Baby bottle tooth decay: a concern for all mothers.

Health care professionals often inappropriately separate dental health from other health functions. Baby bottle tooth decay (BBTD) should be a concern for all professionals who work with expectant or new mothers and very young children. Research indicates that even though many mothers are aware of the etiology of the condition, they continue to allow prolonged nursing with milk or liquids other than water. Nurses can help promote good oral health for children by educating and training expectant and new mothers, children, and others who work with mothers and children in preventing BBTD.

Munchausen syndrome by proxy: a different kind of child abuse.

Munchausen syndrome by proxy (MSBP) continues to mystify health care professionals, law enforcement officials and the judicial system. Even though the first cases were described in 1977, it remains puzzling why a parent would want to induce fictitious symptoms and illnesses in a child. Many professionals do not consider MSBP as a diagnosis because the parent, usually the mother, is so convincing that she is a "good" mother, cares about and wants the best for her child. This article is offered to further educate physicians that MSBP exists, can present in the form of anything and should be considered as a diagnosis in cases that do not make medical sense. Case examples are provided, along with common and not so common presentations. MSBP is a form of severe child abuse that must be reported to Child Protection Service when a child is endangered. Physicians play a critical role in identifying these children and recommending the best course of action to the rest of the system.

Domestic violence: a health concern.

Domestic violence may be the single most common etiology for injuries in women presenting to the health care system. There is a national effort to begin to ask all female patients about family violence. Physicians have a responsibility to identify, educate and appropriately manage and/or refer patients in violent relationships.

Child abuse education: do not overlook dental professionals.

Dental professionals are mandated by law to report suspicions of child abuse and neglect (CAN), but surveys show dentists do not fulfill their obligation to report. Even though more than 50 percent of physical abuse occurs to the head and facial area, and more than 70 percent of child abuse and neglect fatalities are caused by injuries to the head and neck, dental professionals are often overlooked in efforts to educate the public on the problem. Pre-program questionnaires completed by dental professionals attending an educational program on identifying and reporting child abuse indicated that 70 percent had no previous training in identifying and reporting child abuse, 65 percent had suspected child abuse in their patients, but only 19 percent reported the abuse. As a result of this educational program, it is expected that some children in the state of Indiana will receive improved assessments by dentists and suspected child abuse and neglect will be reported to the proper agencies when identified.

Awareness of child abuse: a dental responsibility.

Although Indiana dentists are generally knowledgeable on the topic of child abuse and neglect, they need to be aware of their responsibilities as health care providers to identify and report child abuse and neglect. This is especially true when the abuse and neglect are identified in their patients. This article gives information on the types of abuse and neglect that are most commonly seen by dentists, indicators that should be "red flags" that abuse could be occurring and most importantly, how to report abuse.