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 |