Evaluation of the Orofacial Features in the Victims of Abuse and Neglect of 5–16-Year-old Age Children

Abstract

Background: Oral cavity may be considered a pivotal focal point in physical assault or abuse because of its implication in communication and nutrition. Dentists trained in a child abuse curriculum can provide valuable information and assistance to physicians about oral and dental aspects of child abuse and neglect. The present study was conducted to evaluate the orofacial features of children between the age group of 5–16 years suspected to be victims of child abuse/neglect. Materials and Methods: This study was conducted on 250 children ranging between 5 and 16 years were enrolled in the study. All the participants were suspected to be victims of child abuse/neglect. The orofacial features were carefully examined by a well-trained dentist. Results: Two hundred and fifty children were enrolled in the study. Seventy-two children (30%) presented with laceration of various sites including lip (n = 13), frenum (n = 8), buccal mucosa (n = 26), palate (n = 16), and floor of the mouth (n = 9). Twenty-nine participants exhibited the features of avulsion (11.6%). Eighteen children revealed dento-alveolar fractures, 104 presented with dental caries (41.6%), 19 presented with missing teeth (7.6%), all the candidates presented with deposits (100%). Conclusion: Careful intraoral and perioral examination of the participants victimized to abuse and/neglect is necessary as the oral cavity is a central focus for physical abuse, which may be allied to its importance in communication and nutrition. Physicians and dentists should work together to increase the prevention, detection, and treatment of these conditions.

Orofacial signs of child or adolescent maltreatment identified by dentists and dental hygienists: A scoping review

“…Reported poor oral hygiene parameters included heavy plaque deposits 46,48,54,56,61,62 and plaque index measurements, 48,61,62,65 acute or chronic gingivitis, 48,65 and halitosis 66 . Other reported dental neglect signs were odontogenic infections 27,53,56,67 and dentoalveolar infections 13,61 …”

“…13,61 Intraoral signs of physical abuse were described in 17 studies, comprising bruising/ecchymosis [55][56][57] and lacerations. [54][55][56]61 Only two reports described frenum tearing 54,61 and one described scars from previous abuse. 54 Hard tissue injuries of the teeth and jaw were described as caries dental trauma, 40,44,61,68,69 including subluxations 49,55,56,70 and tooth fractures, 56 dentoalveolar fractures, 13,49,55,61 and malocclusions due to previous fractures.…”

“…[54][55][56]61 Only two reports described frenum tearing 54,61 and one described scars from previous abuse. 54 Hard tissue injuries of the teeth and jaw were described as caries dental trauma, 40,44,61,68,69 including subluxations 49,55,56,70 and tooth fractures, 56 dentoalveolar fractures, 13,49,55,61 and malocclusions due to previous fractures. 55 Enamel infractions were reported as the most common trauma injury.…”

Orofacial manifestations of child maltreatment: A review

“…In one study of 250 children between ages 5 and 16 presenting to a dentist with suspected abuse and neglect, 11.6% had avulsed teeth, most often affecting the permanent maxillary central incisors. 33 The majority of traumatic dental injuries involve a single tooth, though multiple teeth are more likely to be involved when the injury was intentional (Figure 5). 34 Avulsed teeth have also been identified in victims of child torture.…”

“…Careful consideration of the history provided (i.e direction of trauma) along with the angle of displacement is important when determining if an explanation is plausible. In one study of 250 children between ages 5 and 16 presenting to a dentist with suspected abuse and neglect, 11.6% had avulsed teeth, most often affecting the permanent maxillary central incisors 33 . The majority of traumatic dental injuries involve a single tooth, though multiple teeth are more likely to be involved when the injury was intentional (Figure 5).…”