Childsafe guarding and protection Flashcards

1
Q

What does the GDC expect of dentists to be aware of

A

The procedures involved in raising concerns about the possible abuse or neglect in children and vunerable adults

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2
Q

What do dental proffesionals have the responsibility of

A

To raise concerns about the possible abuse neglect of children or vunerable adults andto know who to contact for further advice and how to refer to an appropriate authority

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3
Q

What is Child Protection

A

Activity undertaken to protect specific children who are suffering, or are at risk of suffering, significant harm

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4
Q

What is included in the term ‘safe guarding children’

A

protecting children from maltreatment

preventing impairment of children’s health or development

ensuring that children are growing up in a safe and caring environment

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5
Q

What is meant by childhood abuse or neglect

A

Anything which those entrusted with the care of children do, or fail to do, which damages their prospects of safe and healthy development into adulthood

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6
Q

What 3 elements must be present in the definiton of child abuse

A

Significant harm to child

Carer has some responsibility for that harm

Significant connection between carer’s responsibility for child and harm to child

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7
Q

In scotland what 3 papers are there in regards to child protection

A

National Guidance for Child Protection in Scotland 2014.

Scottish Government
Children and Young Peoples Act 2014

Getting It Right for Every Child (GIRFEC)

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8
Q

What are the righrs of kids

A

The right to respect

The right to information about yourself

The right to be protected from harm

The right to have a say in your life

The right to a good start in life

The right to be and feel secure

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9
Q

What are the 4 aetiology contributing factors of child abuse and give some examples

A

Adult: drugs, alcohol, poverty, unemployment, marital stress, mental illness, disabled, domestic violence, abused as a child,

Child: crying, soiling, disability, unwanted pregnancy (born at wrong time), failed expectations

Community/ environmental: Dwelling place and housing conditions, Neighbourhood

Family violence and dysfunctional family: Intergenerational cycle, Violence toward pets, Social isolation, Poverty

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10
Q

Wha are the 3 concerns of parenting capacity

A

Domestic violence

Drug and alcohol misuse

Menatl health problems

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11
Q

Data suggests what is the volume of children experiencing severe maltreatment

A

1 in 5

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12
Q

What are the categories of child abuse

A

physcial

emotional

neglect

sexual

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13
Q

What are classed as vunerable children

A

Under 5’s

Irregular attenders
-repeatedly DNA, return in pain, exposed to risks of GA

Medical problems and disabilities
-more at risk of experiencing abuse of all kinds
-serious impairment of health or development is more likely as a result of untreated dental disease

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14
Q

In the UK how many children die per week

A

1-2

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15
Q

In scotland how mant children die each year

A

10

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16
Q

In the markers for general neglect what are the child needs

A

Nutrition

Warmth clothing and shelter

Hygiene and health care

Stimulation and education

Affection

17
Q

In the markers for general neglect what are the effects of neglect

A

Failure to thrive/ short stature

Inappropriate clothing (cold injury sun burn)

Ingrained dirt, head lice, dental caries, developmental delay

Withdrawm or attention seeking behaviour

18
Q

What can be the short and long term damage of neglect

A

Short Term:
-Physical health
-Emotional health
-Social development
-Cognitive development

Long term Adults neglected as children-higher incidence of:
-Arrest
-Suicide attempts
-Major depression
-Diabetes
-Heart disease

19
Q

What is the British Society of Paediatric Dentistry 2009
definition of neglect

A

The persistent failure to meet a child’s basic oral health needs, likely to result in the serious impairment of a child’s oral or general health or development
-British Society of Paediatric Dentistry 2009

20
Q

What is dental wilful neglect

A

After dental problems have been pointed out:

-Irregular attendance, repeated failed appointments, repaeated late cancellations
-Failure to complete treatment
-Returning in pain at repeated intervals
-Repeated GA for dental extractions

21
Q

What are indicators of dental neglect

A

Obvious dental disease

Impact on the child (pain/ unable to eat or sleep)

Practical care has been offered, yet the child has not returned for treatment

22
Q

How do you manage dental neglect

A

3 stages

-Preventive dental team management
-Preventive multi-agency management
-Child protection referral

23
Q

What is stage 1 in managing dental neglect and what do you do

A

Preventive dental team management:

raise concerns with parents

offer support

set targets

keep records that you raised concerns and what the targets are and that you have offered appoitments in a awwy that suits the patients

monitor progress

24
Q

What is stage 2 in managing dental neglect and what do you do

A

Preventive multi-agency management:

When first stage doesnt work the patient doesnt come back

liaise with other professionals (e.g. health visitor) to see if concerns are shared for the child

A child may be the subject of a CAF (Common Assessment Framework) at this level.

Check if child is subject to a child protection plan (which replaced the child protection register)

Agree joint plan of action at agreed intervals

Letter to HV of children < 5 who fail appointments and have failed to respond to letter from dental practice

-“If this family is known to you, we would welcome working together to promote their oral health.”

25
Q

What is stage 3 in managing dental neglect and what happens

A

Child Protection Referral:

In complex or deteriorating situations

Follow local guidelines

Referral is to social services

26
Q

What proportion of serious head injuries in the first year of life are non-accidental

A

95%

27
Q

What proportion of injuries in abuse cases are found on the head and neck areas

A

60

28
Q

What are oro facial signs of abuse

A

Extraoral:

-Bruising of face - punch, slap, pinch
-Bruising of ears - pinch, pull
-Abrasions and lacerations
-Burns and bites
-Neck - choke or cord marks
-Eye injuries
-Hair pulling
-Fractures

Intraoral:

-Contusions
-Bruises
-Abrasions and lacerations
-Burns
-Tooth trauma
-Frenal injuries

29
Q

What are major clinical features of physical abuse

A

Skin lesions (Bruises, burns, bites, lacerations)

Bone lesions (fractures)

Intracranial lesions (From shaking)

Visceral lesions

30
Q

What is in the index of suspicion

A

Delay in seeking help

Story vague, lacking in detail, vary with each telling and person to person

Account not compatible with injury

Parents mood abnormal.

Preoccupied.

Parents behaviour gives cause for concern

Child’s appearance and interaction with parents is abnormal

Child may say something contradictory

History of previous injury

History of violence within the family

31
Q

What are the final checklist questions for physical abuse

A

Could the injury have been caused accidentally and if so how

Does the explanation for the injury fit the age and the clinical findings

If the explanation is consistent with the injury, is this itself within normally acceptable limits of behaviour

If there has been delay in seeking advice, are there good reasons for this

32
Q

What are the final checklist observations for physical abuse

A

The general demeanour of the child

The nature of the relationship between guardian and child

The child’s reactions to other people

The reaction of the child to any medical or dental examination

Any comments by the child and or guardian that give concern about the child’s upbringing or lifestyle

33
Q

What is expected of the dental team in possible neglect

A

Observe
Record
Communicate
Refer for assessment

NOT expected to diagnose

34
Q

How can a dental team help in possible neglect

A

Share concerns- Named Person

Know where to go for help and advice:
-Experienced colleague
-Named Safeguarding Nurse
-Child Protection Adviser
-Named Doctor for safeguarding
-Social work / social services(e.g Social care direct)
-Children’s Services -Department (e.g First Contact)
-NSPCC Helpline 0808 800 5000

35
Q

How do you refer/share concerns

A

By telephone initially, follow up in writing

Facts

Statement of concerns