Two studies show how dentists fear young patients are being abused but they often don’t report it for fear of making a mistake, or because they don’t know who to report.
DUBAI // A quarter of UAE dentists surveyed said they suspected that some children brought in for check-ups were at risk of abuse but most failed to report cases over fears of wrongly accusing parents.
Like schoolteachers, dentists are well placed to identify a pattern of abusive behaviour because they are more likely to see children on a regular basis than doctors, according to safety experts.
They can also spot signs of deliberate injuries to the head and neck during check-ups.
Two studies completed in the UAE assessed the level of training dentists have in detecting child abuse, and their knowledge of how to report suspicions.
The College of Dental Medicine at the University of Sharjah distributed 350 questionnaires to dentists to gauge their recognition of child abuse.
Of the 193 who replied, 25 per cent held suspicions that young patients had been abused but only 32 per cent reported their suspicions.
Most feared a wrong diagnosis so did not report children at risk, and said there was a need for training to spot the warning signs.
Further research conducted by Dr Hind Al Hajeri, a paediatric dentistry at the Mohammed bin Rashid University of Medicine and Health Sciences in Dubai, found similar results.
Her study put several questions on child protection issues to 320 UAE dentists.
“I found there was little training in child protection,” Dr Hind said.
“While dentists from the UK had training, UAE dentists did not know who to contact if there were suspicions,” she said.
She called for training to be made mandatory for all health workers.
“Most dentists assumed legal guardians were responsible for reporting abuse, not everyone. Unclear diagnosis was the biggest problem, or not knowing who to contact.”
Postgraduate dentists in the UAE now get training in child-protection issues but it is not mandatory across all health sectors.
Experts want be a better understanding between accidental and deliberate injuries, and how to spot a pattern of abuse that can then be reported to take a child out of harm’s way.
“We ask parents for a child’s history. When that doesn’t match with the injury, we can diagnose abuse,” Dr Hind said.
“If we see a slap [mark] and the parent says the child fell, then it is something we would report. Our index of suspicion rises like a red flag.”
Dr Iyad Hussein, a UK specialist in paediatric dentistry at Hamdan bin Mohammed College of Dental Medicine, said an adequate support structure to protect children and a back-up new legislation could take years to develop.
“Child protection is a sensitive topic,” he said. “Many countries are catching up with legislation and the UAE is leading the region.
“Abuse is not just physical but mental, sexual or neglect. If there is physical abuse, 50 to 60 per cent of children have oral or facial signs that abuse has taken place.”
With the head being a common place to spot signs of abuse, dentists are well placed to detect any issues quickly.
If they see signs of bruising on the neck, it may suggest a non-accidental injury. Dentists should also look for patterns of bruising that may be unusual. When the parents’ story does not tally, they should ask questions.
“It can be hard to make a conclusive judgment,” Dr Hussein said. “It is a sensitive issue. We can’t assume the child has been abused. Training should happen at all levels.
“Dentists have a major role but they are one part of a bigger network that needs to be aware of the signs a child may be abused.”