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| EDITORIAL |
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| Year : 2014 | Volume
: 5
| Issue : 2 | Page : 149 |
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Child protection- raising the awareness of dental neglect
Richard Welbury
Professor of Paediatric Dentistry Glasgow Dental Hospital and School
| Date of Web Publication | 13-May-2014 |
Correspondence Address:
Richard Welbury
Professor of Paediatric Dentistry Glasgow Dental Hospital and School
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/0976-237X.132300
How to cite this article:
Welbury R. Child protection- raising the awareness of dental neglect. Contemp Clin Dent 2014;5:149 |
In 1962, Henry Kempe et al., published "the battered child syndrome' in the Journal of the American Medical Association. In this paper, they drew attention to the fact that children under their care had fractures that could only have been caused on purpose. Since then, there has been an increasing awareness among health care personnel that children under their care may be "at risk." For a time the term "nonaccidental injury" was preferred, but today we recognize the term "child abuse." The term child abuse embraces those children at risk of physical abuse, emotional abuse, sexual abuse, and neglect. Children can be subjected to one specific type of abuse, but more commonly more than one type of abuse coexist. For instance, emotional abuse can occur in isolation, but is also commonly recognized in children who have suffered physical abuse, sexual abuse, and neglect.
There is a good evidence-base that at least 60% of all children who are physically abused have signs on the head and neck that are visible to every member of the dental team. Extra orally common injuries are hematomas or bruises, and abrasions or lacerations. Less commonly burns, bites, and fractures may be seen. Intra orally bruises; abrasions and dental trauma are common.
Dental neglect has only relatively recently been defined in terms of child protection; however, it is pleasing to see that there is an increasing awareness throughout the world that not only can dental neglect be part of general neglect, but that on occasions it may be willful and be the sole presentation of neglect.
The need for appropriate dental care and advice to be readily available for all children is certainly embodied within the United Nations Convention of the Rights of the Child. Why is it that among the health care professions, oral sepsis is not viewed as important in comparison to infections occurring elsewhere in the body? If a parent failed to take their child for treatment of an abscess of the leg for instance there would be an immediate immobilization of health and social services and yet widespread dental caries and dental neglect is almost accepted as the status quo. We must work to correct this inequality and one of the first things we must do is to work with our colleagues in the medical, nursing, and children's services to appraise them of the importance of oral health and how oral disease can have systemic effects. We must start by welcoming all general pediatric trainees into pediatric dental units for a module of study, which would include not only the basics of prevention but also how to carry out an oral examination and what constitutes normal and abnormal appearance. It is a sobering thought that many pediatricians involved in child abuse have to carry out oral examinations without any specialized oral training or support from dental colleagues. As pediatric dentists, I am sure we have never been asked to carry out neurological or endocrine investigations of a child at the request of a medical practitioner.
Landmark cases in many countries involving significant media coverage of child abuse cases and child deaths have resulted in government reports and recommendations. All these reports are unified in their conclusions. The needs of the child are paramount, all adults who work with children have a responsibility to safeguard children, and communication between all the agencies involved in child protection is poor and must be improved. Child protection has been likened to a jig-saw. The full picture about what may be happening to a child will not be visible unless all the small pieces of information from different sources are put together.
Pediatric dentists should seek to work with all the other agencies actively involved in child protection, namely pediatrics, children's (social) services and the police. We should also take the lead in building local referral pathways and protocols to ensure that local dental practitioners are given help and support in child protection matters. Only when these pathways have been established and there is understanding from nondental colleagues about oral and dental health, will we be in a position to address the huge problem of dental neglect.
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Richard Welbury
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