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Summer 2008 Patients | Kids First Parental neglect Recognizing and responding to the signs that a child needs help.
It is a pleasure to come to work when some of our favorite patients are in on the schedule. They are reliable and we can count on them to show up for their appointments. They’re rarely ever late, and they trust us to make treatment recommendations. What could be better? Our schedule also may include patients who choose only to come in every one to three years, or when they are in pain. Some may go so far as to transfer that habit to their child’s appointments. While this happens for a variety of reasons, the likely result in any case is that children experience a lot of unnecessary pain. Don’t Judge, Acknowledge It can be difficult to understand why some children are left with a growing infection in their mouths. It is important, however, not to judge the situation too quickly,because
as there may be deeper issues—emotional and otherwise—not apparent to us. For example, a scenario we often see in my office is a child whose parents are separated and the financial responsibility falls on a single parent or grandparent who is unable to pay for treatment. Many offices expect payment at time of service, so when dealing with questionable parental care, it is best to start by trying to determine if money is the reason why the child’s dental treatment was is not completed; perhaps financial arrangements can be made. If the guardian prefers, he or she can be referred to a more affordable facility. The important thing is that the parents be educated regarding available resources and that the child’s needs are being met. Is it neglect?
Are untreated cavities the same thing as dental neglect? The American Academy of Pediatric Dentistry (AAPD) has defined dental neglect as, “willful failure of a parent or guardian to seek and follow through with treatment necessary to ensure a level of oral health essential for adequate function and freedom from pain and infection.” Negligence is present and intervention is necessary when a parent fails to take action after being fully informed about the extent of the disease and the specific treatment required to bring the child to health. How can you tell if a parent decides not to complete the treatment with your office? He or she... * Repeatedly breaks appointments * Fails to follow through on an accepted treatment plan * Stops payments to your office * Allows months to pass since the initial exam Michelle Riggio, RDH, who practices dental hygiene in Westchester, N.Y., understands it as her responsibility to follow a child’s treatment from the time he or she enters the office until the time the child leaves, making sure no one falls through the cracks. Her goal is to help children achieve excellent dental oral health. Occasionally, there is a child who startbegins restorative treatment but does not complete it, and Michelle will try to find outdetermine the reason for the incomplete treatment. Optimistically, she will attempt to contact the parent or guardian. If she is unable to reach them after several months, she will send out a certified letter making them aware of the child’s condition, and that the office has attempted to schedule treatment without success. When the parent or guardian receives this letter, it must be signed for, as it is a legally binding protective document. A copy of the letter is sent to the child’s pediatrician, asking for support and to make them aware that the patient has not completed treatment and has cavities. The pediatrician will follow up at the next physical exam. Parents need to understand why treatment is needed, and it is a great idea to provide it to them in written form. Sometimes, when they reach the front desk to make financial arrangements, all those careful explanations can be easily forgotten in the distraction of financial concerns.
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