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Associations between child abuse and neglect, and dento-alveolar injuries in a Children's hospital population

Ehsan N Azadani1,2, Dennis J McTigue1,2, Jin Peng3

  • 1Division of Pediatric Dentistry, The Ohio State University College of Dentistry, Columbus, Ohio, USA.

Dental Traumatology : Official Publication of International Association for Dental Traumatology
|November 10, 2023
PubMed

Insights

Demographic factors do not predict child abuse and neglect (CAN) in children with dento-alveolar trauma (DAT). Sibling violence is a significant factor in cases of suspected child abuse and neglect with dental injuries.

Area of Science:

  • Pediatric Emergency Medicine
  • Child Abuse and Neglect Research
  • Dental Trauma Studies

Background:

  • Dento-alveolar trauma (DAT) in children can be associated with child abuse and neglect (CAN).
  • Identifying common social variables between DAT and CAN is crucial for early detection and intervention.
  • Previous research has explored risk factors, but a comprehensive analysis in a large pediatric hospital setting is needed.

Purpose of the Study:

  • To identify social variables common to children experiencing both dento-alveolar trauma (DAT) and child abuse and neglect (CAN).
  • To compare the characteristics of children with co-occurring DAT and CAN to those with DAT only.
  • To inform clinical practice and improve identification of CAN in pediatric patients presenting with dental injuries.

Main Methods:

  • A case-control study design was employed using emergency department data from a Level 1 trauma children's hospital.
  • Data were collected from December 2017 to September 2022, identifying children with both DAT and CAN (cases) and comparing them to children with DAT only (controls).
  • Descriptive statistics and Chi-Squared/Fisher's exact tests were used to analyze demographic and social variables, with significance set at p ≤ 0.05.

Main Results:

  • The study identified 14 children with both DAT and CAN (cases) and 42 age/sex-matched controls with DAT only.
  • No significant demographic differences (language, race, insurance, custody, guardianship, residence type) were found between cases and controls.
  • Cases were more likely to have special needs (35.7% vs. 9.5%, p=0.03) and behavioral problems (64.3% vs. 31%, p=0.05). Facial injuries were more prevalent in cases (74.3% vs. 31%).
  • Siblings were reported as the perpetrator in half of the CAN cases.

Conclusions:

  • Demographic characteristics alone do not reliably predict child abuse and neglect in children with dental injuries.
  • The findings highlight the importance of considering sibling violence as a potential cause in suspected child abuse and neglect cases presenting with dento-alveolar trauma.
  • Further research into social and behavioral factors associated with DAT and CAN is warranted to improve diagnostic accuracy and child protection measures.
Abstract

Keywords:
child abusedental traumadento-alveolar traumainjuryneglect

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