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NEGLECT
By: Ashley Mayeux & Christine Read
Definitions:
Family abuse, also known as domestic violence, is the abuse by one
individual of another in an intimate relationship. It is the nonaccidental physical, emotional, or nonconsensual sexual act against
a child, adult, or elderly person.
Neglect is the intentional or unintentional failure to provide for a
Identification:
Abuse can be detected during the initial assessment of a
Behavioral:
May be very fearful and cry excessively or will show no fear at all.
May appear unhappy and withdrawn.
May not exhibit normal behavior consistent with the present age of
the child.
May act differently when the parent is present than when alone, which
Common sites
of deliberate
injuries:
-Skull injuries ; edema,
combined with ecchymosis
of varying states.
-Bald spots (traumatic
alopecia); caused by pulling
the hair out at the roots.
-Raccoon sign: bilateral
periorbital ecchymosis.
-Nose fractures or
displacement.
-Lip bruises &lacerations;
angular bruising,
lichenification (thickened &
leathery skin), or scarring,
which can be caused from
gags applied to the mouth.
-Marks on the skin that form
a pattern of an object like a
belt buckle or hand print.
-Human bite marks.
Intraoral
Signs of
Abuse
-Care must be given to
the assessment of
intraoral traumatic
injuries. Many injuries of
the mouth in children
can be caused by
accidents.
-Lacerations of the
tongue, buccal mucosa,
or palate.
-Lingual or labial frenal
tears.
-Teeth that are
fractured, displaced,
avulsed, or nonvital.
-Radiographic evidence
of fractures in different
degrees of healing.
Signs of Sexual
Abuse:
-Bruising or
petechia of the
palate can indicate
forced oral sex.
-Sexually
transmitted genital
lesions found
intraorally.
-Exhibits difficulty in
walking or sitting.
-Extreme fear of the
oral examination.
-Pregnancy,
especially in the
early adolescent
years.
Signs of Oral
Neglect:
-Signs of lack of
personal daily
care.
-Untreated
disease, including
rampant caries,
pain, gingival
inflammation, &
bleeding.
-Lack of regularity
of dental care;
appointments may
have been made
primarily for tooth
or mouth pain.
Elder Maltreatment
Mistreatment occurs in institutional settings as well as in
Intraoral Signs:
-Lip trauma.
-Bruising of facial tissues.
-Eye injuries.
-Fractured or bruised mandible.
-Tempromandibular joint pain.
Intraoral Signs:
Same as for children, with the addition of:
reassurance.
Discuss findings in a nonjudgemental manner.
Respect and maintain confidentiality.
Provide references for counseling.
Respect patients autonomy; ask about plans for future safety.
Prepare to share your findings with authorities, if necessary.
When it is known that the interview will be used in a legal setting, a
witness needs to be present.
Document clinical findings, including extra/intraoral photographs of
injuries.
Reporting Maltreatment
Proper training in the recognition and reporting of abuse and neglect
Reporting Laws
-Vary from state to state.
Texas law requires anyone with knowledge of suspected child abuse
or neglect to report it to the appropriate authorities. All persons are
required to make the report immediately, & individuals who are licensed
by the state and have contact with children as a result of their normal
duties, such as teachers, nurses, doctors, & day-care employees, must
report the abuse or neglect within 48 hours.
Test Questions:
1.What percentage of child physical abuse involves injuries
References
dentalcare.comChildAbuseandNeglect:ImplicationsfortheDentalProfe
ssional
www.smu.edu/ola/BriefingPapers/Dutyto
ReportSuspectedChildAbuseintheStateofTexas