Conditions to be considered in the differential diagnosis of child abuse and neglect

Dentists and dental personnel have an obligation to report occurrences of child abuse and neglect (CAN). The general types of abuse and neglect are defined, as is dental neglect. Dental neglect is the "willful failure of parent or guardian to seek and follow through with treatment necessary to ensure a level of oral health essential for adequate function and freedom from pain and infection." Dentists and dental staff should be trained in recognizing and reporting abuse and neglect. In this training, consideration should be given to dental and medical conditions which mimic CAN. These include tooth fractures, nursing caries syndrome, rampant dental decay, skeletal injuries, dermatologic conditions, and genetic and certain congenital defects. The article reviews literature on the subject and includes photographs of conditions which could be mistaken for CAN.