Reporting

If you have reason to believe a child has been abused or neglected, you are legally obligated to report your concern to your local child protection agency and/or local law enforcement. As health care professionals, dentists and their staff are mandated reporters. All states have some type of mandatory reporting statute. In some states, reporting laws only apply to professionals, but in other states, reporting laws apply universally to anyone who suspects child maltreatment, including professionals.⁴

• States have different requirements regarding procedures, forms, and timing for making reports of suspected child maltreatment; consequently, all dentists should be familiar with their own state’s statutes on mandatory reporting; however, in general:^5,25,26

  • The duty to report is activated by “reasonable cause to suspect” or reasonable cause to believe” that a child has been maltreated.

  • If there is reasonable cause to believe the child is at imminent risk of harm, call 911 for emergency law enforcement assistance.

  • In all other cases, the verbal report should be made within 24 hours to maximize the ability of child protection and law enforcement to investigate and keep the child safe (state statutes may differ on the timing requirements).

  • A written report documenting the assessment and treatment recommendations should be made within 48-72 hours (state statutes may differ on the timing requirements).

  • The identity of the reporter is confidential; however, mandated reporters should be aware that they could be subpoenaed to testify about their observations if the case goes to trial, but not the fact that they made a report.

  • A person who makes a good faith report is immune from criminal and/or civil liability.

  • The report triggers an investigation; it does not mean that the child will be taken out of the home immediately. Any out-of-home placement and/or services offered to the family will depend on the outcome of the investigation.

  • Failure to make a mandated report can have implications for professional licensure.

  • Failure to make a mandated report can be a criminal offense.

  Figure 9.

  

  Figure 9.

  Multiple injuries on child abuse victim. The injuries on the face would be readily seen by a dental health care professional. Closer examination of the child may have noted the injuries on the arm and axilla.

• The initial verbal report to authorities should include the following information:^25,26

  • The nature and extent of the suspected maltreatment, including all relevant details from your examination, observations, and any conversations with the child and the caregiver.

  • Identifying information for the child and the person believed to be responsible for the maltreatment if that information is available to you, including birth dates and addresses available to you.

  • What the child said, using the child’s actual words.

  • What the caregiver said, if anything.

  • An explanation of any actions taken or recommendations regarding treatment.

  • The reporter’s name and address if required by the state in which the report is made.

• The dental professional should not do the following:

  • Do not inform the caregiver that a mandated report is being made.¹⁶ If the caregiver is the perpetrator, advance notice gives him/her a chance to pressure the child into denying or recanting the maltreatment or to further harm the child. It also allows time for that individual to contaminate or destroy potential evidence. If the caregiver is not the perpetrator, he/she may still be complicit in the maltreatment. It is not uncommon for a non-abusing caregiver to be motivated to protect the suspected perpetrator for financial or other emotional reasons.

  • Do not delegate the reporting responsibility to a designated person within your health care system in lieu of making the report to the proper authorities yourself.²⁷ You may be tempted to delegate or even directed to delegate if you work for a larger dental or health care system rather than being self-employed. Keep in mind that you are the individual professional who can be held criminally responsible if the designated person within the health care organization does not make the mandated report.