While palpating the head and neck of a 9-year-old client, you notice them wince when you touch the base of their skull. Upon further examination, you see bruising along the back of the neck.
Should the RDH make a report?
One of the more common mandatory reports that RDHs may need to make is where they are treating a child and see bruising or lesions. While causes of bruising or lesions may be difficult to determine, the following should be considered:
- Does the bruise or lesion appear inconsistent with usual childhood activities?
- Can the child provide a reasonable explanation of how they sustained their injury?
- Does the manner of interaction between the child and their parent or guardian raise concerns, particularly if it adds to the explanation provided by the child?
- Do you believe that there is a risk to the child’s safety?
What should you do and not do?
| Do | Don’t |
|---|---|
| Make a routine habit of observing unusual behaviour and signs of abuse during the initial greeting. | Conduct a physical examination for bruising or lesions outside of the oral-facial region. This is outside the RDH’s Scope of Practice. |
| Use the extra- and intra- oral examination form to look for bruising and lesions that may appear inconsistent with childhood activities. | Investigate beyond the assessment phase of the Dental Hygiene process of care. |
| Ask the child and parent or guardian about the cause of any observed injuries. If possible, question each one separately. | Let an employer dissuade you from making a report where reasonable grounds exist. |
| Record the location, appearance, severity and distribution of injuries in the oral health record. | Confront or accuse the parent or guardian of abuse. |
| If these signs raise a reasonable suspicion of abuse, you must make a report to the local Children’s Aid Society. | Delegate the report – you must make the report if you suspect abuse. |
If you have a reasonable suspicion that a child is being abused and needs protection, a report must be made to the local children’s aid society. The Children’s Aid Society will investigate and/or determine future steps.
If you have any questions about mandatory reporting, please get in touch with us at advice@cdho.org or call 1-800-268-2346 (press 3).