Orofacial manifestations of child abuse and neglect.

About one-half of all child abuse cases involve some form of orofacial injury. Common signs of physical abuse include fractures of the teeth or the maxilla, mandible and other facial bones, facial burns, lacerations of the lips and lingual frenum, and bite marks on the face and neck. Sexual abuse should be suspected if erythematous, ulcerative, vesiculopustular, pseudomembranous and condylomatous lesions are present on the lips, tongue, palate, face or pharynx. Dental neglect, a common form of child maltreatment, should be suspected if rampant caries and oral infection, bleeding and trauma persist despite the elimination of financial and transportation obstacles. Questioning the child and parents separately may help uncover an obvious discrepancy between the clinical findings and the history. Reporting suspected child abuse to the appropriate agency may protect the child from further injury and help the family obtain assistance to correct abusive practices and minimize the recurrence of abuse.