The mouth and maltreatment: safeguarding issues in child dental health

From the first cry of a newborn baby, the first smile, first tooth, first word, the mouth plays a key role in children’s health and development. It benefits from a whole team of dental health professionals dedicated to maintenance of its essential and lifelong functions in communication and feeding. Sometimes the mouth becomes the focus of abuse or neglect. In the context of safeguarding and promoting welfare, both dental health and dental care are recognised as notable aspects of children’s needs.1 2 Nevertheless, it is uncommon for paediatricians and dental professionals to work sufficiently closely together to ensure that oral health is fully included in multiagency assessment and planning for children experiencing maltreatment. The aim of this article is to outline the scope of safeguarding issues in child dental health. It will consider the interpretation of oral findings as indicators of maltreatment, discuss the arguably underused contribution that dental professionals can make to child protection and will explore the potential for enhancing working together with paediatricians. The intention is to stimulate discussion and debate

Dental neglect in children

Untreated dental diseases, particularly dental caries, can lead to a range of adverse impacts on children, including pain and infection. Yet caries is preventable if a child’s basic oral health needs are met. Dental neglect occurs when there is persistent failure to meet those needs. Dentists and paediatricians can work together with other health and social care professionals to identify children with dental neglect and to intervene to safeguard their oral and general health and development

Development and evaluation of a 'was not brought' pathway: a team approach to managing children's missed dental appointments

Introduction: Children and young people's (CYP) missed healthcare appointments may be an indicator of neglect. Healthcare providers are encouraged to consider the child as 'was not brought' (WNB) and to assess the need for early multidisciplinary information sharing to safeguard and promote welfare. Method: A new WNB-CYP pathway (flowchart, template patient notes, template letters) for missed appointments was developed. After piloting at one community dental service (CDS) clinic for eight months, a service evaluation was conducted via retrospective review of records and semi-structured interviews with staff. Results: Of 1,238 appointments for CYP, 134 were missed (WNB rate 10.8%) by 91 children. The WNB-CYP pathway was followed consistently 113 times (84.3%) and, when used, three quarters of WNBs were rebooked after communication with parents within three weeks. Written information was shared in 25 cases with general medical practitioners and other health and social care professionals. Staff reported high levels of engagement and pathway acceptability; it relieved uncertainty and supported decision-making, teamwork and inter-professional communication without increasing daily workload. Following minor amendments, the pathway was rolled out service-wide with similar success. Conclusion: A new WNB-CYP pathway facilitated early and consistent sharing of safeguarding information with other professionals about missed CDS dental appointments and improved dental team confidence

The cubic period-distance relation for the Kater reversible pendulum

We describe the correct cubic relation between the mass configuration of a Kater reversible pendulum and its period of oscillation. From an analysis of its solutions we conclude that there could be as many as three distinct mass configurations for which the periods of small oscillations about the two pivots of the pendulum have the same value. We also discuss a real compound Kater pendulum that realizes this property.Comment: 25 pages 4figure

Adherens junction-dependent and -independent steps in the establishment of epithelial cell polarity in Drosophila

Adherens junctions (AJs) are thought to be key landmarks for establishing epithelial cell polarity, but the origin of epithelial polarity in Drosophila remains unclear. Thus, we examined epithelial polarity establishment during early Drosophila development. We found apical accumulation of both Drosophila E-Cadherin (DE-Cad) and the apical cue Bazooka (Baz) as cells first form. Mutant analyses revealed that apical Baz accumulations can be established in the absence of AJs, whereas assembly of apical DE-Cad complexes requires Baz. Thus, Baz acts upstream of AJs during epithelial polarity establishment. During gastrulation the absence of AJs results in widespread cell dissociation and depolarization. Some epithelial structures are retained, however. These structures maintain apical Baz, accumulate apical Crumbs, and organize polarized cytoskeletons, but display abnormal cell morphology and fail to segregate the basolateral cue Discs large from the apical domain. Thus, although epithelial polarity develops in the absence of AJs, AJs play specific roles in maintaining epithelial architecture and segregating basolateral cues

The positioning and segregation of apical cues during epithelial polarity establishment in Drosophila

Cell polarity is critical for epithelial structure and function. Adherens junctions (AJs) often direct this polarity, but we previously found that Bazooka (Baz) acts upstream of AJs as epithelial polarity is first established in Drosophila. This prompted us to ask how Baz is positioned and how downstream polarity is elaborated. Surprisingly, we found that Baz localizes to an apical domain below its typical binding partners atypical protein kinase C (aPKC) and partitioning defective (PAR)-6 as the Drosophila epithelium first forms. In fact, Baz positioning is independent of aPKC and PAR-6 relying instead on cytoskeletal cues, including an apical scaffold and dynein-mediated basal-to-apical transport. AJ assembly is closely coupled to Baz positioning, whereas aPKC and PAR-6 are positioned separately. This forms a stratified apical domain with Baz and AJs localizing basal to aPKC and PAR-6, and we identify specific mechanisms that keep these proteins apart. These results reveal key steps in the assembly of the apical domain in Drosophila

Fuels and Burners for Domestic Heating

Discusses fuels and burners for domestic heating, including hand-fired coal or coke, automatic coal stoker, gas-fired heaters, oil burners. INlcudes table of comparative fuel costs