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Traumatic experiences can impact individuals' oral health and how they experience dental treatment in ways patients and their dental providers may or may not initially anticipate. As approximately half of children and two-thirds of adults in the United States have experienced some type of traumatic event, it is critically important for providers to be aware of patients' trauma histories and to appropriately provide trauma-informed care to their patients when needed. Individuals with a trauma history may experience significant anxiety and distress in the dental setting, even for treatment many providers and patients consider to be "simple," such as a brief intraoral examination, radiographs, or prophylaxis. Such aspects of the dental setting may trigger memories and emotions related to the original trauma and may re-traumatize patients. This short report introduces links between traumatic history, poor oral health, and dental care-related fear and anxiety. Additionally, this paper briefly describes how dental hygienists can provide compassionate trauma-informed care to their patients with the goal of providing whole-person care that considers patients' comfort, health goals, and prior experiences. Specific recommendations for providing trauma-informed care to children and adults within the scope of dental hygiene practice are provided, as is suggested wording for acknowledging a patient's prior trauma and tailoring dental care to accommodate patient experiences and concerns. As dental hygienists are often the oral health providers spending the most time with patients, they are uniquely positioned to provide compassionate effective trauma-informed care to patients with past traumatic experiences. [ABSTRACT FROM AUTHOR]

Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT) is a frontline intervention for posttraumatic stress disorder (PTSD) symptoms among maltreated children. Research suggests that active caregiver participation predicts positive treatment outcomes, but these studies are often based on the perception of the caregiver. Youth perceptions of the caregiver as a source of support who might help confront distressing memories (i.e., attachment security) and how they relate to TF-CBT treatment are unexplored. This paper uses data from a small randomized controlled feasibility trial of TF-CBT to conduct a pilot examination of whether (a) attachment security may improve through the course of TF-CBT, and (b) pre-treatment attachment security predicts response to TF-CBT for the amelioration of posttraumatic stress. Results favored the conclusion that those beginning treatment with attachment insecurity may demonstrate improvement for this outcome by the end of treatment (n = 8; t = 3.3, p =.013, Cohen's d = 1.17). However, although significant improvements were found over the course of treatment for PTSD, there was no evidence that pre-treatment attachment security predicted PTSD outcome (n = 29; ∆ R 2 <.01, ∆ F (1,26) =.001, p =.969). The limitations of the current pilot study are discussed, as well as directions for future research. [ABSTRACT FROM AUTHOR]

• Learning the lessons from serious child abuse cases can prevent harm in future. • Lack of 'professional curiosity' and 'challenge' are inadequate explanations. • More productive understandings for practice would be communication and courage. • Awareness of the ambiguous policy context is also essential. • Well supported staff and properly resourced services are vital. Learning lessons from cases where children have been killed or seriously harmed from abuse or neglect is important for child protection policy and practice around the world. In England there is a long-established system of locally based, multi-agency reviews. Three recurrent themes over the years have been the poor quality of assessments, shortcomings in inter-agency working and information sharing, and not knowing the children and understanding their experiences. The reviews often identify a lack of 'professional curiosity' and insufficient 'challenge' on the part of child protection practitioners as the cause of these problems. This paper analyses these concepts, drawing on four recent studies of child safeguarding reviews conducted by the authors and their research team. It uses qualitative data from the reports and the views of local professionals in online focus groups. The reviews tend to use the perceived lack of curiosity and challenge as the explanation for poor practice without interrogating why, when and in what circumstances it becomes more difficult for professionals to remain curious and appropriately challenging. Professional curiosity and challenge are complex, multifaceted concepts, and applying them in practice is difficult and skilled work. The paper argues for a more nuanced and grounded understanding of the concepts and their application in practice. It sets them in wider frames of communication and courage, and the ambiguous policy context of a preference for cooperative engagement with families but high expectations about protecting children. It offers recommendations for future research into the review process, authorship style, practice in local agencies and national government policy. [ABSTRACT FROM AUTHOR]