Stakeholders have called on dentists to play a more proactive role in safeguarding children by identifying, documenting and reporting suspected cases of child abuse, noting that oral health professionals are uniquely positioned to recognise early signs of abuse and neglect during routine oral examinations.
Speaking during a panel discussion on “Safeguarding Smiles: Multidisciplinary Approaches to Child Abuse in Dental Care” at the 8th Biennial Conference and Scientific Session of the Nigerian Association of Paediatric Dentistry (NAPD) in Ibadan, Oyo State, the experts described child abuse as a growing global public health challenge requiring urgent multidisciplinary action.
Consultant Paediatrician at the University College Hospital (UCH), Ibadan, Dr Joy Alejo, said healthcare professionals must distinguish accidental childhood injuries from those suggestive of abuse.
She identified multiple injuries, bruises on protected areas such as the torso, and delayed presentation for treatment without reasonable explanation as major red flags.
“When a child falls, you expect injuries on typical impact sites. However, bruises around the angle of the jaw, neck, cheeks or marks on the arms suggesting that a child has been forcefully grabbed are not typical and should immediately raise concern,” she said.
Alejo urged dentists to thoroughly document suspected cases, photograph injuries with informed consent, maintain detailed clinical records and utilise established child protection and referral pathways.
Also speaking, Dr Nneka Onyejaka of the Department of Child Dental Health, University of Nigeria, Enugu, warned that many abused children continue to suffer because healthcare professionals fail to recognise or act on early warning signs.
She noted that economic hardship and psychosocial stress have worsened child abuse and neglect in recent years, stressing that abuse can occur in homes, schools, churches and even healthcare facilities.
“It can happen anywhere. We have seen cases in homes, schools, churches and clinics. That is why we must remain observant at all times.”
According to her, dentists are strategically placed to detect abuse because most injuries involve the head, face and oral cavity.
She advised clinicians to watch for unexplained bruises, bite marks, burns, fractured teeth, delayed presentation, inconsistent histories and caregiver-child interactions that raise suspicion.
“When explanations keep changing or do not match the injury, maintain a high index of suspicion. Listen carefully to the child because children often reveal the truth if we give them the opportunity to speak.”
Onyejaka also described persistent poor oral hygiene, untreated dental caries, recurrent infections and severe early childhood caries as indicators of dental neglect and urged the government to make reporting suspected child abuse by dentists mandatory.
Mrs Temiloluwa Morenkeji, a member of the Oyo State Rapid Response Team (RRT) on Gender-Based Violence and the Child Protection Network (CPN), warned that parents who neglect their children’s dental care may unknowingly be committing child abuse.
“The best form of child protection is prevention. If we prevent abuse, many children will never have to suffer its lifelong consequences.”
She challenged the belief that abuse occurs mainly in poor homes, noting that neglect is common among affluent families where caregivers ignore professional advice on children’s oral health.
Morenkeji urged dentists to treat severe dental neglect as a safeguarding concern, remain vigilant for signs of sexual abuse, carefully document suspected cases and make prompt referrals while avoiding direct confrontation with suspected perpetrators.
She also emphasised that abused children should receive mental health support in addition to medical care.
Consultant Psychiatrist at the Child and Adolescent Mental Health Unit, University College Hospital (UCH), Ibadan, Dr Tolulope Bella-Awusah, said child abuse extends far beyond physical injuries, warning that repeated trauma alters brain development and can affect emotional regulation, memory and decision-making throughout life.
She noted that dental clinics are often safe spaces where abused children can be identified because dentists routinely examine the head, face and mouth.
Bella-Awusah warned that childhood abuse increases the risk of depression, anxiety, post-traumatic stress disorder, self-harm, addiction and suicide, making early detection by dentists critical.
She urged dentists to adopt trauma-informed care by explaining procedures before treatment, involving children in simple decisions, agreeing on stop signals during procedures and taking expressions of fear or distress seriously, saying early recognition could protect vulnerable children from lifelong psychological harm.