Recognising abuse and neglect
An approach to assessment
Abuse or neglect may present to the dental team in a number of different ways:
a direct allegation (sometimes termed a ‘disclosure’) made by the child, a parent or some other person
signs and symptoms which are suggestive of physical abuse or neglect
or through observations of child behaviour or parent-child interaction
signs of domestic abuse of a parent, such as bruises or an injury, or the parent (female or male) may disclose domestic abuse to you
concerns about the mental or general health (alcohol, substance misuse or deteriorating health condition) of the parent.
Because of the frequency of injuries to areas routinely examined during a dental check-up, the dentist has an important role in intervening on behalf of an abused child. It is assumed that the dentist will be examining a child who is fully dressed.
In some instances, the diagnosis of child abuse is clear. However, there are occasions when evidence is inconclusive and the diagnosis merely suspected. Members of the dental team are not responsible for making a diagnosis of child abuse or neglect, just for sharing concerns appropriately. If, having viewed the information on this site on how to recognise
sexual abuse and
neglect, you require additional information please take advice or see other relevant sources.21,22,46
Concerns related to a parent
Concerns about the mental or general health (alcohol, substance misuse or deteriorating health condition) of the parent should prompt a discussion with the parent and a referral to children’s services, particularly when other signs of abuse and neglect are present. Children’s services will assess the need for child and family support and identify remedial action.
In respect of domestic abuse, if a parent makes a disclosure to you or a member of your staff, and requests help, contact your local children’s services office. If you suspect domestic abuse, enquire about this with the parent and inform them of your concern for their own and their child’s welfare. You are obliged to make a referral to the local children’s services office if you have concerns about domestic abuse and to inform the parent you are doing so. This is a very sensitive area and must be dealt with carefully so as not to increase any risks for the parent and child. Take advice from your named nurse or doctor for child protection, your local children’s services office or the local police domestic abuse unit.
If in doubt you should always seek advice.