Creating State or Regional Dental Registries to Identify Pediatric Dental Abuse or Neglect
Journal Title: Biomedical Journal of Scientific & Technical Research (BJSTR) - Year 2017, Vol 1, Issue 5
Abstract
In 1967, the American Dental Association published an editorial noting dentists’ infrequent reporting of cases involving child abuse. Subsequently, the ADA adopted the Principles of Ethics and Code of Professional Conduct along with an official policy addressing child abuse [1,2]. Our current child welfare services, including services for dental neglect and abuse, has a genesis dating back to the 1960s following the publication of “The Battered Child Syndrome” by Dr. Henry Kempe and colleagues and which focused primarily on physical abuse, and subsequently on sexual abuse [3]. Because the evolutionary development of legal responses to pediatric dental abuse and neglect has never been a primary focus of legislatures [4], the recognition by dental professionals of their role as mandatory reporters has been somewhat slower than recognition by other health care professionals serving the medical needs of children [5]. Today, dental professionals are clearly recognized as mandatory reporters of oral injuries indicating possible child abuse or child neglect [6]. Dental neglect may occur when a parent or child’s main adult care provider has been properly alerted by a health care professional regarding the nature and extent of the child’s dental condition, the specific treatment needed, and the mechanism of accessing that treatment [7]. Dental neglect may manifest as cavities in baby teeth, “rotting teeth,” gum disease, gingivitis, failure to follow through with agreed-on treatment regimens, communication deficiencies or inability to speak, and lack of functionality due to complications from tooth decay, with tooth decay being the single most common— and preventable—chronic childhood disease [8]. According to the Child Abuse Prevention and Treatment Act of 1974, child abuse and neglect is defined as “at a minimum, any recent act or failure to act on the part of a parent or caretaker which results in death, serious physical or emotional harm, sexual abuse or exploitation; or an act or failure to act which presents an imminent risk of serious harm [9].” Michael Wald of Stanford Law School has noted that “[n]eglect and poverty have always been closely linked,” and although neglect has not substantially decreased in twenty years and served as a basis for child protection service interventions, researchers and practitioners have asserted for over 40 years that there is a “deep failure of policymakers to acknowledge the problems in ‘neglectful’ families, and take the steps necessary to meet the needs of their children—the ‘neglect of neglect [10]’” The issue to address is how to respond and attempt to prevent pediatric dental abuse and neglect? Pediatric dental abuse is often the easier condition for dental professionals to identify, but dental neglect is perhaps more problematic in many instances [11]. If a parent or caregiver obtains a dental treatment plan, but fails to follow through with the child’s treatment, how would the dentist be made aware in the event that the parent or caregiver simply does not bring the child back to the same dentist? Currently, there is no mechanism by which dentists might otherwise be made aware that the patient they are treating has previously been diagnosed and provided with a treatment plan that has been ignored or not complied with by the parent or caregiver. Noncompliance with children’s dental treatment plans may constitute acts of legal child neglect. Such a case triggers the mandatory reporting requirement imposed on dentists and dental care providers.
Authors and Affiliations
David R Katner JD
Keywords
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- EP ID EP578888
- DOI 10.26717/BJSTR.2017.01.000451
- Views 144
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