April is Child Abuse Prevention Month

By Maria Perno Goldie, RDH, MS
Child abuse is a painful topic for most of us to think about but for children who live in abusive households, that pain and fear is immeasurable. April is Child Abuse Prevention Month and I would like to focus on the role of the oral health professional in combating child abuse. This article will provide rationale and resources for recognizing and reporting child abuse.

Nearly 65 percent of all child abuse injuries involve injury to the head, neck or mouth, often putting oral health professionals in a prime position to notice abuse of patients. Lynn Mouden, DDS, MPH, Director of the Office of Oral Health, Arkansas Department of Health, has made child abuse prevention in the dental office his personal mission. He is the founder of the international P.A.N.D.A. (Prevent Abuse and Neglect Through Dental Awareness) program, which has empowered dental care professionals throughout the world to look for signs of abuse and take action when discovered. He has partnered with Oral Health America (OHA) and encourages the dental community to help protect America’s children.How can we help? By looking for signs of abuse on our patients. “For one, bilateral injuries to the face are automatic indicators of abuse,” said Dr. Mouden. “For example, it is extremely difficult for a person to fall down and hit both sides of their face.” Similarly, patterned injuries that indicate trauma from a hand or implement may also trigger further inquiry. “Dentists in every state and dental hygienists in most states are required by law to report suspected cases of child abuse and neglect, and elder abuse and neglect, to the proper authorities. P.A.N.D.A. programs in each state work make sure that providers in all areas know the correct reporting procedures and contact numbers for protective services agencies,” Dr. Mouden said.(1)

Oral health professionals are not required to prove abuse or neglect, but are required to report suspected abuse cases. The protective services agencies will determine whether abuse is present. According to Dr. Mouden, “ Above all, care providers should remember that nothing could be worse than suspecting abuse or neglect, not wanting to report or failing to report it, and having that patient become a fatality of further maltreatment.“(1)Child Abuse Statistics:(2)• A report of child abuse is made every ten seconds.• Almost five children die everyday as a result of child abuse. More than three out of four are under the age of 4.• It is estimated that between 60-85% of child fatalities due to maltreatment are not recorded as such on death certificates.• 90% of child sexual abuse victims know the perpetrator in some way; 68% are abused by family members.• Child abuse occurs at every socioeconomic level, across ethnic and cultural lines, within all religions and at all levels of education.

P.A.N.D.A.’s tagline is “Prevent Abuse and Neglect Through Dental Awareness.” “She’s not hiding, She’s hurting.” The P.A.N.D.A. program is designed to train dental professionals and other healthcare providers to recognize and respond to signs of abuse and neglect in their patients. The program has grown into various P.A.N.D.A. coalitions across 44 states and 7 countries. Dentists and dental hygienists are mandated to report suspected cases of child abuse and neglect. Individuals who commit abuse often avoid taking their victims to the same physician, but usually return to the same dental office. Dentists and dental hygienists are in a unique position to recognize signs of physical and sexual abuse that occur around the head and neck area.(3)

Childhelp is an organization that focuses on focuses on prevention, intervention and treatment of child abuse.(4) Since 1959, Sara O’Meara has provided leadership in humanitarian service to children throughout the world. As Childhelp Co-Founder, Mrs. O’Meara is actively involved in the development and oversight of the leading national nonprofit organization dedicated to helping victims of child abuse and neglect. The organization has put a national spotlight on the problem of child abuse in America and developed cutting-edge solutions.For professionals, there is the Childhelp National Child Abuse Hotline is dedicated to the prevention of child abuse.(5) Serving the United States, Canada, U.S. Virgin Islands, Puerto Rico, and Guam, the hotline is staffed 24 hours daily with professional crisis counselors who utilize a database of thousands of emergency, social service and support resources.* The hotline's services are available to professionals who need to report suspected abuse. This includes school nurses, teachers, counselors, psychologists, psychiatrists, pediatric dentists, fire investigators, and members of the faith community. All calls are anonymous and toll-free.The Childhelp hotline counselors can: discuss signs and symptoms of abuse with you; help you decide a course of action; prepare you as to what to expect when reporting child abuse; provide the number of the local reporting agency you should call (The Childhelp National Child Abuse Hotline is not a reporting agency); and recommend books if you would like to learn more about child abuse. Call 1-800-4-A-CHILD (1-800-422-4453), and then push 1 to talk to a hotline counselor. There is a resource available with valuable information on bonding with maltreated children and compassion fatigue.(6) For information on compassion fatigue, visit the Compassion Fatigue Awareness Project.(7,8)The site has numerous resources for caregivers working in many professions. The Compassion Fatigue Awareness Project also offers original training materials, workbooks, and texts through our parent organization, Healthy Caregiving LLC.If Not You, Who? If Not Now, When?References
1. Press Release OHA. APRIL IS CHILD ABUSE PREVENTION MONTH. Oral Health America Encourages the Dental Community to Watch Out for America’s Children. For Immediate Release, March 30, 2011. Contact: Melissa Hoebbel. 312.836.9900. [email protected].2. www.childhelp.org/pages/statistics.3. midatlanticpanda.org/html/provider_role.cfm. 4. www.childhelp.org/. 5. www.childhelp.org/pages/help-for-professionals. 6. childhelp.3cdn.net/e0797c5e54560b1962_bym6b9foq.pdf. 7. www.compassionfatigue.org/. 8. www.healthycaregiving.com.