369

Abuse

the role of

Forensic dentists

John d. mCdowell

Contents

15.1 Introduction and Background 3 69
15.2 Child Maltreatment 370
15.3 Abuse during Pregnancy 371
15.4 Physical Injuries during Dating 3 72
15.5 Spouse Abuse (Intimate Partner Violence) 3 72
15.6 Elder Abuse 3 74
15.7 Conclusion 376
References 378

15.1 Introduction and Background

It has often been stated that intrafamily and intimate partner violence (IPV)
is epidemic in the United States. Over the previous decades, best estimates
indicate that somewhere between 20 and 50% of U.S. households have expe-
rienced some form of violence. Many of the injuries associated with inflicted
(also termed nonaccidental or intentional) trauma are seen in the maxillo-
facial complex. These inflicted injuries are often treated on an immediate
or delayed basis by general dentists, specialists within the dental profession,
physicians, or ancillary members of the oral health care team. This chapter
will provide useful information when determining if the facial/dental injuries
are accidental in nature or if the trauma is more likely to be the result of
nonaccidental trauma. The key features that are helpful in differentiating
accidental injuries from inflicted injuries are:

1. Injuries at variance with history given


2. Injuries at various stages of healing


3. Interpersonal difficulties


4. Delayed presentation for care

15