Early childhood caries: exploring the ethical implications for dental neglect in South Africa
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University of the Western Cape “Tygerberg Oral Health Centre, Francie Van Zijl Drive, Parow, Cape Town, 7500”, South Africa
Publication date: 2023-04-26
Popul. Med. 2023;5(Supplement):A1473
Child neglect is a significant public health issue. South Africa (SA) has a significant burden of early childhood caries (ECC). The ECC prevalence raises a concern. This presentation aims to explore if ECC constitutes as child neglect in SAs context? Child neglect is an act of “deliberate neglect” of a child. Untreated caries is the most common type of dental neglect. Dental neglect is based on the root causes of the neglect and is an indication of broader child neglect. A high ECC prevalence and unmet treatment needs among SA children was reported. The lifetime prevalence of ECC was 44.94% in SA children below 6 years. A study on children of a low socio-economic area in SA reported that 67.5% of the children (> 6 months-<6 years old) had ECC. Considering SA’s socio-economic context, the public health problem of ECC is part of a broader social problem and has a degree of societal neglect as a result of the political, social, and economic forces which shape families' living conditions and the range of opportunities and services available. Thus, neglect shifts focus away from parents or guardians and toward the policies and actions of governments, service providers, and public utilities which harm children through the conditions and constraints imposed on families. The health promotion levy, integrated school health programmes, improving oral health services, targeted preventive programmes, early intervention and inter-professional screening can aid this problem.

As SA prepares for a health system overhaul through the National Health Insurance, child protection, care and the prevention of neglect should be at the forefront. A more workable, context-specific and integrated oral health policy could provide the appropriate resources and realise the implementation of a proper prevention programme against ECC, and prevent the prevalence of this passive form of child neglect in SA.