Your role as a dentist includes a mandate by Colorado statute to report and document suspected cases of abuse and neglect in children and at-risk adults. Your obligation is not to prove abuse or neglect but to report what is suspected. As long as the report is made in good faith, you are immune from any criminal charges or a civil lawsuit for damages. Abuse and neglect can come in many forms and can affect people of all races, ethnicities, classes, sexual orientations, gender identities, religious affiliations, ages, immigration status and abilities.
- Vulnerable populations for maltreatment include children (up to age 18) and at-risk adults.
- At-risk adults include any person 70 years or older (at-risk elder) and any person who is 18 years or older with a developmental/physical disability.
Anyone can experience maltreatment, which is why dental professionals should know the signs and symptoms and know how to screen and potentially report suspected cases of maltreatment.
It is essential that you know the potential signs, symptoms and/or indications of abuse.
Signs, symptoms, or indications of abuse:
- oral and facial lesions;
- tearing of the labial frenum or mucosal lining of the lip from the gingiva;
- prematurely loosened, fractured or avulsed teeth;
- darkened and/or non-vital teeth; and
- jaw fractures or multiple scars about the head and neck.
Additional red flags to watch for when interacting with a patient include:
- multiple injuries, at once or over time;
- extraordinary delay in seeking treatment;
- an implausible explanation for the injury; and/or
- reluctance to discuss the circumstances of the injury.
The current expansion of teledental services provides an additional opportunity to access individuals who need healthcare, while they are maintaining social distancing orders. The signs and symptoms identified above are just as relevant to assess during a teledental visit as they are in person. You can ask your patient for an extraoral picture to be able to assess for facial or other head and neck injuries. Given the heightened risk that has been linked to social isolation, your role is key in keeping vulnerable adults and children safe.
Referral resources:
- If your patient is in a life-threatening situation regardless of age, call 911.
- If you suspect a child is being maltreated, immediately report abuse or neglect to 844-CO-4-KIDS (844-264-5437). Learn more at co4kids.org.
- If you suspect an at-risk adult is being maltreated, use this link to report abuse or neglect to Adult Protective Services (APS): https://bit.ly/2sJSvFF (use the correct intake number for the county where the at-risk adult lives).
- For more information, please review this flowchart on making a report.
Additional information:
- Online resources:
- About Mandatory Reporting, State of Colorado
- The Duty of a Dentist to Report, CDA
- Information on COVID-19 for Survivors, Communities, and DV/SA Programs
- Safety Planning (includes information for youth)
- Teledentistry Resources, Dentaquest
- Training resources:
- Interactive on-line training module
- CUES: An evidence-based intervention, National Health Resource Center on Domestic Violence
- Mid-Atlantic P.A.N.D.A: https://midatlanticpanda.org/
For more information, or to share additional needs related to your role as a mandatory reporter, please contact Ashleigh Kirk directly at ashleigh.kirk@state.co.us.