Exploring Child Abuse and Neglect Responses: Qualitative Insights From Oral Health Practitioners in Aotearoa New Zealand

Abstract

Background: Child abuse and neglect (CAN) remain significant concerns in Aotearoa New Zealand (NZ), with persistent inequities affecting indigenous Māori communities. Oral health practitioners (OHPs) are uniquely positioned to support CAN prevention and response through regular interactions with children via national dental care programs. Objective: To explore the experiences and perspectives of OHPs in CAN prevention, identification, and response, and identify actionable strategies to enhance their responsiveness across dental settings. Participants and setting: Twenty-one OHPs, including oral health therapists, dental therapists, dentists, dental specialists, and community oral health service managers, were recruited from diverse geographic regions and dental settings, including community clinics, private practices and school-based clinics. Methods: A qualitative design was used, involving twelve semi-structured interviews and two focus groups conducted between August 2023 and August 2024. Reflective thematic analysis was conducted to ensure a deep, contextual understanding of participants' insights. Results: Four themes were generated: opportunities to build relationships with families, needs for cultural and systemic awareness, collaborative approaches to child protection, and creating safer and more supportive practice environments. Two sub-themes emphasized the need for context-specific and straightforward guidelines and active workforce development in child protection. Conclusions: OHPs' responses to CAN varied depending on access to training, organizational support, and contextual factors. Enhancing culturally safe, interdisciplinary training and establishing accessible, practical guidance are key strategies to support OHPs' protective role. Policy reform should prioritize these supports to ensure better outcomes for children and their families.