Dentist attitudes and responsibilities concerning child sexual abuse. A review and a case report

Abstract

According to the World Health Organization, child abuse and neglect is “every kind of physical, sexual, emotional abuse, neglect or negligent treatment, commercial or other exploitation resulting in actual or potential harm to the child’s health, survival, development or dignity in the context of a relationship of responsibility, trust or power”. The aim of the present report is to inform about the most relevant aspects of child abuse and the characteristics of injuries to the head, neck, and orofacial regions, in addition to the suggested role of, and management by, the dentist for the evaluation of this condition, and also for reporting a case of a physically and sexually abused girl aged 5 years 8 months. Throughout the appointments, some type of abuse in this patient was suspected by the treating dentists at the clinic, mainly due to the initial behavior exhibited by the patient in the dental chair. Based on the clinical diagnostic an intensive preventive plan and restorative treatment was realized. The timely detection of the signs and symptoms of sexual abuse, often present in the orofacial region, place the pediatric dentist in a strategic situation, with the capacity to recognize, register, and later report those cases considered as suspect, including the dental treatment delivered and the intensive behavioral-psychological management, in order to achieve acceptation by the otherwise very anxious patient of the indicated restorative and preventive dental procedures. Key words:Child abuse, dentistry, behavior management.

Child Abuse and Neglect: Do We know enough? A Cross-sectional Study of Knowledge, Attitude, and Behavior of Dentists regarding Child Abuse and Neglect in Pune, India

“…20 Due to an alarming rise in child abuse cases, reporting is ethical and legal obligation of health care professionals. 21 Most common signs of child abuse are in the orofacial region, hence, the dentists are in a unique position to detect the cases of child abuse. 22 Lips are the most common site for inflicted injuries (54%) followed by the oral mucosa, teeth, gingiva, and tongue.…”

Role of a Dentist in the Diagnosis of Child Abuse and Neglect: A Literature and Narrative Review

“…The most frequent risk factor for abuse was behavioral alterations in the form of depression, personality alterations, anxiety, stress or social isolation [36,37]. A low socioeconomic level and alcohol and drug abuse were also associated with an increased risk of abuse [38], in the same way as monoparental families or criminality [6,39,40].…”

“…In this regard, the United Kingdom and the United States provide more training in this field than Brazil or Greece, according to Rodrigues et al [59]. There is an important discrepancy between studies that consider dentists to have sufficient knowledge and capacity to detect cases of CA [9,14,44,47,55] and those that consider knowledge and preparation to be insufficient [6,43,46]. According to different authors [43,60], approximately 50% of those surveyed considered themselves to be in a key position for detecting CA, but almost 78% were not prepared to report the detected cases.…”

Child sexual abuse as an etiological factor of overweight and eating disorders — considerations for primary health care providers

“…With regard to dental profession, visible oral signs of this type of abuse are considered rare [2,20,21]. In cases of oral gonorrhea or human papillomavirus warts, injuries or petechiae of the palate, oro-genital contact might be suspected [22].…”

“…In cases of oral gonorrhea or human papillomavirus warts, injuries or petechiae of the palate, oro-genital contact might be suspected [22]. Bite marks or suction-type bruises in an ovoid pattern may be also related with CSA [20][21][22].…”