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A difficult call

05 June 2020

Dr X saw two sisters, aged 8 and 10, for a routine examination. They attended with their mother who explained it had been some time since the family had attended a dentist. Both children had a number of carious lesions and the family was provided with preventive advice.

The mother, Mrs C, brought both children back for two more appointments. Treatment was carried out successfully on each occasion for both patients.       

At the third appointment only the eldest child was brought by her father, Mr C, who accompanied her into the surgery. He explained gruffly that the mother was “away”.

The actual treatment proceeded without any incident but Dr X felt that by contrast with the previous appointments, when the patient was relaxed, the child was very subdued and glanced nervously at her father who was watching her very intently.

Dr X felt uncomfortable with the atmosphere and the intimidating way the father interacted with the child. Dr X felt that the child was frightened, but not about the dental treatment. There was a gut feeling that something was not right.

After the appointment Dr X spoke with his dental nurse who shared his view of the father’s demeanour and the child’s reaction. The matter was then discussed with the safeguarding lead at the practice and after some consideration, advice on the situation was sought on an anonymous basis from the local child protection services, who suggested contacting the social service department to flag the concern. Dr X duly got in touch and provided his observations.

It later transpired that social services were already aware of child safety concerns in relation to the father from other sources and were already in contact with the family about other matters. This latest information fed into the bigger picture.

Although this meant the family obviously had some troubles, Dr X was at some level reassured that he had done the right thing in flagging his concerns as he had originally had reservations about escalating his misgivings for fear of creating trouble.

Some weeks later Dr X received a threatening letter from Mr C complaining that he had been treated unfairly and had been the subject of discrimination. Although he had not been told of Dr X’s input officially in his recent dealings with social services, he had surmised that Dr X must have “said something to stir things up” and he was going to seek legal advice. Dr X sought assistance from Dental Protection in dealing with the complaint.

Dr X and the practice had kept contemporaneous notes of the matter with details of the initial concern, the steps followed within the practice, including the internal discussion, and the decision to seek professional external advice. It was clear that the practice protocol had been followed. This enabled Dr X to demonstrate that the practice team had acted appropriately and in line with professional responsibilities rather than the situation being one where the father had been discriminated against.

With assistance from Dental Protection, Dr X provided a robust letter of response vindicating the approach taken by the practice and which included an explanation of the ethical duty on dental professionals to act if they have any concerns regarding child welfare and safety. There was nothing further heard from the father.

Learning points

The dental team often face instances involving safeguarding concerns. It is important to follow practice protocol and to document each step, including discussions and decisions.

Dental Protection is here to support and advise members who are facing what can be difficult situations. Always contact us for help and advice in these circumstances – we’re here to help you.    


These case studies are based on real events and provided here as guidance. They do not constitute legal advice but are published to help members better understand how they might deal with certain situations. This is just one of the many benefits Dental Protection members enjoy as part of their subscription. 
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