Oral Exams Don’t Just Save Teeth – Check the Mouth for Signs of Child Abuse and Neglect

Posted & filed under Children's Oral Health and Fluoride.

Today, the American Academy of Pediatrics (AAP) and the American Academy of Pediatric Dentistry (AAPD) released a revision to the clinical report, Oral and Dental Aspects of Child Abuse and Neglect. The report helps pediatricians and other primary care providers as well as dentists and other dental providers to identify oral and dental issues that may indicate child abuse or neglect. The signs include bruises in the mouth from forced feeding, burns or blisters from scalding liquids, and fractures in the jaw and teeth. By doing a simple oral exam these signs can be detected by a medical or dental provider. Bite marks, oral sores or rashes from sexually transmitted infections or injury may also be indicators of physical or sexual abuse. Just as it is important for pediatricians to screen for dental caries and apply fluoride varnish it is essential that they also examine the mouth for oral and dental aspects of child abuse and neglect, especially if there is already cause for concern.

The report also explains the issue of dental neglect and how this can impact the lives of children. Dental neglect occurs when a parent or guardian willfully fails to seek and follow through with oral health care despite adequate access to care and knowledge of the care needed and its importance. When assessing for dental neglect, providers need to acknowledge that many families are simply unable to access care, afford dental hygiene products, or struggle with health literacy and that this may be the reason for their children’s poor oral health, not neglect. Families should be assisted in understanding oral hygiene, obtaining dental products, and how to access care for their child. Without treatment, dental caries lead to infections and pain that interfere with communication, eating, and sleep, all of which inhibit a child’s proper growth and development. The report cites studies that show dental or mouth abnormalities frequently cause a child to be a target of bullying, and the child faces a higher risk of depression and suicidal thoughts. Victims of sex trafficking or forced prostitution often have caries, infections, and tooth loss from abuse or malnutrition.

To access the AAP/AAPD clinical report please visit https://doi.org/10.1542/peds.2017-1487.