Dental aspects of child abuse

Dentists, other health care practitioners, and police and social service organizations all have legal mandates to report any incidence of suspected child abuse or neglect to each other in all 50 states. The aim of this paper is to examine the oral and dental elements of physical and sexual abuse, as well as dental neglect, in children, and the importance of pediatric healthcare professionals and dentistry professionals in identifying and handling cases of those disorders. This paper focuses on the assessment of bite marks as well as facial and oral injuries, illnesses, and disorders that may generate suspicions of child abuse or neglect. Oral health disorders are often related to bullying and human trafficking victims are also often identified with oral health disorders. The amount of education provided to medical professionals on oral health and dental injury and illness may differ. Some medical professionals may miss injuries or illness in the mouth that are connected to abuse or neglect when they are discovered in other locations. For this reason, pediatricians and dentists are advised to cooperate to raise the rates of the early identification, diagnosis, and treatment of these diseases in children.

As may be seen in the Figure 1, An injury, such as a fall, may also bruise the bones in areas such as the knees, elbows, and chin in early infancy as part of the normal process of growth and development. Figures 2 and 3 show that as children begin to walk, they often slide, which is likely to result in dental injury such as fractured teeth, and Figure 4 shows that individuals who wear braces have increased likelihood of luxation of their main anterior teeth. Despite the injuries being unintended, they may often be a consequence of physical aggression, such as slapping someone on the lips or forcing someone to eat. So as a consequence, further questioning of the parent or caregiver is necessary to distinguish between an unintentional or non-accidental etiology and whether or not a child neglect inquiry is necessary. When used in tandem with other sources of information, certain sorts of situations ought to trigger alarms of violent acts. Pediatric medical conditions in children can manifest clinically as conditions that could be misinterpreted as physical violence. Many fractures in various phases of recovery, for example, may be the result of trauma, but they may also be the result of continuing care for a blood disorder. Hair loss can be caused by some type of neglect, or it may be caused by medical disorders such as alopecia or chemotherapy medication. Because of the likelihood of other factors, making a hasty decision to investigate child neglect is ill-advised before additional questioning or the existence of other signs indicates a need for suspicion.

When there are clear and unmistakable bodily injuries, there is no question as to whether a report is required. Wrap a cloth over your hand to protect your skin and face, then use a hard, blunt object like a brick or stick to hit your cheek or slap your face. A hard, blunt object like a brick or stick may be used to strike the face or smack the face.

When the skin of a child’s face is slapped, the blood from the injury will flow and cause pooling on the palm of the person who caused the harm. Use of a belt or strap will create an injury that will follow the different phases of healing. It will seem very similar to a bruise, only instead of discoloring, it will become black-and-blue. The treatment of slap marks to the face, without further interrogation of the parent or caregiver, need no more inquiry. Such non-accidental physical abuse injuries need quick reporting in the child’s best interests.

While animal bite markings, such as those generated by a dog or other predatory animals, might be confused with human bite marks, human bite markings must be differentiated from these other markings. Human bite marks look like ovoid or elliptical in form with a central region of ecchymosis (also known as a contusion) generated by compression of the tissue and rupture of the underlying tiny blood vessels. In a person who has been bitten by a carnivorous animal, such as a shark, a “V”-shaped pattern with ripped flesh and deep indentations will be seen in the area around the canines. Filing an instant complaint of physical abuse if you see a human bite mark on the skin of a kid is mandated by law.

Scalding and immersion burns vary from first degree to third degree burns, whereas contact burns from things such as curling irons or cigarettes vary from second degree to fourth degree burns. The characteristic that cigarette burns are circular is mostly dependent on the kind of hand the smoker holds the cigarette in and the pressure applied to the cigarette to the skin. While it is likely that a single cigarette burn is an accident, it is also certain that several cigarette burns need quick reporting.

Seemingly ambiguous markings around the neck that may be signs of the hands and fingers of the attacker, a strap mark, or a rope burn may be seen on the victim’s body. The kid’s continued health and safety is always in jeopardy if these markings are noticed during the course of a normal dental checkup, and therefore a report must be quickly completed to safeguard the youngster.


  1. Fisher-Owens, S. A., Lukefahr, J. L., Tate, A. R., American Academy of Pediatrics, S. on O. H., Neglect, C. on C. A. A., American Academy of Pediatric Dentistry, C. on C. A., & Neglect, A. H. W. G. on C. A. A. (2017). Oral and Dental Aspects of Child Abuse and Neglect. Pediatrics140(2).
  2. Costacurta M, Benavoli D, Arcudi G, Docimo R. Oral and dental signs of child abuse and neglect. Oral Implantol (Rome) 2015;8:68–73. [PMC free article] [PubMed] [Google Scholar]

Categories: Dental