Recognising Concerns in Adults at Risk

Adult safeguarding means protecting a person’s right to live in safety, free from abuse and neglect, while respecting their views, choices, dignity and legal rights.

An adult at risk may have care and support needs and be unable to protect themselves from abuse or neglect. In dental practice, concerns can include physical, psychological, sexual or domestic abuse; financial abuse; neglect or self-neglect; discriminatory or organisational abuse; modern slavery; and coercive control. Signs to notice include unexplained bruising, fearfulness, poor hygiene, untreated pain, pressure from a companion, or a patient who cannot speak freely.

Adult safeguarding differs from child safeguarding because adults with capacity usually have the legal right to make their own decisions, even unwise ones. Safeguarding duties remain: listen, offer privacy, ask whether the patient feels safe, record what you observe, seek advice, and escalate if there is immediate danger, coercion, lack of capacity, or risk to others.

• Try to create an opportunity for the adult to speak privately where it is safe to do so.
• Consider whether a companion is supporting the patient or exerting control.
• Look for repeating patterns, such as unpaid bills, missed care, or recurrent unexplained injuries.
• Escalate immediately if you suspect the person is at imminent risk of harm.
• Respect the adult’s autonomy unless there is a lawful reason to override confidentiality.

Adult safeguarding balances protection with respect for the person’s choices; the patient’s voice matters wherever they can safely express it.

Six Adult Safeguarding Principles