American Academy of Pediatrics Reviews How Children’s Dental Health May Signal Neglect or Abuse

AAP recommends collaboration between pediatricians, dental professionals, and other physicians to detect, treat oral injuries due to child abuse and neglect
 
ITASCA, IL--The American Academy of Pediatrics has updated its recommendations for physicians on how to identify problems involving a child's teeth, gums and mouth that may be signs of physical or sexual abuse or neglect.
 
The clinical report, “Oral and Dental Aspects of Child Abuse and Neglect,” written by the AAP Section on Oral Health and AAP Council on Child Abuse and Neglect, will be published in the September 2024 issue of Pediatrics (published online Aug. 19).
  
“A child’s oral health can be an important indicator and predictor of overall health,” said Susan A. Fisher-Owens, MD, MPH, FAAP, an author of the clinical report. “Pediatricians play an essential role in encouraging families to seek dental care and explaining benefits of completing needed dental treatment.”
 
Clinical reports created by AAP are written by medical experts, reflect the latest evidence in the field, and go through several rounds of peer review before being approved by the AAP Board of Directors and published in Pediatrics. 
 
The AAP clinical report recommends collaboration among health care and dental professionals to help prevent, detect and treat cases of child abuse and neglect. The AAP reviews the oral aspects of abuse and dental neglect in children and provides guidance on how pediatricians, dental professionals and other physicians can evaluate such conditions. It includes sections on physical abuse, sexual abuse, medical child abuse, bite marks on the skin, bullying, human sex trafficking and dental neglect.
 
Pediatricians, dental professionals and other physicians must report injuries concerning abuse or neglect to child protective services in accordance with local or state legal requirements. 
 
The AAP recommends:

• Because children with dental abnormalities are at increased risk for bullying, providers should ask their patients about bullying and advocate for antibullying prevention programs in schools and other community settings.
• Health care providers and dental professionals are encouraged to be aware of human trafficking screening tools and the risk factors for human trafficking to identify children at risk and to safely report and connect patients to resources.
• If parents do not obtain necessary treatment for a child’s oral or dental disease after barriers to care have been addressed, the case should be reported to the appropriate child protective services agency for dental neglect.
• The report provides an update on evaluating whether acute or healed bite marks on skin signal abuse and their use in identifying potential perpetrators. Because guidelines no longer endorse the use of bite marks to identify suspects of abuse, pediatricians, other physicians, and dental professionals should consult with a forensic odontologist (a pediatric dentist experienced in forensic issues) or child abuse pediatrician for help in evaluating bite marks.

At least one in seven children in the United States experiences child abuse and neglect each year, according to national data. Maltreatment may have been even higher during and after the COVID-19 pandemic due to factors such as increased family stressors, isolation from community support systems and underreporting.
 
“Some families may struggle with finances or transportation concerning their dental appointments, and so it is important to know what community resources are available,” Dr. Fisher-Owens said. “The pediatrician and dental professionals can work together to help patients understand the importance of dental care and overcome obstacles.”

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The American Academy of Pediatrics is an organization of 67,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults.