Adaptation measures in dental care for children with history of Adverse Childhood Experiences: A practical proposal

Abstract

Adverse Childhood Experiences (ACEs) such as maltreatment, abuse, or neglect can disrupt childhood development and increase the risk of health issues, including dental health. Such a vulnerable population frequently may deny dental treatment due to fear of intimate contact in the oral cavity, resulting in a vicious cycle that further leads to detrimental oral health. It is important for dentists, particularly pediatric dentists, to not only understand how to identify potential cases of abuse or maltreatment but also how to treat these patients so that the dental treatment does not become a negative experience. The purpose of this paper is to understand the psychological and physical implications of pediatric patients who have had ACEs and to identify the best methods to manage these patients during the dental treatment.

Knowledge, Attitudes, and Practices of Dental Practitioners in Providing Care to Children in Out-of-Home Care: A Scoping Review

“…One guideline was to aid UK dental practitioners [ 5 ]. And the final guideline was not specific to any geographic location; however, the authors were associated with a dental school in Mexico [ 23 ].…”

“…Three guidelines were identified which offer general information related to OOHC-specific systems, such as who is authorized to provide consent for children’s dental treatment [ 5 , 32 , 33 ]. Information related to children’s increased oral health care needs and the importance of understanding children’s emotional vulnerability when providing dental care was also featured in two of these guidelines [ 5 , 23 ].…”

“…Many of these circumstances can lead to children needing to be placed into OOHC for their safety and wellbeing [ 4 , 20 , 21 ]. ACEs can cause neurophysiological changes in a child’s developing brain; this can cause children to be more sensitive to stressors both physiologically and psychologically, and they are more likely to have problems regulating their emotions, leading to aggressive or destructive behavior, emotionally withdrawn behavior, and avoidant and disengaged coping mechanisms [ 22 , 23 ]. These behaviors can have a negative impact on the oral health care of these children.…”

Theories, Models, Frameworks, Guidelines, and Recommendations for Trauma-Informed Oral Healthcare Services: A Scoping Review

“…The model suggested by Raja et al (2015b) was referred to by Oh & López-Santacruz (2021). Each proposed education model suggested methods to improve education about TIC and improve trauma-informed communication skills for dental students.…”

“…The “Trauma-informed Care Pyramid for Dental Practice” is suggested as a framework for practice adaptations at the appointment-level, provider-level, and practice level (Raja et al, 2014). It is designed to be customized according to setting, specialty, and the patient’s individual needs; incorporates aspects relating to communication, reporting, and working with anxious patients, and was referred to in a further three included articles (Akinkugbe et al, 2019; Amir, 2017; Oh & López-Santacruz, 2021).…”