Abuse

Identification and reporting of abuse is a complex and emotional area.

Healthcare practitioners are required by law in most jurisdictions to report

suspected cases of abuse. The head and neck area is a common target in

abuse. Extraoral injuries consistent in shape and appearance to a hand or

object are identifiable. Intraoral trauma can occur as the result of strikes to

the face, causing torn frena and fractured, mobile, or avulsed teeth. Intraoral

soft tissue pathology may be noted following forced feeding or forced fellatio.

Some cases may require the consideration of whether extensive or rampant

caries are a result of the caregivers’ lack of knowledge or stem from neglect

or abuse. In areas where access to dental care is an issue there will likely be

a higher caries incidence that could further exacerbate the determination of

whether reporting of abuse may be necessary. Deciding to report suspected

abuse requires sound judgment, especially considering that the parent or

guardian may be the perpetrator. If a report is initiated, the ensuing investigation

will be difficult for all concerned (see Chapter 15).