Strengthening oral health practitioners’ responsiveness to child abuse and neglect: A mixed-methods study in Aotearoa New Zealand

Background: Oral health practitioners are well-positioned to contribute to child protection responses, as they may identify orofacial injuries, dental neglect, behavioural indicators, and patterns of missed or delayed care. However, their role in recognising and responding to suspected child abuse and neglect remains inconsistently recognised, supported, and embedded within wider child protection systems.

Aim: This study explored oral health practitioners’ understanding, confidence, and support needs in responding to suspected child abuse and neglect in New Zealand.

Methods: A mixed-methods design was used, involving a nationwide survey of oral health practitioners, qualitative interviews/focus groups, and analysis of relevant professional, legal, and policy frameworks. Quantitative data examined practitioners’ previous training, knowledge, confidence, and self-reported preparedness. Qualitative data explored practitioners’ experiences, perceived barriers, and views on what would support safer and more effective child protection responses. The findings were integrated to identify key individual, professional, and system-level factors influencing responsiveness.

Findings: Practitioners generally recognised child protection as relevant to oral health practice, particularly regarding dental neglect, orofacial trauma, and concerns identified through clinical and family interactions. However, many reported limited or inconsistent education, low confidence in responding to suspected concerns, uncertainty around reporting thresholds and pathways, and limited guidance on documentation and interprofessional communication. Participants also highlighted the importance of culturally safe, family-centred approaches that support children and families while reducing the risk of both under-reporting and inappropriate escalation. The analysis of professional and policy frameworks further indicated that oral health practitioners’ role in child protection is not consistently visible or clearly supported.

Conclusion: Oral health practitioners require stronger integration into interdisciplinary child protection responses. Targeted education, clearer guidance, culturally safe practice frameworks, and improved referral and communication pathways may strengthen practitioner confidence and support timely, appropriate, and child-centred responses to suspected abuse and neglect.