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

Abstract

Background: Child Abuse (CA) is defined as any physical or psychological harm inflicted upon children. The most commonly affected anatomical region in these cases is the orofacial complex, thereby placing dentists in a dominant position for detecting CA. The statistical figures referred to CA are high, and many cases go unreported. Objective: To determine the level of knowledge, the aptitudes and capacity of dentists in reporting cases of CA; the barriers facing the reporting of cases; and the key clinical characteristics for the detection of CA. Methodology: A search was made of the PubMed (MEDLINE), ScienceDirect, LILACS and SciELO databases for articles published up until March 2019, involving analytical observational and descriptive studies relevant to the objectives of our study. All articles were independently reviewed by two authors. Results: Injuries caused by CA are largely located in the orofacial region – the most prevalent being caries, burns and fractures. The most frequently identified risk factor is behavioral alterations on the part of the parents or caregivers. The reviewed studies reflect a discrepancy between suspected and reported cases of CA. Conclusion: Although dentists are able to detect injuries, there is a great lack of knowledge about how to report cases of CA to the authorities. It is interesting to establish guidelines for the detection and reporting of suspicious cases. Improved training in forensic and legal dentistry is needed, together with the establishment of detection and reporting protocols. The clinical signs detected in the case of CA and neglect include untreated caries, poor oral hygiene, traumatisms, burns, lacerations and biting. The recognition of such signs and correct case history compilation are essential for the detection of CA.

Child abuse and neglect: A comparative study between dental and medical students' competencies in Germany

“…35 Despite their key role mentioned at the beginning, reports of CAN by dentists are internationally rare. 25,36 A significant discrepancy between the number of suspicious cases and reported cases by dentists has been confirmed in studies worldwide. 20,22,24,37,38 The dentists surveyed, mainly justified their hesitation by knowledge deficits in diagnosis, 22,24,38 uncertainties in managing reporting pathways 15,[19][20][21] and fear of consequences for the practice or the child.…”

“…Despite their key role mentioned at the beginning, reports of CAN by dentists are internationally rare 25,36 . A significant discrepancy between the number of suspicious cases and reported cases by dentists has been confirmed in studies worldwide 20,22,24,37,38 .…”

“…In the past years, several studies examined how and to what extent this knowledge was taught 13–18 and whether it could be applied in clinical practice 19–24 . Further studies reported important discrepancies between suspected and reported cases 19,22–26 . The results of these studies showed an increased need for better pre‐ and postgraduate education of dentists.…”

“…[19][20][21][22][23][24] Further studies reported important discrepancies between suspected and reported cases. 19,[22][23][24][25][26] The results of these studies showed an increased need for better pre-and postgraduate education of dentists.…”

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

“…It was reported that the main orofacial signs found were the presence of caries; increased dental plaque and gingival inflammation scores reflecting the close association between abuse and/or neglect and poor oral hygiene and heath. [ 11 ]…”