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The mouth and maltreatment: safeguarding issues in child dental health
  1. Jenny C Harris1,2
  1. 1Charles Clifford Dental Services, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
  2. 2School of Clinical Dentistry, University of Sheffield, Sheffield, UK
  1. Correspondence to Jenny C Harris, Community & Special Care Dentistry, Firth Park Clinic, North Quadrant, Sheffield S5 6NU, UK; jenny.harris{at}

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From the first cry of a newborn baby, the first smile, first tooth, first word, the mouth plays a key role in children’s health and development. It benefits from a whole team of dental health professionals dedicated to maintenance of its essential and lifelong functions in communication and feeding. Sometimes the mouth becomes the focus of abuse or neglect. In the context of safeguarding and promoting welfare, both dental health and dental care are recognised as notable aspects of children’s needs.1 2 Nevertheless, it is uncommon for paediatricians and dental professionals to work sufficiently closely together to ensure that oral health is fully included in multiagency assessment and planning for children experiencing maltreatment.

The aim of this article is to outline the scope of safeguarding issues in child dental health. It will consider the interpretation of oral findings as indicators of maltreatment, discuss the arguably underused contribution that dental professionals can make to child protection and will explore the potential for enhancing working together with paediatricians. The intention is to stimulate discussion and debate.

Oral signs of child maltreatment

Examination of the mouth ‘should be part of every child protection assessment that the paediatrician undertakes’.3 Anything less should be recognised as an incomplete examination of the child. However, it is acknowledged that doctors may not recognise oral signs of maltreatment as readily as those affecting other parts of the body.4 5 If there is obvious dental decay or other pathology, the child should be referred for a dental opinion.3 While dental decay (caries) as a potential indicator of neglect is the most obvious sign, signs of physical abuse, sexual abuse and conditions associated with emotional harm may all be observed in the oral cavity.

Dental caries and dental neglect

Dental caries is one of the most common diseases of childhood both in the UK …

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