Adults at risk

Dental teams across the UK come into contact with millions of individuals every year, so dental staff are ideally placed to recognise the signs of abuse and neglect, and to take appropriate action in reporting concerns. While it is true that a large number of safeguarding referrals are made about children each year, it is important to remember that individuals can fall victim to abuse at any age. For dental staff, this means safeguarding training should be undertaken on how to spot the signs of abuse and neglect in both children and vulnerable adults.

Vera is a 43-year-old woman with learning difficulties, and has been a patient at your dental practice for many years. She lived with her mother until she passed away six months ago, and now Vera has moved in with her brother and his family. Vera missed her check-up appointment a couple of months ago, but despite calling, you were unable to make contact with her at the time. Today, Vera has arrived at the practice with her brother. She is in agony with a toothache, and when the dentist agrees to see Vera, her brother leaves, claiming he hasn't got time to wait and that Vera can get the bus home. Normally, Vera is very smartly dressed, and she used to enjoy showing off her new outfits to the staff. However, you notice a real chance in her appearance now; her clothing is old and worn, Vera has lost a significant amount of weight, and she has a very strong smell of body odour. While waiting to see the dentist, she gets uncharacteristically anxious and confesses that she doesn't have any money to pay as her brother has all her money. You reassure Vera that payment will be sorted out later, and take her in to see the dentist. On examination, it becomes apparent that Vera is suffering from an infection that has most likely been caused by poor dental hygiene. You discuss this with Vera, who becomes upset once again. She tells you she has been in pain for two weeks, but her brother keeps her money and she daren't ask him for things like new clothes or toiletries because he won't pay for anything for her. She also tells you that her brother isn't very nice to her, but she doesn't want to live alone because she cannot care for herself properly and is afraid being alone at night. Vera then begins to sob as she tells you how sad and lonely she feels, and how she really misses her mother. She tells you she spends a lot of time hiding with her brother's children in their bedroom upstairs because he and his wife are always arguing and it's scary for her to listen to.