Each year millions of children are abused and hundreds of children die from abuse. Early intervention is the key to breaking the cycle of abuse and neglect of children, and dentists have the opportunity to identify and report suspected cases of child maltreatment. Most physical trauma associated with abuse occurs in the face or neck area. Abused patients often continue their dental maintenance appointments in the same dental practice, and it is essential that the dentist and the dental staff recognize subtle signs of abuse. It is critical to consider the age of the child when evaluating injuries. The age at which a child can crawl or start to walk will often dictate the type of injuries one would expect to see. Multiple bruises or abrasions and bruises of varying colors indicate various stages of healing and should raise suspicions, especially when they occur in unusual areas such as the back of the legs. Inappropriate clothing for the weather conditions should be noted because the clothing may be used to conceal bruises or injuries. It is important to document signs of abuse, and usually this is done by photographing the abused areas. Reporting suspicions to proper authorities can protect a child from continued abuse or neglect. Reporting suspicion of abuse is a call for help, not an accusation. If there is suspicion and evidence, the dentist is mandated to report the case.
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