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When Oral Injuries Lead To Suspicion Of Abuse Or Neglect

When Oral Injuries Lead To Suspicion Of Abuse Or Neglect
by Alyson Sulaski Wyckoff

Could the bitemarks, swollen lips or severely decayed teeth in your patient be related to child abuse or neglect?

A clinical report from the Academy and the American Academy of Pediatric Dentistry aims to help pediatric and dental providers review the signs and symptoms of the multiple kinds of maltreatment that manifest in the mouth.

Craniofacial, head, face and neck injuries make up more than half of child abuse cases, according to the updated report. New in this version are warnings that victims of bullying and human trafficking also can have oral health conditions indicative of abuse.

Oral and Dental Aspects of Child Abuse and Neglect, from the AAP Section on Oral Health and the Committee on Child Abuse and Neglect will be published in the August issue of Pediatrics.

Examining victims, collaborating with experts

The report recommends collaboration among health care and dental professionals to help prevent, detect and treat cases. Providers need to know how to document suspicious injuries, obtain laboratory evidence and photo documentation, and consult with experts. Pediatric dentists and oral and maxillofacial surgeons can provide assistance, and a pediatric dentist or dentist trained in forensic odontology can help ensure appropriate testing, diagnosis and treatment.

Recommendations call for providers to examine suspected victims, including children in state custody or foster care, for signs of oral trauma, caries, gingivitis and other oral health problems, which are more prevalent in maltreated children.

Dental neglect, which is a form of child abuse, can be difficult to differentiate from lack of access to dental care, said Anupama Rao Tate, D.M.D., M.P.H., a lead author of the report and a pediatric dentist. The clinical report outlines factors to consider when evaluating for neglect.

Some patients with oral/dental evidence of abuse could be victims of human trafficking or bullying. Often, children with orofacial or dental abnormalities are bullied, which may lead to mental health issues. Children who report being bullied or who have been physically or sexually abused also can have poor dental health.

Clinicians have a role to play in asking children and families how things are going at school, etc., providing the opportunity to bring up bullying, Dr. Tate said. “If nothing else,” she said, “it’s a resource for the child and shows support by opening that conversation.”

Read full article on AAP News.