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Table 2 Data analysis chart

From: Dental neglect as a marker of broader neglect: a qualitative investigation of public health nurses’ assessments of oral health in preschool children

Main theme Sub-theme Theme dimensions # Cited
Question 1: How do public health nurses assess oral health?
Observation Child’s teeth   15
   Opportunistic look in mouth 10
   Do not look directly in mouth routinely 9
   As part of holistic assessment 9
   Look in mouth if asked 9
   Look in mouth if concerned 7
   Observe decayed front teeth 6
  Family teeth   
   Parents teeth 11
   Siblings teeth 4
Assessing parental attitudes Gauge parental interest in oral health   9
   If parental concern e.g. pain 7
   Parental dental phobia 6
  Parental feeding and weaning practices   
   Use of feeding bottles/dummies/juice/sweets 14
Communication With parents   
   Ask if registered with dentist (routinely) 15
   Ask about teeth brushing 13
   Mention dental health services 10
   Use of assessment framework 7
   Ask about recent attendance with dentist 6
  Other communication channels   
   Knowledge of family/family history (e.g. through records) 7
   Through information from other professionals 4
Question 2: What are the potential barriers to assessment?
  Public health nurse role   
   Not likely to be aware of problems further back in child’s mouth 7
   Public health nurses’ role is advisory 5
   Public health nurses not qualified to look in children’s mouths 4
   Not top of public health nurses’ agenda 4
  Parental expectation   
   Parents do not expect public health nurses to assess dental health 7
   Parents might consider it intrusive to look in child’s mouth 4
   Dental health - a very ‘sensitive’ subject 3
   Tension between choice and protection 3
Question 3: What threshold levels of dental decay are used by public health nurses as an indicator of the need for targeted public health nurse support?
Threshold levels for support    
  Concerns about other social issues   
   Homelessness/drugs/domestic abuse 10
  Concerns about dental health   
   Concerns about child’s teeth 5
   Concerns about parent’s teeth 4
Responses to identified need    
  Issue dental packs   
   Additional issuing of dental pack 6
  Referral   
   Referral to dental services 10
Question 4: What are the factors relating to dental neglect beyond which public health nurses initiate child protection intervention?
Threshold levels for concern    
  Concerns about other social issues   
   Dental decay alone is not a child protection issue 12
   Dental decay is a marker of broader neglect 11
  Concerns about dental health   
   Untreated dental caries or pain 10
   Not taking child to dentist 7
Responses to concern    
  Referral to dental services   
   Facilitate further dental appointment / attendance at appointment 7
   Repeated referrals to dentist 2
  Notifying another agency of concern /sharing information   
   Include or consider including information within child protection reports / risk assessments 8
   Notify (or consider notification) to social work of concern 2
Barriers to intervention    
  Communication and Feedback   
   Poor liaison between services 6