Years ago, I attended an interesting seminar that focused on observing the child patient for signs of physical, psychological, or sexual abuse. Astute dental and medical professionals look for signs of trauma- cuts, bruising, swellings, a disquieted persona.
There exists a fine line between castigating a parent/ caregiver and being an adroit advocate for a child. Case in point: A young, single mother comes in with her 2 year old daughter (visiting the dentist for the 1st time*). it turns out that a television set fell on the child, knocking out three of her baby teeth on the bottom right side! I had to, somehow, take an x-ray to discern whether roots had broken off in the bone… After developing a plan of action, developing some levels of trust/ familiarity and taking additional records, I was able to, eventually, have a little partial denture cemented in the child’s mouth. It would be an additional 3- to 7 years before her permanent teeth would erupt and the prosthesis would provide esthetics and also keep the space available for the interrupted permanent teeth; avoiding future surgical and orthodontic interventions. Recently, I received a report of an unfortunate incident between the same mother and her child undergoing a temper tantrum at a nearby mall. The mother, severely agitated, screamed, grabbed the child by the neck and threw her into the wall! Upon hearing this, I wondered, “ If this behavior can happen in public, I shudder to think what might be happening at home.” The child needs an advocate. I am still contemplating Child Protective Services, but am awaiting more information from the person who witnessed that unfortunate experience.
Another form of child abuse that one does not readily consider is dental neglect. Sometimes, I see children for their first time, presenting with pain or an abscessed tooth. This is not the best scenario for a child’s first visit to the dentist. Often, the parent points the blame on the child (sneaking sweets), a spouse or grandparent for supplying ‘candy’. In my head, I’m shaking my head. It would be great if the mother’s physician or gynecologist would inform her of the need for an early risk assessment of the baby, once he or she develops their first tooth- around their first birthday.* Unfortunately, unknowledgeable parents don’t place dental care high enough on the totem pole. According to the American Academy of Pediatric Dentistry, tooth decay, one of the most common chronic infectious diseases among U.S. children, can result in pain, dysfunction, malnutrition, having a poor appearance, halitosis- factors that can have a lasting effect on a child’s scholastic performance, self-esteem and overall health.
Lawrence A. Dobrin, D
MD, a spokesperson for the Delta Dental of New Jersey P.A.N.D.A. Coalition (Prevent Abuse and Neglect through Dental Awareness), practicing dentist in Roselle Park and the Chief Forensic Dentist for New York City, has had experience identifying and reporting dental neglect through his work: https://www.deltadentalnj.com/company/panda.html “An adult in the presence of a child who is experiencing dental neglect might observe that the child’s teeth are rotted or grossly discolored. Also, the offending odor that comes from badly decayed teeth is quite noticeable,” explained Dr. Dobrin.
Additional signs of dental neglect that those caring for children can look out for include when a child is unable to eat normally; does not smile with his or her teeth; demonstrates changes in behavior, for example puts his or her hand in front of his or her mouth; or is in chronic pain. There are many social, economical, and even cultural reasons why neglect may happen in families. However, many times a parent or guardian may not realize that their child’s oral health is being neglected, or they simply may not understand the consequences.
“Parents cannot expect young children to properly take care of their teeth without guidance. Here again, I have to roll my eyes when the parent, proudly, announces that their 2 1/2 or 3 year old “brushes and floss their own teeth!” It is also a grave misconception of some parents that baby teeth will fall out, and therefore do not need to be taken care of,” said Dr. Dobrin. “Baby teeth have nerves in them and can get infected if badly decayed, just like adult teeth. In fact, these teeth hold the space for permanent teeth to erupt and can remain in the child’s mouth up until they are about 12 years old. Neglect can create serious oral and overall health problems for the child to deal with, well into adulthood.” The following is most unfortunate and unnecessary:
For more information on preventing problems like this, visit: http://www.teethforlife.co.za/news/12%20Bottle%20decay.htm
Proper nurturing appears to come naturally in the animal kingdom but for the most intelligent mammals on this planet, early education and compassion can go a long way. It is entirely conceivable that in today’s society, a child can grow into adulthood without experiencing problems with cavities or progressive gum disease. Babies don’t ask to come into this world, but once we have them, it is our charge to love them and keep them from harm.
Dr. Rodney O’Connor
L E O’Connor, DDS, PC
521 Beahan Rd., Rochester, NY 14624
www.droconnor.com
