Oral and dental signs of child abuse and neglect.
Oral and dental signs of child abuse and neglect.
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DOI：
10.11138/orl/2015.8.2.068
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发表时间：
2015-04-01
影响因子：
--
通讯作者：
Docimo, R
中科院分区：
文献类型：
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作者：
Costacurta, M;Benavoli, D;Docimo, R
目的：本报告的目的是确定主要的口腔和牙科方面的身体和性虐待和牙科忽视在童年，有助于早熟的识别和诊断在牙科practice.METHODS：口腔和牙科表现进行了划分和分类，根据类型的儿童虐待：身体虐待，性虐待，忽视。文献中的几项研究表明，约50%的身体虐待儿童发生口腔或面部创伤;口腔可能是身体虐待的中心焦点。身体虐待的口面部表现包括舌头、嘴唇、口腔粘膜、硬腭和软腭、牙龈、牙槽粘膜、系带的瘀伤、擦伤或撕裂伤;牙齿骨折、牙齿脱位、牙齿撕脱;上颌骨和下颌骨骨折。性虐待：虽然口腔是儿童性虐待的常见部位，但可见的口腔损伤或感染很少见。一些口腔体征可能是性虐待的重要迹象，如红斑、溃疡、水疱伴脓性引流或假膜，以及唇、舌、腭和鼻咽部的湿疣性病变。此外，如果在软腭和硬腭交界处或口底发现不明原因的红斑和瘀点，肯定是强迫口交的明显证据。牙齿忽视：忽视的口腔症状很容易识别，包括：口腔卫生不良、口臭、幼儿龋齿（ECC）、牙源性感染（复发性和先前的牙周病）、牙周病、由于营养缺乏状态导致的口疮病变。此外，它分析了评估的咬痕，因为往往与儿童虐待，识别和收集的临床证据，这种类型的injuries.CONCLUSION：一个早熟的诊断儿童虐待，在牙科的做法，可以大大有助于在暴力案件的识别和早期干预。
AIM: The aim of this report is to identify the main oral and dental aspects of physical and sexual abuse and dental neglect in childhood, contributing to the precocious identification and diagnosis in a dental practice.METHODS: The oral and dental manifestations were divided and classified according to the type of child abuse: physical abuse, sexual abuse, neglect.PHYSICAL ABUSE: Several studies in the literature have shown that oral or facial trauma occurs in about 50% of physically abused children; the oral cavity may be a central focus for physical abuse. Oro-facial manifestations of physical abuse include bruising, abrasions or lacerations of tongue, lips, oral mucosa, hard and soft palate, gingiva, alveolar mucosa, frenum; dental fractures, dental dislocations, dental avulsions; maxilla and mandible fractures.SEXUAL ABUSE: Although the oral cavity is a frequent site of sexual abuse in children, visible oral injuries or infections are rare. Some oral signs may represent significant indications of sexual abuse, as erythema, ulcer, vescicle with purulent drainage or pseudomembranus and condylomatous lesions of lips, tongue, palate and nose-pharynx. Furthermore, if present erythema and petechiae, of unknown etiology, found on soft and hard palates junction or on the floor of the mouth, can be certainly evident proofs of forced oral sex.DENTAL NEGLECT: Oral signs of neglect are easily identifiable and are: poor oral hygiene, halitosis, Early Childhood Caries (ECC), odontogenous infections (recurrent and previous abscesses), periodontal disease, aptha lesions as a consequence of a nutritional deficiency status. Moreover, it is analyzed the assessment of bite marks because often associated with child abuse, the identification and collection of clinical evidence of this type of injury.CONCLUSION: A precocious diagnosis of child abuse, in a dental practice, could considerably contribute in the identification of violence cases and in an early intervention.