Knowledge of Child Abuse and Dental Neglect in Education Providers in Sangareddy: Cross-Sectional Survey Study

ABSTRACT

Background:

Child abuse and dental neglect (CAN) are significant global issues impacting various segments of society. These problems are evident across diverse social, ethnic, religious, and professional groups. Educators hold a crucial position in recognizing and addressing the symptoms of child abuse.

Objective:

This study aims to assess educators’ knowledge and attitudes towards recognizing signs and symptoms of child abuse, as well as their understanding of the procedures for reporting child abuse and dental neglect.

Methodology:

A self-administered, validated questionnaire consisting of 25 items was distributed to 150 school teachers in Sangareddy after obtaining informed consent. The survey assessed various aspects of awareness, including the identification and reporting of child abuse and neglect.

Results:

The majority of the teachers surveyed demonstrated awareness of the causes and indicators of child maltreatment. However, many participants were unclear about the appropriate authorities to contact for reporting such cases.

Conclusion:

Pediatric dentists are uniquely positioned to identify physical abuse, as approximately 50% of injuries in such cases occur in the head and neck region. It is essential to establish collaborative platforms in child protection programs, enabling educators to work closely with pediatricians and pediatric dentists to enhance the identification and reporting of child abuse and neglect.

INTRODUCTION

Educators play a vital role in children’s lives, often serving as trusted observers of their well-being. Child abuse, a global crisis with severe and lasting consequences, affects children across all socioeconomic backgrounds. Recognized as a major social issue since Caffey’s early work, child maltreatment includes physical, emotional, and sexual abuse, as well as neglect and exploitation.[1,2] The WHO (1999) defines it as any act causing actual or potential harm within a relationship of trust or power.[3] Alarmingly, nearly three in four children aged 2–4 experience physical punishment or psychological violence from caregivers.[4]

The dental profession plays a crucial role in identifying and addressing the oral health impacts of child maltreatment.[5] Given their frequent interactions with children, dental professionals are well-positioned to detect signs of abuse and neglect.[6] Child abuse includes any harmful act by a caregiver, while the American Academy of Pediatric Dentistry (2017)[7] defines dental neglect as the willful failure to provide essential oral care. Despite growing awareness, gaps remain in recognizing and reporting abuse. Educators, often a child’s first point of contact, may lack proper training, while inconsistent guidelines and limited collaboration hinder dental professionals’ interventions. This study examines educators’ knowledge, attitudes, and understanding of reporting procedures for child abuse and dental neglect.

METHODOLOGY

This cross-sectional study, conducted in Sangareddy, Telangana, India, assessed education providers’ knowledge, attitudes, and practices regarding child abuse and dental neglect. Ethical approval was obtained, and written informed consent was secured from all participants. The study included teachers and counselors from local schools, with a sample size of 150 determined using Cochran’s formula, adjusted for a finite population of ~ 500. Participants were selected through purposive sampling, meeting the inclusion criterion of active employment during the study period, while those who declined consent were excluded. A structured, self-administered 25-item questionnaire, validated by 15 experts (CVI > 95%), covered four sections: demographics and professional profile (age, gender, education, experience, school type), knowledge of oral health and school dental programs (awareness of dental issues, school dental camps, oral hygiene importance), attitudes toward child abuse and neglect (perceptions and recognition), and practices in identifying and reporting abuse (reporting protocols and barriers). Responses were tabulated and analyzed using descriptive statistics for demographic data and inferential analysis to assess associations between demographic characteristics and study variables.

RESULTS

The findings revealed that while 75% of teachers acknowledged the significance of dental health for children’s well-being, a substantial proportion of parents were not addressing treatment needs. Lack of awareness about oral health emerged as the primary barrier, followed by parental ignorance and neglect, parental literacy, and financial constraints. While 50% of teachers accompanied their students to dental colleges for screenings, only 60% actively explained dental neglect to parents. Regarding child abuse, a significant majority (72%) of teachers reported having substantial knowledge, primarily gained through media and discussions with colleagues. However, 78% were unaware of Indian laws related to child abuse and reporting procedures. Physical abuse was the most frequently observed type of abuse, followed by emotional abuse. Knowledge gaps were evident regarding common indicators of abuse, such as bruises, dental trauma, and bite marks. Despite 70% of teachers believing abused children might disclose abuse to them, only 62% felt comfortable discussing such cases with pediatric dentists during school dental camps. Female teachers demonstrated greater sensitivity to children’s needs compared to male teachers

DISCUSSION

This study highlights the crucial role of teachers in identifying child abuse and dental neglect, though gaps in awareness persist. While 75% recognized the importance of dental health, many parents failed to seek treatment due to factors like low awareness, neglect, literacy levels, and financial constraints. Ramazani emphasized the long-term effects of dental neglect, including malnutrition and poor academic performance. Notably, 50% of teachers accompanied students to dental screenings, yet only 60% discussed neglect with parents, revealing missed advocacy opportunities. As Ramazani noted, teachers, given their close relationships with children, can play a key role in family education.[8]

While 72% of teachers had substantial knowledge of child abuse, mostly from media and peers, 78% were unaware of Indian laws and reporting procedures, highlighting the need for targeted training. This aligns with Mathews and Kenny,[9] who noted that legal ambiguity hinders mandatory reporting. Starling et al.[10] emphasized that clear legal knowledge improves reporting effectiveness, underscoring the importance of educator training.

The study found physical abuse to be the most commonly observed, followed by emotional abuse. While 70% of teachers believed children might confide in them, only 62% felt comfortable discussing cases with pediatric dentists at school camps. This hesitancy, likely due to insufficient training, aligns with Badakar’s findings that professionals, including teachers, require further education to effectively identify and address child abuse.[11]

Female teachers showed greater sensitivity to children’s needs, aligning with Poreddi et al.[12] findings on gender differences in child welfare attitudes. This highlights the need for gender-sensitive training to enhance awareness among male educators. Research indicates that 50% of child abuse injuries affect the head and neck, making pediatric dentists key in diagnosis, while teachers, as frontline observers, can aid early detection.[13] However, many teachers lack awareness of common abuse signs like bruises, dental trauma, and bite marks, underscoring the need for mandatory training, as recommended by Starling and Boos.[10]

Teacher training (both pre-service and in-service) increases confidence in recognizing and responding to child abuse (Mathews, 2011).[14] This underscores the importance of capacity-building efforts like workshops and training for educators in child protection. However, the study has limitations: self-reported data may be biased; the limited geographic scope hinders generalizability.

CONCLUSION

In conclusion, while teachers demonstrate a foundational awareness of oral health and child abuse, significant gaps persist in their knowledge of reporting mechanisms, legal obligations, and abuse indicators. Bridging these gaps requires a multipronged approach, including enhanced training programs, collaboration with pediatric dentists, and policy reforms to empower educators.

Ethical clearance

After the institutional ethical clearence we have conducted this study. Ethical clearence no: MNRDCH/SS/22-020.

Conflicts of interest

There are no conflicts of interest.

Funding Statement

Nil.