A patient with Down syndrome arrives with their caregiver. Most teeth show deep decay and multiple fractures. The last dental visit was 5 years ago. How do you proceed?

Correct answer: B. Report neglect to the appropriate authorities

• A. A treatment plan is ultimately needed, but reporting suspected neglect takes immediate priority.
• B. A dependent patient with Down syndrome who cannot advocate for themselves, with extensive untreated dental disease and a 5-year care gap, presents strong evidence of dental neglect by the caregiver. Mandatory reporting of suspected neglect of a vulnerable adult is legally and ethically required in most jurisdictions.
• C. Treating only the chief complaint without addressing suspected neglect would fail this vulnerable patient.
• D. Referral may be needed for specialized care, but the obligation to report suspected neglect is immediate.