Dental Professionals Recognizing and Reporting Child Abuse and Neglect
Child abuse is any mistreatment or neglect of a child that results in harm or injury. This can include physical, emotional or sexual abuse. More than half of cases occur in the face, head or neck.
Recognizing signs that MAY indicate problems.
Child
- Changes in physical appearance from last dental visit not explained in health history
- Routine head and neck exam reveals unexplained bruises, or intra-oral burns
- Fractures of teeth or any facial structure not easily explained by history
- Lacerations or abrasions to tongue, buccal mucosa, palate (soft and hard), lips
- Frenum lacerations, mainly in pre-mobile children
- Injuries inappropriate to the child’s stage of development
- Untreated dental disease once parents/caregivers have been informed of treatment options
- Habit disorders such as prolonged sucking, biting
- Oral and perioral gonorrhea
- Unexplained erythema of the palate
- Antisocial or destructive behavior while in dental office
- Extremes in behavior compliant and passive or aggressive and demanding
Age appropriate non-abusive injuries to the mouth are common. Distinguish difference by history of family, circumstances of the injury, pattern of repeated traumas, behavior and development of the child and caregiver/ parent attitude and behavior.
Parent/caregiver
- Denies the existence of injuries
- Blames child for the injuries inappropriately
- Describes the child in negative terms (bad, worthless, burdensome)
- Fails to follow up with appropriate dental care without explanation
Dental professional actions
- Medical and/or mental health consultation for a complete examination and evaluation for abuse is appropriate, in problems of uncertain cause, which don’t rise to the level of immediate concern for abuse or neglect.
- Reporting of suspected cases of abuse or neglect is mandatory when you have “reasonable cause to believe” the child is a victim of abuse or neglect. RCW 26.44.030.
Resources within Washington State
- Call to report suspected cases of abuse: 1-866 END HARM (1-866-363-4276) or at night 1-800-562-5624.
- WA State Child Abuse and Neglect Information. How to report abuse, laws, reporting requirements and more.
Additional Resources
- Prevent Child Abuse America
- Reading List-Arkansas PANDA Program
Readings for the dental professionals from Prevent Abuse and Neglect through Dental Awareness (PANDA)
References
- Guideline on oral and dental aspects of child abuse and neglect.American Academy of Pediatrics Committee on Child Abuse and Neglect; American Academy of Pediatric Dentistry; American Academy of Pediatric Dentistry Council on Clinical Affairs. Ped Dent 2005-2006;27(7 Suppl):64-7.
- Oral and Dental Aspects of Child Abuse and Neglect. Committee on Child Abuse and Neglect and Ad Hoc Work Group on Child Abuse and Neglect. Joint Statement of the American Academy of Pediatrics and the American Academy of Pediatric Dentistry. Pediatrics 104(2): 348-350.