Oral and Dental Problems That May Signal Child Abuse and Neglect

A report from the American Academy of Pediatrics and the American Academy of Pediatric Dentistry in the August 2017 Pediatrics (published online July 31) aims to help identify problems involving a child's teeth, gums and mouth that may be signs of physical or sexual abuse and neglect. According to the updated clinical report, "Oral and Dental Aspects of Child Abuse and Neglect," injuries and infections in and around the mouth appear often in children who are maltreated. These may occur when caregivers react violently during developmentally normal fussiness at mealtime or bedtime, for example.

Symptoms that may be signs of child abuse or neglect include:

• bruises on the lips, gums, tongue, lips or soft tissue inside the mouth from eating utensils or a bottle during forced feeding;
• burns or blisters from scalding liquids or fractures to teeth, facial or jaw bones or scars or blackened teeth from previous injuries;
• skin irritation, bruising or scarring at the corners of the mouth, which could be from gags applied to the mouth in forceful attempts to quiet a child;
• injuries to the back of the throat, sometimes intentionally inflicted to make a child cough up or vomit blood or create other symptoms that would require medical attention and care;
• injuries and infections tied to forced oral sex, such as tears and other signs of trauma inside the mouth or sores or rashes caused by sexually transmitted disease.
• bite marks inside the mouth from the child's own teeth, which sometimes are caused by physical or sexual abuse.

In cases of dental neglect, authors note, untreated cavities and gum disease interfere with a child's ability to eat, communicate, grow and develop properly. The report also describes the connection between bullying and dental health, citing research indicating that children with mouth or dental abnormalities are frequent targets of bullying and face increased risk of depression and suicidal thoughts or actions.

In addition, the estimated 100,000 U.S. children involved in sex trafficking or forced prostitution each year have oral and dental problems from abuse and from malnutrition, which can lead to poorly formed teeth, cavities, infections and tooth loss.