Identification: Sexual Abuse

While dentists are not as involved as other health professionals in the diagnosis of sexual abuse, they should remain alert for the following signs and symptoms:

Orofacial Manifestations of Sexual Abuse20,24

  • Gonorrhea – most commonly sexually transmitted disease in sexually abused children. May appear symptomatically on lips, tongue, palate, face, and especially pharynx in forms ranging from erythema to ulcerations and from vesiculopustular to pseudomembranous lesions.
  • Condylomata Acuminata (veneral warts) – appear as single or multiple raised, pedunculated, cauliflower-like lesions. In addition to the oral cavity, lesions may also be found on the anal or genital areas.
  • Syphilis – manifests as a papule on the lip or dermis at the site of inoculation. The papule ulcerates to form the classic chancre in primary syphilis and a maculopapular rash in secondary syphilis.
  • Herpes simplex virus, Type 2 (HSV-2) – Herpes simplex virus, Type 2 (genital herpes), presents as an oral or perioral painful, reddened area with a grape-like cluster of vesicles (blisters) that rupture to form lesions or sores.
  • Erythema and petechia – such trauma at the junction of the hard and soft palate may indicate forced oral sex.