Professional Documents
Culture Documents
Weeblyhandout - Mrs Harrell
Weeblyhandout - Mrs Harrell
Weeblyhandout - Mrs Harrell
DOMESTIC VIOLENCE
Abuse by one individual of another in an intimate or family relationship
MOST AT RISK
Abuse of women: spousal and dating violence
Categorized: violence, emotional abuse, sexual abuse, neglect, or financial exploitation.
DETECTING ABUSE
Can be seen in initial assessment of patient
Extra/intraoral exam
Head and facial injuries
Oral trauma
Lesions
Abnormal pathology
CHILD MALTREATMENT
And act or series of acts of abuse and neglect by parent or other care giver that results in harm,
potential for harm, or threat of harm to a child under the age of 18.
Abuse: non-accidental, physical, emotional, or sexual acts against a child
Neglect: the intentional or un-intentional failure to provide for a child’s basic physical,
emotional, educational, and medical/dental needs.
Dental Neglect: the willful failure of a parent or guardian to seek and follow through with
treatment necessary to ensure a level of oral health essential for adequate function and
freedom from pain and infection
General signs of abuse and neglect:
RED FLAGS
Condyloma acuminatum- focal sessile based lesion presents also as a multiple papillary lesion.
When present it is necessary to look for other signs of sexual abuse because it can also occur
from contact with verruca vulgaris or from self-inoculation
Primary herpetic gingivostomatitis- can occur as a primary infection of herpes simplex virus type
2. (genital infection transmitted through oral sex)
PARENTAL ATTITUDES
General attitudes
Disinterest or denial in relationship to child: critical, scolding, and belittling
Lack of interest or unavailability in treatment plan: only want pain relief, may not be the same
for the other children of the family, doesn’t show up for appointments- may send sibling instead
Inconsistent information regarding signs of abuse
Reasons for Abuse and Neglect
REPORTING MALTREATMENT
Discuss findings:
The decision is made by the dental team whether or not the suspicion of abuse should be
discussed with the caregiver
The professional should never directly accuse anyone and refrain from being judgmental
The legal obligation to report a suspected case of abuse can be explained
Proper Training:
The dental team should have training in the recognition and reporting of abuse and neglect
Abusers may avoid the same physician but return to the same dentist
Many states require CE courses on abuse and neglect before licensure and re-licensure
“Prevent Abuse and Neglect through Dental Awareness (PANDA) – program for training dental
personnel
o Founded in 1992
o Missouri Bureau of Dental Health and Delta Dental of Missouri
o Public-private partnership committed to the education of all dental professionals in the
recognition and reporting of suspected cases of child abuse and neglect
“Ask, Validate, Document, Refer (AVDR) Tutorial for Dentists” – interactive tutorial program the
uses a case study to demonstrate the four step process in response to domestic violence
o Asking the patient about the abuse
o Validating messages that acknowledge battering is wrong
o Documenting the signs, symptoms, and disclosures
o Referring victims to specialists and community resources
Project RADAR seeks to enable healthcare providers to recognize and respond to IPV (intimate
partner violence) by providing them access to
o “Best Practices” policies, guidelines, and assessment tools
o Training programs and specialty-specific curricula
o Awareness and educational materials
o Information on the latest research/data related to IPV
Routinely inquire about current and past violence
Ask direct questions
Document findings
Assess safety
Review options and referrals
Reporting Laws:
Varies state-to-state
o Each state has laws regarding the reporting of abuse and neglect to the proper authorities
o It is imperative to research the laws for the state and have them available for reference
in the office
o Each dental practice needs a written protocol for the documentation and reporting of
abuse and neglect
Reportable Required Information:
All states mandate healthcare workers to report suspected violence, abuse, and neglect of
children to CPS agencies
When reporting suspected abuse:
o Name and address of the child and parents or persons with legal custody
o Child’s age
o Names of siblings if there are any
o Nature of the child’s condition, including evidence of pervious injuries
o Any information that might be helpful in establishing the case of abuse or neglect
o Identity of the person believed to have caused such abuse or neglect
Most states require healthcare workers to report suspected abuse
Only a few states require healthcare workers to report IPV
FORENSIC DENTISTRY
Dental science that relates and applies dental facts to legal problems
o Forensic dentistry encompasses:
Dental identification
Malpractice litigation
Legislation
Peer review
Dental licensure
DOCUMENTATION
True/False