Dental aspects of 1248 cases of child maltreatment on file at a major county hospital.

The frequency of head, face, mouth, and neck injuries due to child maltreatment was investigated in a review of 1248 cases on file in the pediatrics office at Hennepin County Medical Center in Minneapolis, Minnesota, from January, 1985, to December, 1989. There were 485 boys (38.8%) and 763 girls (61.2%) examined. Physical abuse cases (41.0%) outnumbered sexual abuse (35.4%) and neglect episodes (23.6%). The gender ratio was distributed equally except in sexual abuse, where there were 4.7 girls for each boy examined. More than half of the children (52.9%) were in the 0-to-4 year age group. Considering all cases together, 37.5% presented with injuries to the head, face, mouth, and neck. However, that percentage doubled (75.5%) when physical abuse episodes were reviewed alone. The intraoral injuries seen were five tooth fractures, three tongue and tongue frenulum lacerations, two lip frenulum lacerations, 11 injuries to the oral mucosa, eight palatal lesions, two fractures of the mandible or maxilla, loose and missing teeth, and dental neglect. Despite the high frequency of injuries, no dentists examined children at the time of the hospital intake or referred children for suspicion of maltreatment in the population studied. The findings suggest the importance of involving dental professionals in identifying, reporting, and preventing child abuse and neglect.