The Role of Dental Professionals in Child Protection: A Contemporary Evidence-Based Review
Michael B. Guess, DDS, MS, MA*, Audrey Zhou, MBS1
*Correspondence to: Michael B. Guess, DDS, MS, MA, US.
Copyright.
© 2025 Michael B. Guess This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Received: 18 Aug 2025
Published: 01 Sep 2025
DOI: https://doi.org/10.5281/zenodo.17053136
Background: Dental professionals serve as critical frontline defenders in child protection, with 50-75% of child abuse cases involving injuries to the head, neck, and oral cavity. Despite mandatory reporting laws in all 50 states, dental professionals report suspected maltreatment at significantly lower rates than other healthcare providers.
Objective: This review synthesizes current evidence on dental professionals' roles in child protection and provides evidence-based recommendations for contemporary practice, including COVID-19 impacts and trauma-informed care approaches.
Methods: We conducted a comprehensive review of literature from 2010 to 2025 using PubMed, MEDLINE, and specialty databases. We included peer-reviewed studies, systematic reviews, and professional guidelines addressing child abuse identification, reporting barriers, training effectiveness, and implementation strategies.
Results: Recent New Zealand research reveals that 70% of dental professionals fear false reporting, while only 48% report familiarity with reporting processes. The COVID-19 pandemic reduced dental office visits by 33% overall and decreased children's dental visits by 27% in 2020 compared to 2019. Evidence demonstrates that targeted training programs significantly improve reporting likelihood, while trauma-informed care approaches enhance patient outcomes. Current research identifies 15 validated screening tools and establishes frameworks for multidisciplinary collaboration.
Conclusions: Dental professionals must adopt evidence-based approaches, including universal trauma-informed care, validated screening tools, and enhanced training programs. Integration of COVID-19-specific protocols and multidisciplinary partnerships will strengthen child protection outcomes.
Keywords: child abuse detection, dental professionals, mandated reporting, trauma-informed care, COVID-19 impact, screening tools.
Introduction
Child maltreatment affects millions of children annually, with dental professionals uniquely positioned to identify and respond to suspected abuse. The National Child Abuse and Neglect Data System reports that child protective services agencies received 4.4 million referrals involving approximately 7.9 million children in 2020. Yet, experts estimate that three in four cases go unreported (1). This underreporting represents a critical gap in child protection systems.
Dental professionals examine the head, neck, and oral cavity during routine visits, placing them strategically to identify physical signs of abuse that other healthcare providers might miss. Research consistently demonstrates that 50-75% of physically abused children sustain injuries to the head, face, neck, and mouth. Additionally, dental neglect represents the most prevalent form of child neglect, occurring across all demographic groups.
The COVID-19 pandemic significantly impacted child protection systems, with official reports declining 20-70% due to reduced contact between children and mandated reporters (3). Simultaneously, children experienced a 27% lower likelihood of dental visits in 2020 compared to 2019, potentially missing critical opportunities for abuse detection (4). These pandemic-related disruptions highlight the urgent need for enhanced vigilance and improved reporting protocols.
Recent advances in trauma-informed care recognize that approximately half of children and two-thirds of adults have experienced traumatic events (11). This evidence necessitates fundamental changes in how dental professionals approach patient care, moving beyond traditional clinical models to incorporate biopsychosocial perspectives that address trauma's impact on oral health and treatment experiences.
Current barriers to reporting persist despite legal mandates. New Zealand research reveals that 70% of dental professionals fear false reporting, while only 48% report familiarity with the reporting process (2). These findings underscore the critical need for evidence-based training programs and systematic approaches to child protection in dental settings.
This review synthesizes contemporary evidence on dental professionals' roles in child protection, examining identification strategies, documentation protocols, reporting barriers, and innovative approaches, including trauma-informed care and COVID-19 adaptations. We provide actionable recommendations based on current research to enhance child protection outcomes in dental practice.
Contemporary Evidence on Child Maltreatment
Current Prevalence and Demographics
Recent research provides an updated understanding of child maltreatment epidemiology. Studies indicate that up to 16% of children experience physical abuse in high-income countries, while 10% of girls and 5% of boys experience sexual abuse (13). New Zealand longitudinal data spanning 17 years reveal that approximately 20% of children have statutory child protection reports, with approximately 10% substantiated.
Table 1: Child Maltreatment by Type (2020 Data)
Source: U.S. Department of Health and Human Services, Child Maltreatment 2020
Children under one year experience the highest maltreatment rates at 25.3 per 1,000 children, with rates declining as age increases. Racial and ethnic minority children face disproportionate risks, with African American children experiencing abuse at nearly twice the rate of white children. Children with disabilities demonstrate a 3.4 times higher likelihood of experiencing abuse or neglect compared to non-disabled peers.
Figure 1: Age Distribution of Child Maltreatment Victims
COVID-19 Pandemic Impact
The COVID-19 pandemic created unprecedented challenges for child protection systems. CDC surveillance data show that emerg