As a founder and spokesperson for Missouri`s model Prevent Abuse and Neglect through Dental Awareness (PANDA) Coalition, I want to thank you for helping dental hygienists protect children from abuse and neglect in your article, "Looking Inside a Child`s World" (RDH, August 1995, p.12). It is important for all dental professionals to be aware of possible child maltreatment among their patients.
Dental hygienists currently are mandated reporters of suspected child abuse and neglect in 40 states and the District of Columbia. However, those hygienists practicing in the remaining states may also report suspected cases, even though reporting is not required by law. Also, along with New York`s mandate for continuing education on child abuse discussed in the article, both Iowa and Florida have similar requirements.
The "Dental Team Checklist" for detecting suspected child abuse should also list bilateral injuries to the face. These injuries are almost pathognomonic (automatic indicators) of abuse, because of the unlikely event of injuring both sides of the face in an accident. In the same checklist, I take issue with the author discussing the "average disciplinary parental slap" leaving a mark. Even those adults who still feel that spanking is an appropriate form of discipline would say that blows that leave marks on the child`s face are abusive.
PANDA coalitions are now in place in 26 states and in Romania, and dental hygienists are involved in every coalition. The success of our educational and awareness initiative is best measured by reporting rates. Since PANDA`s inception, although child abuse reports have increased by 6 percent, reports by dentists are up 60 percent. We expect similar increases have occurred among dental hygienists. Efforts are underway to have every state track data for both dentists and dental hygienists and also try to mandate reporting for all dental hygienists.
Although, as state dental hygienists have the opportunity to talk with young patients, PANDA targets educational efforts to the entire dental team and anyone who works with children. We must be aware that anyone may see victims of all forms of family violence. Though increased awareness by all members of the dental team, we have a chance to stop the twin epidemics of abuse and neglect.
Lynn Douglas Mouden, DDS, MPH
Missouri Department of Health
Jefferson City, Missouri
Readers interested in obtaining additional information about the PANDA program, contact Lynn Douglas Mouden, c/o the Missouri Department of Health, P.O. Box 570, Jefferson City, MO 65102-0570; (317) 751-6400.