Safeguarding and confidentiality — ORE Part 1 MCQ

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HardDental Public Health, Ethics, Law and Infection ControlSafeguarding and confidentialityORE Part 1

A 9-year-old attends repeatedly with untreated dental pain, poor hygiene and multiple missed appointments. The parent becomes angry when safeguarding is mentioned and says the dentist must keep the visit confidential. The child appears withdrawn and reports difficulty eating. What is the most appropriate action?

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Reveal the answer and explanation

Correct answer: E — Share relevant information with safeguarding services in accordance with local child protection procedures

The correct answer is E. This scenario presents multiple safeguarding red flags: untreated dental pain, poor oral hygiene, repeated missed appointments (the most common trigger for child protection referrals in dentistry), and clinical signs of possible harm (withdrawn behaviour, eating difficulty). These indicators meet the threshold for reasonable concern of significant harm. UK guidance from the GDC, SDCEP, and NHS is explicit: parental refusal to consent does not prevent the dentist's statutory obligation to share information with safeguarding services. Confidentiality is overridden by child protection concerns (A is wrong). Discharging the child abandons safeguarding responsibility (B is incorrect). Providing only oral health advice ignores the welfare concern (C fails duty). Discussing publicly breaches confidentiality and bypasses proper channels (E is unethical). Option E is the only legally and ethically defensible response: dentists must follow their local child protection procedures and refer concerns to appropriate authorities such as social services, regardless of parental resistance.

Reference: General Dental Council Standards for the Dental Team (2013); SDCEP Practice Support Manual – Child Protection (2021); UK Government Safeguarding in General Dental Practice Toolkit (2019); BDA Safeguarding Resources – 'Was Not Brought' Initiative (2025); available at https://www.gdc-uk.org/standards-guidance/standards-and-guidance/gdc-guidance-for-dental-professionals/guidance-on-child-protection-and-vulnerable-adults and https://www.psm.sdcep.org.uk/topics/ethical-practice/child-protection/