MARKERS OF NEGLECT:
The child’s needs Effects of neglect Nutrition Failure to thrive; short stature Warmth, clothing, shelter Inappropriate clothing; cold injury; sunburn Safe environment Frequent injuries e.g. burns/cuts from playing with matches/knives Hygiene and health-care Ingrained dirt (finger nails); headlice; dental caries Stimulation and education Developmental delay Affection Withdrawn or attention seeking behaviour
Dental neglect – wilful neglect? Severe dental disease may result from a parent or carer’s lack of knowledge of its causation or from difficulty implementing the dietary habits and oral hygiene measures they would wish to; for example, because of family stress or poverty. This cannot be equated with wilful neglect of a child. However, when the dental problems have been pointed out and appropriate and acceptable treatment offered, the following may be indicators that give concern:
• irregular attendance and repeatedly failed appointments
• failure to complete planned treatment
• returning in pain at repeated intervals
• requiring repeated general anaesthesia for dental extractions
Dental neglect – general neglect?
When assessing whether multiple carious teeth and poor oral hygiene are an indicator of general neglect, the dentist should focus on assessing the impact of dental disease on the individual child (Figure 2.15). Severe dental disease can cause:
• toothache
• disturbed sleep
• difficulty eating or change in food preferences
• absence from school and may put a child at risk of:
• being teased because of poor dental appearance
• needing repeated antibiotics
• repeated general anaesthetic extractions
• severe infection.
