Sir, we write in response to Dr Hussain's letter (BDJ 2006; 200: 540) which highlights the challenges of acting in the best interests of children when we have concerns about their possible abuse and neglect. We write as a team comprised of dentist, dental nurse, receptionist and dental health educator, with very recent experience of a similar case which may offer some encouragement.

A 10-year-old boy was referred to our salaried service by his GDP for restoration of carious teeth and two fractured incisors, traumatised on separate occasions some months previously. He gave an adequate accidental explanation for the injuries, confirmed by his mother. He had presented for treatment at the time of injury but had been anxious and unable to cooperate.

When scheduling the next appointment our receptionist noted a strong smell of alcohol as his mother handed over her appointment card at arm's reach. At subsequent appointments with both the dentist and dental health educator the same was noted. On each occasion we were careful to observe that his mother appeared sober and that the family were travelling home by taxi, not driving. There were no other features of concern – the boy was clean, appropriately dressed, oral hygiene had improved following instruction and there appeared to be a warm supportive parent-child interaction which contributed to his rapid acclimatisation to dental treatment.

We were aware of recent policy changes, particularly in response to the Victoria Climbié Inquiry,1 which encourage health professionals to intervene early to promote the welfare of vulnerable children.2 Advice was obtained by telephone from our local child protection nurse adviser. It was agreed that these findings did not indicate immediate referral to social services. However, we were advised that parental alcohol abuse would have an impact on the child's welfare and we should raise the issue with his mother and encourage her to seek help from her own general medical practitioner or the child's school nurse. The dentist did so at the next visit, accompanied in surgery by the dental nurse, while the child received toothbrushing instruction with the dental health educator in an adjacent room. It was a daunting task but our fears proved unfounded. His mother was embarrassed and tearful but neither angry nor aggressive. She readily admitted her problem. She agreed to see her doctor and to allow us to phone him and share information. We all tried to communicate with empathy and to make it clear that we welcomed the family to return. They have done so on three further occasions. At the last two visits she looked well and, for the first time, did not smell of alcohol. We dare to hope that perhaps this conversation may have been a turning point for this particular family. Perhaps colleagues will be somewhat reassured by our experience that such action need not inevitably lead to conflict.

Your readers will be aware from articles in recent editions of the journal that further information on child protection is now available specifically for the dental team as an open access website www.cpdt.org.uk and in a handbook sent to NHS practices in England and Scotland.3 This includes advice on how to contact local advisers and access training.