Safeguarding is an essential element of continuous professional development for a dental team. Your safeguarding training should be updated periodically to ensure you have the correct knowledge to deal with any incident that might occur in your workplace.

It goes without saying that keeping children safe should be of paramount importance to everyone regardless of their role, but when it is your professional responsibility to know exactly how to help an individual in need, extra care should be taken to learn the signs that something isn't quite right.

Noticing the Signs

Credit: ©mrs/Moment/Getty Images Plus

There are countless signs of abuse and neglect—some of these are easily noticeable, whereas others are more hidden. For example, it is easy to connect the dots if a child comes into your dental practice with adult handprint-shaped bruises on their upper arms, but it is less easy to recognise a child's quiet, withdrawn nature as a sign of abuse.

Similarly, there are many signs of abuse that may turn out to be perfectly innocent. For example, a child learning to ride their bike might catch their ankles on the frame or fall off and graze their knee. This is a perfectly normal part of childhood development, and indeed, even as adults we all occasionally injure ourselves. Likewise, many individuals are naturally shy and may come across as nervous or frightened, but this may not necessarily have been caused by abuse.

For this reason, it is always best to ask a child or vulnerable adult how they got their injury, or how they are feeling, if you suspect abuse may have happened. Then use your own initiative and all the other information you have available to reach a conclusion about whether or not there is cause for concern.

As a dental professional, you will already know that there are different types of abuse. Below are some of the warning signs to look out for in the children and vulnerable adults who visit your dental practice.

Sexual Abuse

Some children and adults at risk of harm are sexually abused from a very young age, and consequently, they may not understand that it's wrong until they are much older. By this point, it may be difficult for them to disclose their history of abuse due to feelings of shame, guilt, fear, or the threat of further harm.

The majority of sexual abuse cases in the United Kingdom are carried out by someone the victim knows well. The perpetrator may be a family member, a close friend, or another person in a position of trust. Adults and children, male and female, can be a perpetrator or a victim of sexual abuse.

Some of the signs of sexual abuse that you might notice in the individuals attending your dental practice include (but are not limited to):

  • A fear of medical examinations

  • Excessively affectionate or sexual behaviour towards others

  • Changes in mood or sudden withdrawal from activities

  • A detailed sexual knowledge inappropriate to the age of the individual

  • Sexually explicit language or behaviour

  • Older boyfriends or girlfriends, or relationships where there is a difference in power.

Neglect

Neglect can develop quickly or over a period of time. It may not always be immediately obvious as everyone has different standards of living. There are a variety of reasons why, and situations in which neglect may occur.

Long-term, sustained neglect is damaging emotionally, socially, and educationally, and it is likely to cause far more developmental delays and medical impairments than any other form of abuse. Some of the signs that an individual is being neglected include (but are not limited to):

  • Poor hygiene

  • Frequent accidental injuries and illnesses

  • Constant hunger and/or tiredness, malnutrition, stealing food

  • Parent or caregiver appears stressed and unable to cope

  • Developmental delays

  • Parent or caregiver treats them differently.

Physical Abuse

It is important to keep in mind that injuries can happen to anybody at any time for perfectly innocent reasons, and this is especially the case for young children and older children who enjoy being outdoors and playing sports.

Certain locations on the body are more likely to sustain accidental injury. These include the knees, elbows, shins, and forehead. However, protected body parts such as the back, thighs, genital area, buttocks, backs of legs, and face, are more common as the sites of non-accidental injury (physical abuse).

Some of the signs an individual may have been a victim of physical abuse include (but are not limited to):

  • Damage to the mouth such as burnt, bruised, or cut lips

  • Torn or bruised skin where the upper lip joins the mouth

  • Fractured incisors

  • Injuries at different stages of healing

  • Object marks, clear outlines of objects

  • An inconsistent explanation of how the injury happened.

Update Your Training

For a full overview of the signs of abuse and neglect, we recommend our Introduction to Adult/Child Protection online training course. Recommended by the British Dental Association and recognised by the General Dental Council as 3 hours of verifiable CPD, you can have an up to date safeguarding certificate in 1 to 2 hours, and a full breadth of knowledge to help you recognise the signs of child abuse in children who might be visiting your dental practice.

Anyone who works in a clinical capacity, or who takes on extra responsibilities with children in your dental team will also benefit from taking our Further Adult/Child Protection online training course. This expands on the knowledge gained in our Introduction course and gives you all the knowledge you need to handle concerns and referrals effectively.

For more information: Please visit www.childprotectioncompany.com or call 01327 552030.

Alternatively, the Child Protection and the Dental Team resource is hosted by the BDA and provides free CPD to members and non-members: https://bda.org/childprotection

Coming soon: An article by Jenny Harris, a consultant in community paediatric dentistry and project lead for Child Protection and the Dental Team, who will give an insight into dental neglect.