Role of a Dentist in the Diagnosis of Child Abuse and Neglect: A Literature and Narrative Review
Maria Melo1, 2, Fadi Ata-Ali1, 3, *, Teresa Cobo3, José Diago1, María Teresa Chofré-Lorente1, Leticia Bagán1, Cristina Sanchez-Recio4, Javier Ata-Ali1, 5
1 Unit of Master's Degree in Advanced Orthodontics, Department of Dentistry, Faculty of Health Sciences, European University of Valencia. Valencia, Spain
2 Valencia University Medical and Dental School, University of Valencia Valencia, Spain
3 Department of Surgery and Medical-Surgical Specialities, Area of Orthodontics, University Medical and Dental School. University of Oviedo, Instituto Asturiano de Odontologia, Oviedo, Spain
4 Private Practive in Oral Surgery. Hospital de Manises, Valencia, Spain
5 Public Dental Health Service. Conselleria de Sanitat Universal i Salut Pública, Generalitat Valenciana, Valencia, Spain
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.
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.
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.
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.
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.
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* Address correspondence to this author at the Unit of Master's Degree in Advanced Orthodontics, Department of Dentistry, Faculty of Health Sciences, Universidad Europea de Valencia. C/General Elio, 2. 46010-Valencia, Spain and Department of Surgery and Medical-Surgical Specialities, Area of Orthodontics, University Medical and Dental School. University of Oviedo, Instituto Asturiano de Odontologia, Oviedo, Spain; Tel: +0034985966014;