The examiner should always be alert to the potential for child abuse in injury cases and cognizant of the legal responsibility to report any suspicions to the proper authorities. Physical abuse is usually recognized by the pattern of injury and/or its inconsistency with history. Bruises, welts, fractures, burns, and lacerations are commonly inflicted physical injuries. Head, face, and neck injuries occur in more than half of the cases of child abuse. Sexual abuse may be suspected when there is palatal bruising. While the oral cavity is a frequent site of sexual abuse in children, visible oral injuries or infections can be rare.
Unintentional or accidental injuries to the mouth are common and must be distinguished from abuse based on whether the history, including the timing and mechanism of injury, is consistent with the characteristics of the injury and the child’s developmental capabilities.
Dentists are mandatory reporters for suspected child abuse and must be advocates for children.