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Oral and Dental Aspects of Child Abuse and Neglect (From Child Abuse and Neglect: Guidelines for Identification, Assessment, and Case Management, P 58-60, 2003, Marilyn Strachen Peterson and Michael Durfee, eds. -- See NCJ-200932)

NCJ Number
200938
Author(s)
Stephen M. Blain D.D.S; Norman Sperber D.D.S; Kathleen A. Shanel-Hogan D.D.S
Date Published
2003
Length
3 pages
Annotation
This chapter provides recommendations for screening and detecting child abuse and neglect based on oral and dental symptoms.
Abstract
The chapter states that blunt trauma injuries in child abuse are most often inflicted with an object, eating utensils, hands, or fingers, or by scalding liquids or caustic substance. This may result in contusions; lacerations of the tongue, buccal mucosa, palate, gingiva alveolar mucosa, or frenum; fractured, displaced, or avulsed teeth; facial bone and jaw fractures; and burns. Discolored teeth, indicating pulpal necrosis, may result from previous injury; and gags applied to the mouth may leave bruises or scarring at the corners of the mouth. The key factor in evaluating injuries for abuse is whether the observed injuries are consistent with the history supplied by the caretakers and/or the child. In addition to oral indications of physical abuse, the oral cavity is also a frequent site of sexual abuse in children. The presence of oral and perioral gonorrhea or syphilis in prepubertal children is indicative of sexual abuse. Dental neglect occurs when caretakers willfully fail to seek and follow through with the treatment necessary to ensure a level of oral health essential for adequate functioning and freedom from pain and infection. The chapter recommends that when a child has oral injuries or dental neglect is suspected by a medical practitioner, the child's dentist, a pediatric dentist, or a dentist with formal training in forensic odontology should be consulted. Pediatric dentists and oral and maxillofacial surgeons, whose advanced education programs include a mandated child abuse curriculum, can provide valuable information and assistance to physicians on oral and dental aspects of child abuse and neglect. The chapter also recommends that all children placed in foster care be screened for dental problems during the required medical examination within 30 days of placement into foster care. A relevant case vignette with follow-up questions is provided. 20 references