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Child Abuse: A Dentist's Guide

2 CE Credits

You will receive 2 units of continuing education credit upon successful completion of this course.

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ADA Member: $56.00
Nonmember: $84.00
Dental Team Member: $30.00

Author:

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H. Edward Lyon

Learning Objectives:

Upon completion of this course, participants should be able to do the following:

  1. be familiar with the federal and state statutes about child abuse, including those that govern the dentist’s obligation to report suspected abuse. 
  2. be able to recognize the subtle signs of child abuse. 
  3. be aware of what children are more at risk to be abused. 
  4. be more familiar with the incidence of abuse. 
  5. be knowledgeable in how to document suspected abuse. 
  6. be knowledgeable in how to report suspected abuse

Abstract:

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. 

Outline:

COURSE OUTLINE

  1. Introduction

  2. Statutes

  3. Definitions

  4. Incidence of Abuse and Neglect

  5. Behavioral Results of Child Abuse and Neglect

  6. Risk Factors

  7. Obligation to Report

  8. Signs of Child Abuse

  9. Differential Diagnosis

  10. Reporting Child Abuse and Neglect

  11. Documentation of Abuse

  12. Role of Social Service Agencies, Law Enforcement and Legal Services

    1. Child Protective Services

    2. Law Enforcement

    3. Legal Services


  13. Dental Treatment for Adults who were Victims of Child Abuse

  14. Conclusion

  15. Appendix (list of state agencies)

References:

  1. Chez N. Helping the victim of domestic violence.  Amer J Nurs 1994; 94:32-7.
  2. Meskin LH.  If not us, then who?  JADA 1994; 125:12.
  3. Tilden VP, Schmidt TA, Limandri BJ et al.  Factors that influence clinicians’ assessment and management of family volence.  Am J Public Health 1994; 84:628-33.
  4. The Dental Clinics of North America. Vol. 45 (2) Philadelphia: W.B. Saunders; 2001:344-8.
  5. Gibson-Howell JC.  Domestic violence identification and referral.  J Dent Hyg 1996; 70:74-9.
  6. Statutes at-a-glance.  National Clearinghouse on Child Abuse and Neglect Information.  May 2000.     
  7. Child Abuse Prevention and Treatment Act.  PL104-235, 1992.
  8. Pediatric Dentistry Special Issue: Reference Manual.  American Academy of Pediatric Dentistry.  1995.
  9. National Committee to Prevent Child Abuse (NCPCA):  Current trends in child abuse
    reporting and fatalities: The results of the 1997 Annual Fifty State Survey. 
  10. Prino CT, Peyrot M.  The effect of child physical abuse and neglect on aggressive,          withdrawn, and prosocial behavior. Child Abuse Negl 1994; 18:871-84.  
  11. Coons PM.  Psychiatric problems associated with child abuse. In Psychiatric sequellae of 
    child abuse.  Springfield, IL: CC Thomas; 1986: 177.
  12. Dubowitz H, Black M. Child neglect. In Child abuse: Medical diagnosis and management.  
    Philadelphia: Lea and Fibiger; 1994: 290-1.
  13. Jessee SA. Behavioral indicators of child maltreatment. J Dent Child 1999; 66:17-22.
  14. Children of Alcoholics Foundation, Inc.  Helping children affected by parental addiction and
    Family violence. New York: Children of Alcoholics Foundation; 1996.
  15. Klein M, Stein I. Low birth weight and the battered child syndrome.  Am J Dis Child 1971;
    122:15-23.
  16. Cohn F, Salmon ME, Stobo JD. Confronting chronic neglect: The education and training of
    health professionals on family violence. Washington: National Academy Press; 2002.   
  17. Love C, Gerbert B, Caspers N, Bronstone A, Perry D, Bird W.  Dentists’ attitudes and
    behaviors regarding domestic violence: the need for an effective response.
    JADA 2001; 132:85-93.
  18. Danley D, Gansky SA, Chow D, Gerbert B.  Preparing dental students to recognize and
    respond to domestic violence. JADA 2004; 135:67-73. 
  19. Sfikas PM.  Reporting abuse and neglect.  JADA 1999; 130:1797.
  20. Edwards LP. Child Abuse and Neglect Reporting Act. Thompson West Publishing; 2003.
  21. Lough P.  Mandated reporting of child abuse: Answers for dentists. CDA Journal 2004;
    4:307-12.
  22. Woodall M. Doctor guilty of failing to report abuse. Philadelphia Inquirer, Feb 26, 1995.
  23. Monteleone JA.  Recognition of child abuse for the mandated reporter. 2nd ed. St. Louis:
    G.W. Medical Publishing, Inc; 1996: p 180.
  24. American Dental Association.  The dentists responsibility in identifying and reporting child
    abuse and neglect. 2nd ed. 1995: p 11-12.
  25. Hobbs C, Wynne J.  Physical signs of child abuse.  London: Harcourt Publishers Ltd. 2001.
  26. Holowaty R, Stechey FM.  Dentistry’s responsibility to child abuse.  Oral Health 2002; 92:15-25.
  27. Spencer DE.  Recognizing and reporting child abuse. CDA Journal 1996; 24:43-9.
  28. Spencer DE.  Bite marks in child abuse.  In Manual of forensic odontology. 3rd ed. Pontpelier, VT:Printing Specialists; 1995: 177-8.
  29. Giardino AP, Giardino ER.  Recogniion of child abuse for the mandated reporter. 3rd ed.
    St. Louis: G. W. Medical Publishing, Inc; 2002: p 8.
  30. Sinha S, Acharya P, Jafar H, Bower E, Harrison V, Newton JR.  The management of
    abuse: A resource manual for the dental team.  London: Stephen Hancocks Limited; 2005: 17.
  31. Sanger RG, Bross DC.  Clinical management of child abuse and neglect.  Chicago:
    Quintessence Books; 1984.
  32. Simon PA.  Recognizing and reporting the orofacial trauma of child abuse/neglect.  Texas
    Dental Journal 2000; 117:21-31.     
  33. American Dental Association, Proceedings: Dentists C.A.R.E. Conference 1998
  34. National Clearinghouse for Child Abuse and Neglect.  A coordinated response to child abuse and neglect: A basic manual. 1992.
  35. Fergusson DM, Mullen PE.  Childhood sexual abuse: An evidence-based perspective. 
    Thousand Oaks, CA: Sage; 1999:13-33.
  36. Stalker CA, Russell BDC, Teram E, Schachter CL.  Providing dental care to survivors of
    childhood sexual abuse. JADA 2005; 136:1277-81.  
  37. Stein M, Hanna C, Koverola C, Torchia M, McClarty B.  Structural brain changes in PTSD:
    Does trauma alter neuroanatomy?  Ann NY Acad Sci 1997; 821:76-82.
  38. American Dental Association. Principles of Ethics and Code of Professional Conduct
    Revised January 2006.

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