Dental Tribune United Kingdom Edition

19Education TribuneSeptember 3-9, 2012United Kingdom Edition page 20DT Supported by Email info@smile-on.com Telephone 020 7400 89 89 19-21 Hatton Garden, Floor 4, Treasure House, London, EC1N 8BA children diagnosed with phys- ical abuse. Also be aware that accidental injuries typically involve bony prominences such as the nose, chin, knees etc, so document injuries seen on both sides of the body, on soft tissue and any history of similar or untreated injuries. Black eyes and injuries to the cheeks, intra-oral, ears and neck are also an indicator. Emotional – being made to feel worthless, unloved, bul- lied etc -Emotional abuse is often harder to recognise but signs include clingy or agitated be- haviour and distress when a parent or carer is not present, self harm, abuse of drugs and alcohol, delinquent behaviour and educational problems Sexual – Including the wit- nessing of sexual acts or por- nography etc - Signs of this abuse can in- clude erythema, physical damage to the mouth, ulcera- tion and vesicle formation arising from an STD, inap- propriate sexual behaviour or knowledge, anxiety or depres- sion, delayed development, or pregnancy Neglect – failure to provide adequate food, clothing, shel- ter, supervision, emotional neglect etc - Signs of this neglect can of- ten include failure to comply with professional advice, a child being under or mal- nourished, have inappropri- ate clothing for the weather, ingrained dirt or head lice, withdrawn or attention seek- ing behaviour. There is also the issue of dental neglect which includes severe caries, irregular dental attendance and missed appointments, failure to complete treatment plans and returning in pain at regular intervals In all these cases, you must be prepared to exercise your judgement - failure to pass on information that might pre- vent a tragedy could expose you to criticism. Your patient is the most important per- son, so don’t think ‘what if I’m wrong?’, but instead think ‘what if I’m right?’ Document- ing and reporting potential abuse is essential and you must follow your LSCB guide- lines. Sample child protec- tion referral flowcharts are also available from Denplan, which you can modify to fit with your local guidelines. You should also bear in mind that members of the dental team are not responsible for making a diagnosis of child abuse or neglect, just for shar- ing concerns appropriately. Vulnerable adults Vulnerable adults are at risk of all of the same abuse as children, but with the added risk of financial abuse too. A vulnerable adult is classified as someone “who is or may be in need of community care services by reason of mental or other disability, age or ill- ness; and who is or may be unable to take care of him or herself, or unable to protect him or herself against signifi- ‘Your patient is the most important person, so don’t think ‘what if I’m wrong?’, but in- stead think ‘what if I’m right?’ Abuse comes in many forms including physical