited students, 115 responded (57.5%; 74 female, 41 male). Physical abuse was recognised by all participants (100%) but neglect by only ~75%. Female students scored higher than males (adjusted means 19.97 vs. 18.08; p = 0.005; partial η² = 0.07), with no difference by year of study. Overall recognition scores were similar in students with and without prior CAN education (p = 0.713), but trained students more often endorsed the dentist's safeguarding role (88.3% vs. 57.9%; p = 0.001) and intended to report suspected cases (66.2% vs. 39.5%; p = 0.011). In multivariable models, prior education (adjusted OR 3.31) and the recognition score (adjusted OR 1.32 per point) were each independently associated with the intention to report (both p ≤ 0.012). Over half (51%) considered their training insufficient and 94.8% wanted further education, preferring case-based seminars (71.3%).

A clear gap exists between awareness of CAN and readiness to act; prior education related to readiness to act rather than to broader recognition. Structured, practice-oriented training with clear local reporting pathways and interprofessional learning is needed.