Emergency Med Medical News about Child protection

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Child protection: training and experiences of dental therapists
British Dental Journal , 07/28/09

Chadwick BL et al. – The majority of dental therapists have received training in child protection. Overall, 34% have suspected child abuse and 83% of these DTs recorded their suspicions in the patient record. In line with current guidance, most DTs would discuss a case with another dentist.

Exclusive Author Commentary
B. L. Chadwick, 07/29/09

Dental Therapists (DT) , like dentists work with children and are therefore well placed to identify possible child abuse. The importance of dental decay as a possible sign of neglect is confirmed by its inclusion in NICE guidance "When to suspect child maltreatment" this month. This questionnaire survey was sent to all DTs registered in the UK in October 2007 and 49% (N= 420) responded. Encouragingly over 83% recalled receiving training, far higher numbers than reported in previous surveys of dentists. A third of respondents had seen a case where they suspected child abuse and 83% of them recorded their suspicions in the patient record. Like dentists these workers were concerned about their ability to correctly diagnose child abuse and worried about the consequences of referral. For DTs, who work to a dentists treatment plan and who are not used to making a dental diagnosis this may be a particularly important issue. However, child protection guidance makes it quite clear that the threshold for referring a child to social services is “having concern” the practitioner is not need to be sure of the diagnosis before doing this. When faced with a possible case of child abuse almost half (48%) DTs would speak to the principle dentist, however, dentists are also reluctant to refer so it is likely that many suspected cases are not referred on to social services. Familiarity with guidelines and improved communication lines with other health professionals would facilitate better child protection practice. Undertaking child protection training in a mixed group of health care practitioners rather than only with other dental workers would go some way to breaking down some of these barriers. Mechanisms that encourage dental therapists and the dental team to report suspected child abuse are still required.

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