The examiner should always be alert to the potential for child abuse in injurycases and cognizant of the legal responsibility to report any suspicions to theproper authorities. Physical abuse is usually recognized by the pattern ofinjury and/or its inconsistency with the history related. 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 oralcavity is a frequent site of sexual abuse in children, visible oral injuries orinfections are rare.
Unintentional or accidental injuries to the mouth are common and must be distinguishedfrom 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 developmentalcapabilities.