Child Protection

Question 1

What is child protection?

Answer 1

Activity taken to protect specific children who are suffering, or at risk of suffering

Question 2

What is safeguarding children?

Answer 2

Minimising risk of harm to children

1. Protect children from maltreatment
2. Prevent impairment of childs health or development
3. Ensure child growing up safe and caring environment

Question 3

What laws are in place?

Answer 3

Children’s right
Article 19 - children should be protected from all forms of physical and mental abuse
Article 24 - children have right to health and facilities for tx

Question 4

What are the 5Rs that make good practice guidance?

Answer 4

1. Responsibility
2. Recognise
3. Respond
4. Reorganise
5. Resources

Question 5

How can dentists recognise abuse?

Answer 5

Skilled examining head of neck - frequently site of injury in physical abuse
Children should attend dentist regularity

Question 6

What may physical abuse involve?

Answer 6

Hitting, shaking, throwing, burning, suffocation, drowning or otherwise causing physical harm

Question 7

How to recognise physical abuse?

Answer 7

Bruising, abrasions, lacerations, burns, bite marks, bone fractures, IO injuries

Look for: size, shape, pattern
Delay in presentation
Doesn’t fit explanation given

Question 8

How to tell if accidental injury?

Answer 8

Involve bony prominence
Match history
In keeping w/ development of child

Question 9

How to tell if injury abusive?

Answer 9

Injuries both sides of body
Patterns to injury
Don't fit explanation
Delayed presentation
Untreated injuries
In triangle of safety

Question 10

What is triangle of safety?

Answer 10

Ears, side of face, neck and top of shoulders

Question 11

What pattern of bruising would make you suspicious?

Answer 11

Pinch marks, grip marks, slap marks, bite marks
In non-mobile infants
Large, multiple, clusters

Question 12

How to tell if burns (scalds and burns) accidental or abusive?

Answer 12

Accidental scald e.g spill injury - irregular edge
Intentional scald e.g immersion - glove pattern

Accidental burn - single/ palm hand
Intentional burn - multiple burns

Question 13

What could differential diagnosis of marks be?

Answer 13

Birth marks
Infection e.g impetigo
Unintentional injury
Bleeding disorder
Osteogeneisis imperfecta

Question 14

What oral injuries are seen in abuse?

Answer 14

Remember accidental oral injuries common
Lips common site in abuse
Any oral-injury in non-mobile children concern
Torn frenum could be sign

Question 15

What is definition of sexual abuse?

Answer 15

Forcing or enticing child or young person to take part in sexual activity

Question 16

How to recognise sexual abuse?

Answer 16

Direct allegations
Sexually transmitted disease
Infections
Pregnancy 
Emotional and behaviour signs - esp anxiety and depression

Question 17

What is definition of emotional abuse?

Answer 17

Persistant emotional maltreatment of child to cause severe and persistent adverse effect on childs emotional development

Question 18

How to recognise emotional abuse?

Answer 18

Poor growth - developmental delay
Social immaturity 
Aggression or over friendly
Attention difficulties
Concerning child-parent interaction

Question 19

What is neglect?

Answer 19

Persistent failure to meet childs basic physical and/or psychological needs

Question 20

What are the different types of neglect?

Answer 20

1. Physical - basic needs
2. Educational
3. Emotional
4. Medical

Question 21

What are the short and long term impact of neglect?

Answer 21

Short term: emotional health, social development, cognitive development, physical health

Long term: arrest, suicide attempt, depression

Question 22

What is dental neglect?

Answer 22

Persistent failure to meet childs basic oral health needs

Question 23

Features of concern for dental neglect?

Answer 23

Obvious dental disease
Impact on the child
Acceptable care has been offered

Toothache, crying, stopping playing, difficulty eating, absence school, repeats antibiotics, dental GA, lower body weight

Question 24

How should you respond if concerned?

Answer 24

Speak to experience colleagues
If still concerned seek action immediately
- Talk child and parent - express concern
-Inform of intention to refer - seek consent to share info (unless puts child immediate risk)

KEEP FULL CLINICAL RECORDS

Question 25

How can you refer to child service?

Answer 25

By telephone

Follow up in writing by 48hrs

Question 26

What agency can be involved?

Answer 26

Children social care/ services
Criminal justice
Health
Education