2. What ‘harm’ can look like — children and adults

Children and young people

Harm includes physical, emotional and sexual abuse, and neglect. In a dental practice you might notice a child in unexplained pain, a story that does not fit, a parent who will not let you speak to an older child, or repeated missed appointments when the child is clearly unwell.

Adults at risk

An adult at risk (Care Act language in England) is someone who has care and support needs, is experiencing or at risk of abuse or neglect, and cannot protect themselves because of those needs. Harm includes physical, sexual, psychological, financial and organisational abuse, neglect, domestic abuse, modern slavery and self-neglect.

At the desk and in the waiting room

• A person who never speaks while a relative answers everything
• Bruising or a limp with a weak explanation
• Fear when a particular person arrives
• Someone who asks you not to tell anyone, then looks terrified
• Money, appointments or transport always controlled by someone else

Poverty is not abuse. One missed appointment is not neglect. You are looking at patterns, fear, and unmet need.

You do not need the perfect label

If something feels wrong, report it. The lead and children’s or adult social care decide what it is called.