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In recent years the community has become increasingly aware of the problem of child abuse which is one of the most heinous crimes committed against one of the most vulnerable and defenseless sections of the community. Although the problem is deeply rooted, it is one that the community is hesitant to acknowledge.
Epidemiological studies indicate that 50 to 77% of physical injuries in abused children appear in Dentists may often be in a position to recognize signs of Child abuse owing to the fact that they are usually the first health professionals to identify and manage oral and facial injuries. Nevertheless, the literature has shown that dentists are unsure of what to do if they suspect that a child has been abused and feel unprepared to take on the responsibility.
In Egypt, there are no data available about the knowledge and attitude of dentists on child abuse. The aim of this study was to identify Knowledge, attitude, experience, of dental practitioners regarding the recognition and reporting of abused children & correlation factors affecting them.
The study was being carried out at three places that provide pediatric dental care in Alexandria: Alexandria Dental Research Center (ADRC), El-Ramad Hospital, and El-Anfoshi Hospital. Dentists participated to study filled out the questionnaire about their knowledge, attitude, and practices. Children had been examined by the researcher to assess the prevalence of child abuse among cases. An educational program had been provided to participants to improve knowledge of dentists regarding child abuse then the knowledge and attitude of dentists had been assessed immediately after program and three months later.
Results revealed that the prevalence of child abuse among the studied sample of children in Alexandria was 32.4 %. Abuse amounted for 4%, neglect 21%, and both neglect and abuse were 7.4% and there was a significantly increased risk of abuse by age, sex and mother education. For abuse & neglect and neglect only, sex and mother education were the ones.
Dentists’ attitude about detection and reporting child abuse is important and their ethical duty to report child abuse was 100% followed by their attitude about the importance of providing child abuse training in the workplace 72.3%.
The participants were asked different questions to assess their knowledge of child abuse. The participants responded correctly to some statements; if a child readily states that an adult has caused him/her harm, the accusation should be addressed 69.7%, repeated injury to the dentition resulting in discolored or avulsed teeth may indicate repeated trauma from abuse 51.0%, (burns are associated with many child abuse cases 47.0%.
87.7% of dentists who had no formal training in dental collage as they claimed and only 10% of them had experience about suspected child abuse cases. Even after understanding the importance of reporting the child abuse cases, participants had reservations in reporting. The barriers in reporting mentioned by participants are lack of knowledge of referral procedures 23.3%, possible effect participant’s practice 23.3%, fear of litigation 20%, uncertainty about the diagnosis of child abuse 10%, possible future harmful effect on the child 10%, and fear of anger from parents and family. 6.7%.
The baseline means value of attitude score was 65.7018.312 and knowledge score was 51.6626.969. Post-program means value of attitude score was 90.00.00 and knowledge score was 68.884.466. After three months, mean value was 89.601.363 and 65.805.321 respectively.
The study concluded that the prevalence of child abuse among the studied sample of children in Alexandria was high with risk significantly increased by age, sex and mother education, the same pattern was observed for abuse and neglect. Dentists’ believed detection and reporting child abuse is important and believed that they have the ethical duty to report cases. They claimed that the amount of knowledge and training presented on the topic of child abuse at their dental college was not sufﬁcient. That will lead to the need for conducting periodically in-service training about child abuse topic to dentists in health care facilities