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Dental And Orofacial Aspects Of Child Abuse
Children are our most valuable national resource. Nevertheless, child abuse continues to be a serious cause of injury and death for many young children. In 1997, just under one million children were victims of child abuse or neglect. In 65% of physical abuse cases, there were head, neck, or facial injuries. Physicians and dentists therefore play a key role in the detection, treatment, and reporting of child abuse.

Child abuse is defined as any act that endangers or impairs a child's physical or emotional health or development. Neglect occurs in 55% of child abuse cases. Dental neglect is the willful failure by a parent or guardian to seek and obtain treatment for dental problems which cause pain, infection, or interfere with adequate function.

Child abuse was first brought to national attention in 1962 with Dr. Kempe's landmark article in JAMA: "The Battered Child Syndrome." By 1974, the national Child Abuse and Treatment Act was signed into law. Currently, each of the 50 states requires physicians, dentists, and healthcare workers to report cases of suspected child abuse to authorities, such as police and Child Protective Services.

The various types of child abuse include: physical, emotional, sexual, Munchausen Syndrome by proxy, and neglect. Factors contributing to abuse include: stress, family crisis, lack of support network, substance/alcohol abuse, and learned behavior. The role of physicians and dentists is: detection, documentation, treatment, and notification of authorities. The role of Child Protective Services or Social Services is: determining whether abuse has occurred.

The detection protocol used by physicians and dentist takes into account: child behavioral indicators, child history indicators, caretaker indicators, and physical indicators.

Behavioral indicators of the abused child may include: