SPOTTING THE UNSEEN: A NARRATIVE REVIEW OF CHILD ABUSE AND NEGLECT THROUGH DENTAL AND PSYCHIATRIC LENSES

The Centers for Disease Control and Prevention (CDC) define child maltreatment as any act or series of actions, whether through commission or omission, by a caregiver that poses a threat to or harms a child. Child neglect is generally characterized by a continuing failure to fulfill a child's basic physical and/or psychological needs, which can significantly impair the child's development or health. Specifically, dental neglect refers to the willful neglect by a caregiver or legal guardian to prevent the onset of oral diseases and the failure to seek necessary treatment to maintain proper oral health, functionality and freedom from pain and infection. Child maltreatment can be classified into several categories, which may occur independently or in combination. These categories include physical abuse, sexual abuse, emotional or psychological abuse and neglect, physical neglect, human trafficking, medical care and Munchausen syndrome by proxy. Child abuse and neglect are critical issues that extend beyond social contexts to significantly impact healthcare professionals who may encounter abused children. With over half of trauma cases occurring in the head and neck area, dental professionals are uniquely positioned to offer vital insights into instances of abuse and are essential in identifying oral signs indicative of neglect. This makes the detection and reporting of abuse not only a moral duty but also a legal obligation. This review focuses on assessing perioral and intraoral injuries, bite marks, infections, diseases and psychological distress that might indicate potential child abuse or neglect. Additionally, it notes that oral health problems may also be associated with victims of human trafficking.