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Types of Abuse
- neglect
- physical abuse
- sexual abuse
- emotional/psychological abuse
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non-accidental physical, emotional, or sexual acts against a child under 18
abuse
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intentional or unintentional failure to provide what is neccessary for physical, intellectual, and emotional development of a child by a person who is reponsible for the child's welfare
neglect
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willful failure of a parent or guardian to seek and follow through with teatment necessary to ensure a level of oral health essential for adequate function and freedom from pain and infection
dental neglect
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general signs of abuse and neglect
- overall appearance:
- long sleeves long pants
- uncleanliness
- malnutrition/failure to thrive
- lice
- behavioral:
- fearful and crys excessively; may show no fear at all
- unhappy and withdrawn
- behavior not developed for age
- acts differently around parent
- developmental delays (speech and motor skills)
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extraoral signs of abuse
- skull injuries: edma, combined with eccchymosis
- bald spots (traumatic alopecia)
- raccoon sign
- nose fractures
- lip brusis and lacerations
- human bite marks
- marks on the skin resembaling buckles or hands
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common accidntal injury sites
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non common sites of injury
- nose
- upper arm
- thigh
- calf
- private areas
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Intraoral signs of abuse
- tongue, buccal mucosa, or palatal lacerateions
- lingual and lbial frenal tears
- fractured, displaced, avulsed, or nonvital teeth
- radiographic evidence of fractures
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signs of sexual abuse
- bruising of petechiae on palate
- sexually transmitted genital lesions in mouth
- exhibiting difficulty in walking or sitting
- extreme fear of oral exam
- pregnancy (especially in early adolenscent years)
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signs of oral neglect
- lack of regularity of dental care
- untreated disease
- rampant caries
- pain
- gingival inflammation and bleeding
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reasons for dental neglect
- consider dental care low prioraty
- lack of education
- limited finances
- access to care
- religious beliefs
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general attitude fo abusers
- disinterest/denial in relationship to child
- only wants pain relief for child
- does not accompany child
- inconsistencies about causes of trauma
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contributing factors to abusive parents
- immature/unprepared for parenthood
- abused themselves
- unable to hadle daily stress
- drugs/alcohol
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signs of abuse and neglect in elderly
- general: withdrawn, anxious, shy, low selfesteem
- physical: bruises, traumatic alopecia, human bite marks, dislocations or sprains w/ fingertip pattern, poor hygiene, inadequazte clothing fo the season, scratches or burns, patterned bruises , cachexia
- extraoral: lip trauma, bruises of facial tissues, eye injuries, fractured or bruised mandible, tmj pain
- inraoral: fracutured, diplaced, avulsed teeth, brusing of the edentulous ridge, std lesions, lesions or sore ares in the mouth from ill-fitting dentures, fracutred denture, poor oral hygiene, rampant dental caries, untreated periodontal disease
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signs and attitudes of abused partner
- similar to elder
- involve face, eyes, and neck
- reluctant to admit abuse due to threats of harm
- may defend the abuser or provide excuses
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dental hygienist's approach
- provide support
- discuss finding in a nonjudgmental manner
- respect/maintain confidentiality
- provide references for counseling
- respect patient's autonomy
- prepare to share findings with authorites
- have witness when interview may be used in legal setting
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content of records for abused patient
- thorough histories from patient and caregiver
- date, tiem and place of exam
- record all observable facts
- record/document in abused patient's exact words (use quotations)
- document all lesions: size, location, shape, color
- photograph (need patient's concent)
- use the word "suspected abuse" if patient denies abuse
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PANDA
Prevent Abuse and Neglect through Dental Awareness (training for dental professionals)
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reportable required info for abused child
- name and address of child and parents
- chil's age
- names of siblings
- nature of chil's condition adn signs of previous injury
- any additional info helpful
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DFPS
texas department of family and protective services
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if you don't report suspected abuse you are held liable for what?
class B misdemeanor
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