Making a stand

Have you ever been concerned by something you’ve seen between a child and their parent/carer in the waiting room? The vast majority of receptionists and other members of the dental team have seen the signs of child abuse or neglect but have been unsure about the best way to respond.

Firstly you need to be assured that yes, it is your place to act upon your concerns. We all hear news about appalling child abuse cases and wonder how many healthcare professionals had failed to act upon their concerns.

The dental profession has recently produced clear guidance and training on how to respond to such concerns by publishing Child Protection and the Dental Team, an introduction to safeguarding children in dental practice.

In addition to our responsibility as members of society to protect children from those who would harm them, as dental professionals we have an ethical responsibility to follow procedures for child protection as set out in the General Dental Council’s Standards for Guidance. This is not just up to the dentist, but all team members.

Some forms of child abuse are clear cut and so obvious that people simply cannot stand by and ignore them. However, other cases are complex and covert, making it difficult for casual observers to convince themselves there’s real cause for concern.

To make a decision on whether to act in individual cases, we need a clear definition of abuse. The DoH’s Working Together to Safeguard Children paper defines child abuse in the following categories: physical abuse, emotional abuse, sexual abuse or neglect.

So what should you do if you have concerns? Remember your first duty is to the child. If you are faced with a child who may have been abused, you will not have to manage this on your own if your practice has a child protection policy. Very few practices have such a policy but now is the time to ask the practice management for guidance.

Your policy will define actions and determine decisions based upon a statement affirming the practice’s commitment to protecting children from harm. It should go on to explain how this will be achieved. This will include assessing the child, discussing concerns with experienced colleagues within the practice and outside colleagues such as child protection nurses, paediatricians or GPs.

If, after speaking to others, there is still cause for concern, immediate action is needed. In the first place this will involve talking with the child and parent about your concerns. Although this will not be easy, it could well enable the family to get the help they desperately need.

Inform them of your intention to refer and seek their consent to share information. It is rare that this will place the child or others at increased immediate risk. If permission is refused, discuss this with your defence organisation and managers.

As part of the Working Together to Safeguard Children initiative, the Child Protection and the Dental Team handbook was launched earlier this summer. Copies will be going out to every dental practice in the UK to help professionals recognise the features of child abuse and provide simple, practical measures to incorporate into everyday working life.

You can download a copy of both papers from www.dh.gov.uk/dental.

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