I was pleasantly surprised to bump into my old friend Richard Welbury at the BDA conference 10 years ago, I hadn’t realised at the time what a milestone he and his colleagues were making. Richard was the first person I knew who shared the facts around oral signs of child abuse, his memorable talks produced a determination from everyone who heard them to do everything they could to ensure that children would stay safe. Their work is worth remembering and continues.
From The British Society of Paediatric Dentistry via Dentinal Tubules
A decade ago, dental neglect in children was a neglected issue. But this is no longer the case thanks to the guidance Child Protection and the Dental Team (CPDT) which was launched at the BDA conference in 2006 by the then Health Minister Rosie Winterton.
The document and its associated website (http://www.cpdt.org.uk/index.aspx) came about after Jenny Harris, a paediatric dentist in Rotherham, wrote to the Chief Dental Officer, Raman Bedi, to raise her concerns. This was in the aftermath of the death of Victoria Climbié in 2000 and Lord Laming’s Inquiry report in 2003.
Said Jenny: “I asked myself: If a child like Victoria walked into my surgery, would I recognize her. Would I know what to do and would I have done it? For months I checked the dental press but there was nothing new to educate us about child protection.”
Jenny had already set up a dental neglect working group in Rotherham. Her job was to define best practice so that children in her area would not slip through the net. But she still felt the dental profession needed expert national guidance.
After receiving her letter Professor Bedi met Jenny and invited her to chair an expert group to produce an educational resource. She was given a generous budget but just a year to complete the project.
The input of Jenny’s paediatric colleagues proved invaluable. She sent out a questionnaire (1) to BSPD members who were asked about their knowledge and experience of safeguarding as well as to share examples of good practice. This research is being repeated for the 10th anniversary to see how much has changed.
In the decade since its launch, CPDT has been highly influential. In 2008, a survey of GDPs (2) showed that dentists had taken on board the new guidance and it was influencing knowledge, training and policies in the practice.
And there has been extensive involvement with other bodies, both in and outside dentistry. Jenny has become:
• BSPD’s representative on the NSPCC’s Health Liaison Committee – she presented a paper on dental neglect in children as recently as September 2015
• A contributor to the development of a NICE clinical guideline: When to suspect child maltreatment
• Lead author of the first BSPD policy document on dental neglect in children
• Initiator of a working group bringing BSPD together with the Royal College of Paediatrics and Child Health (RCPCH), the NSPCC and the Advanced Life Support Group (ALSG) to adapt standardized child protection training – a recognition and response course – for the paediatric dentistry specialty trainees
The May anniversary is also an opportunity to celebrate the valuable contribution of the rest of the expert group: Professor Richard Welbury, an early champion of child protection in dentistry, Peter Sidebotham, a leading community paediatrician, Ranee Townsend, a CDS clinical director, Martyn Green, a dentist and vocational trainer in Devon, Janet Goodwin, a dental nurse representative and Chris Franklin, postgraduate Dean.
Now working as a community-based consultant in paediatric dentistry in Sheffield, hardly a week goes by without someone somewhere in the world contacting Jenny for information or advice and she helps where she can. Child protection and the dental team has already been translated into Croatian and Greek, with work on Spanish and Arabic versions now in the hands of enthusiastic teams of paediatric dentists.
Jenny believes there is still some way to go: “We have got better at recognizing signs of child maltreatment and at referring it but it does make a huge extra workload for clinicians and that hasn’t yet been recognized.” Jenny also believes the dental profession needs to have someone in every region who is identified as being responsible for safeguarding children leadership. Currently too much is down to the goodwill and enthusiasm of individuals.
Said Jenny: “I am grateful to BSPD Council for encouraging me to forge links and raise awareness of dental health among other professions involved in safeguarding. There is much more interest in children’s teeth than when we started a decade ago.”
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