2. What maltreatment can look like in the chair

Physical

Head and neck injuries, burns, or a torn upper labial frenum in a child who is not walking yet — always ask whether the history fits age and mobility. Do not decide “it is definitely abuse” from one sign; do not ignore a cluster of signs.

Emotional

Persistent humiliation, a watchful child, or a parent who answers every question for a competent teenager.

Sexual

You will rarely see “the offence”. Take any disclosure seriously. Unusual sexualised behaviour or extreme refusal of examination is a reason to pause and speak to the lead — not a reason to force an exam.

Neglect and dental neglect

Persistent failure to meet oral health needs, with suffering, despite reasonable offers of help (appointments, explanation, support). One DNA is not neglect. Repeated untreated pain is different.

Fabricated or induced illness

Rare. Inconsistency between reported history and clinical findings, or repeated unexplained symptoms, should go to the lead — not a public accusation.

Parents’ health

Parental mental illness, substance use or domestic abuse can affect a child’s wellbeing. You are not treating the parent’s diagnosis; you are noticing impact on the child.