In all 50 states, physicians are required to report suspected cases of child abuse and neglect to social service or law enforcement agencies. Dentists are similarly required to report such suspected cases in most states and are allowed to report in all states; however, a minority of dentists are aware of these legal requirements.1-4 Physicians and dentists could aid in educating each other and in collaborating to increase the detection, treatment, and prevention of these disorders. Physicians typically receive limited training in dental injury and disease and thus may not detect dental abuse or neglect as readily as they do child abuse and neglect involving other areas of the body.
Because craniofacial injuries occur in half of child abuse cases,3,5,6 evaluation of these injuries is essential. Some authorities believe the oral cavity may be a central focus for physical abuse because of its significance in communication and nutrition.2 The injuries are most commonly inflicted as blunt trauma with an instrument, eating utensil, hand, or finger or by scalding liquids or caustic substances. The abuse may result in ecchymoses, lacerations, traumatized or avulsed teeth, facial fractures, burns, or other injuries. Discolored teeth may result from repeated trauma.7,8 Gags applied to the mouth may leave bruises, lichenification, or scarring at the corners of the mouth. 9 Multiple injuries, injuries in different stages of healing, injuries inappropriate for the child's stage of development, and/or a discrepant history should arouse suspicion of abuse.
The oral cavity is a frequent site of sexual abuse in children.
- Copyright © 1986 by the American Academy of Pediatrics