Hygiene Tribune U.S. Edition

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Edition Publisher & Chairman Torsten Oemus t.oemus@dental-tribune.com Chief Operating Officer Eric Seid e.seid@dental-tribune.com Group Editor & Designer Robin Goodman r.goodman@dental-tribune.com Editor in Chief Hygiene Tribune Angie Stone, RDH, BS a.stone@dental-tribune.com Managing Editor/Designer Implant, Endo & Lab Tribunes Sierra Rendon s.rendon@dental-tribune.com Managing Editor/Designer Ortho Tribune & Show Dailies Kristine Colker k.colker@dental-tribune.com Online Editor Fred Michmershuizen f.michmershuizen@dental-tribune. com Account Manager Mark Eisen m.eisen@dental-tribune.com Marketing Manager Anna Wlodarczyk a.wlodarczyk@dental-tribune.com Sales & Marketing Assistant Lorrie Young l.young@dental-tribune.com C.E. Manager Julia E. Wehkamp j.wehkamp@dental-tribune.com C.E. International Sales Manager Christiane Ferret c.ferret@dtstudyclub.com Dental Tribune America, LLC 116 West 23rd Street, Suite 500 New York, NY 10011 Tel.: (212) 244-7181 Fax: (212) 244-7185 Published by Dental Tribune America © 2011 Dental Tribune America, LLC All rights reserved. Hygiene Tribune strives to maintain utmost accuracy in its news and clinical reports. If you find a factual error or content that requires clarification, please contact Group Editor Robin Goodman at r.goodman@dental-tribune.com. Hygiene Tribune cannot assume responsibility for the validity of product claims or for typographical errors. The publisher also does not assume responsibility for product names or statements made by advertisers. Opinions expressed by authors are their own and may not reflect those of Dental Tribune America. Clinical HYGIENE TRIBUNE | April 20112D AD needs); emotional (e.g., inattention to a child’s emotional needs, failure to provide psychological care or permit- ting the child to use alcohol or other drugs). These situations do not always mean a child is neglected. Sometimes cultural values, standards of care in the community or poverty may be con- tributing factors, indicating the family is in need of information or assistance. When a family fails to use information and resources and the child’s health or safety is at risk, then child welfare intervention may be required. “Physical abuse” is physical inju- ry (ranging from minor bruises to severe fractures or death) as a result of punching, beating, kicking, biting, shaking, throwing, stabbing, choking, hitting (with a hand, stick, strap or other object), burning or otherwise harming a child. Such injury is con- sidered abuse regardless of whether the caretaker intended to hurt the child. “Sexual abuse” includes activities by a parent or caretaker such as fon- dling a child’s genitals, penetration, incest, rape, sodomy, indecent expo- sure and exploitation through pros- titution or the production of porno- graphic materials. “Emotional abuse” is a pattern of behavior that impairs a child’s emo- tional development or sense of self- worth. This may include constant criticism, threats or rejection, as well as withholding love, support or guid- ance. Emotional abuse is often dif- ficult to prove, and therefore child protective services may not be able to intervene without evidence of harm to the child. Emotional abuse is almost always present when other forms are identified. Individual states also have differ- ent reporting laws when it comes to child abuse and neglect. Currently, every state has immunity (individuals cannot be sued or held liable follow- ing a report) for mandated reporters, which are most health-care profes- sionals, including dental profession- als. Those states that do not have mandated reporting and penalties for health care professionals who fail to report are: Mississippi, North Carolina and Wyoming.4 One key to reporting child abuse and neglect is being able to recognize common indicators. A dental profes- sional may easily identify some of these physical and behavioral indica- tors during routine dental care. Den- tal professionals should establish an office protocol for identifying drug- endangered children. According to the Arkansas Office of Oral Health, there are four recommended steps in identifying a suspected case of child abuse or neglect. Those four steps include: • General physical assessment of the child. Although general physical examinations may not be appropriate in all settings, be aware of obvious physical traits that may indicate abuse or neglect (e.g., difficulty in walking or sitting, physical signs that may be consistent with the use of force). • Behavior assessment. Judge the child’s behavior against the demeanor and the elderly involve injuries to the head, neck and mouth, less than one percent of all reports of child mal- treatment are made by dental profes- sionals.2 Identifying the DEC It is important for the dental profes- sional to understand the legal respon- sibilities to identify and report sus- pected child abuse and neglect cases. Part of that understanding is learning the legal definitions associated with child abuse and neglect. Federal legislation provides a foundation for states by identifying a minimum set of acts or behaviors that define child abuse and neglect. The Federal Child Abuse Preven- tion and Treatment Act (CAPTA), as amended by the Keeping Children and Families Safe Act of 2003, defines child abuse and neglect as, at mini- mum: Any recent act or failure to act on the part of a parent or caretaker that results in death, serious physi- cal or emotional harm, sexual abuse or exploitation; or an act or failure to act that presents an imminent risk of serious harm. This definition of child abuse and neglect refers specifically to parents and other caregivers. A “child” under this definition generally means a per- son who is younger than 18 or who is not an emancipated minor. While CAPTA provides definitions for sexual abuse and the special cases related to withholding or failing to provide medically indicated treat- ment, it does not provide specific definitions for other types of maltreat- ment such as physical abuse, neglect or emotional abuse. While federal legislation sets minimum standards, each state is responsible for provid- ing its own definition of maltreatment within civil and criminal contexts. Within the minimum standards set by CAPTA, each state is respon- sible for providing its own definitions of child abuse and neglect. Gener- ally, most states recognize four major types of maltreatment: neglect, physi- cal abuse, sexual abuse and emo- tional abuse.3 According to the Child Welfare Information Gateway, the following definitions of major maltreatment are the generally recognized standard used by most states. “Neglect” is failure to provide for a child’s basic needs. Neglect may be: physical (e.g., failure to provide necessary food or shelter, or lack of appropriate supervision); medi- cal (e.g., failure to provide necessary medical or mental health treatment); educational (e.g., failure to educate a child or attend to special education f HT page 1D