Injuries to the head, face, mouth and neck in physically abused children in a community setting

The aims of the present study were to identify the incidence of orofacial injuries found within a cohort of physically abused children, and examine demographic data surrounding the alleged perpetrator, the location in which the alleged assault occurred, the mechanism of injury and the actual orofacial injury incurred.

The research took the form of a retrospective study of clinical case records of children with suspected physical abuse from 1 June 1998 to 31 May 2003. Seven hundred and fifty case records were identified and 390 (46.7%) were available for data extraction.

Fifty-nine per cent (n = 230) of children had signs of abuse on the head, face or neck. The alleged perpetrator was the mother in 104 cases (26.7%), the father in 100 (25.6%) and mother's partner in 49 other cases (12.6%). More than half (53.3%) of the alleged abuse occurred in the child's home; in 32.3% of cases, the location was not recorded. Other locations included outside in a public place, school and at the home of the alleged abuser. Some 23.4% (n = 54) had been punched or slapped around the head, neck or face, 17.4% (n = 40) had been struck by an object, and 15.2% (n = 35) had allegedly sustained multiple modes of injury. Bruising to the head, neck or face was seen in 95.2% (n = 219) of children, and 32.6% (n = 75) had abrasions; 65.2% (n = 150) of the bruises and 22.9% (n = 53) of the abrasions were on the face.

Fifty-nine per cent of physically abused children in the present cohort had orofacial signs of abuse which would be easily visible to a dental practitioner. The commonest injuries were bruises and abrasions. This concurs with previous reports in the literature and highlights the important role of dental practitioners in the recognition of children who have been abused.