Upon discovery of a suspected case of child abuse while at a dental appointment, the practitioner may find that the caregiver presents conflicting information not corresponding with the clinical appearance of the injuries, or they may give a history that is inconsistent with the explanation of how the injuries occurred. Often, the caregiver may refuse to cooperate when questioned or reject the recommended treatment for the child. Many times, caregivers seek treatment for the child elsewhere if they suspect someone believes the child has been abused. Unfortunately, statistics have shown that dental health care providers typically do not report suspected cases of abuse. As a result, caregivers typically have little to no fear of being reported after seeking treatment in a dental office.
Many times, the caregiver will delay seeking care hoping the injuries will heal regardless of how severe they are. This explains why an abused child often will have multiple injuries in different stages of healing. If the child is questioned about how the injuries occurred, frequently the caregiver will speak for the child including being highly critical of the child or even prevent them from speaking. All of these behaviors should alert the dental team to a possible case of child abuse that must be reported.
Contrary to popular belief, most caregivers who abuse children are not mentally ill. The abuse toward children transcends all socio-economic classes, educational levels, races, religions and personal lifestyle choices. In most instances, the abusers themselves were victims of abuse when they were children, thus making the abuse “learned behavior.” The goal of intervention is to break the chain of violence and learned behavior. Forensic odontology can provide one link in educating the dental profession about human abuse and work to stop the propagation of violence in the home for future generations.
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