Forensic Dentistry, Second Edition

372 Forensic dentistry

Obstetricians and Gynecologists (ACOG) has produced an excellent publica-
tion that describes abuse during pregnancy.^5 The ACOG reports that during
pregnancy, the abuser is more likely to direct blows at the pregnant woman’s

breasts and belly, sometimes resulting in maternal homicide or miscarriage.^5
However, while some of the inflicted trauma is directed at the breast and belly,
the abusive acts can take many forms, including pushing, hitting, slapping,
k ick i ng , chok i ng , beat i ng , or at t ack i ng w it h a weapon.^5 A lt hou g h t he se fig u re s
are alarming, not every pregnant women is the victim of abuse—in fact, most
women are not abused during pregnancy. In some cases of women reporting
being in an abusive relationship, abuse might actually decrease during preg-
nancy. Some women report that they actually feel safe only when carrying
a child.^5 Since some of the trauma may be in areas not commonly seen by
ora l hea lth care prov iders, dentists, hygienists, and ancillar y personnel should
be aware that there is a need for medical (or law enforcement) evaluation of
pregnant women with suspicious maxillofacial injuries.

15.4 Physical Injuries during Dating

Violence in intimate (to include dating) relationships can begin at an early
age. Dating violence (also termed physical dating violence [PDV]) has been
defined as physical, sexual, or psychological violence within a dating rela-
tionship. A study of dating violence among students in grades 7 to 12 found
that physical and psychological violence was 12 and 20%, respectively.^6 These
self-reports of violence behaviors indicated that there was hitting, slapping,
or some other form of physical harm during the dating period. Students with
poorer grades (mostly Ds and Fs), blacks, non-Hispanics, and students from
the northeastern United States were at greatest risk for dating violence and

victimization.^6 In addition to the risk for physical injury and death asso-
ciated with physical violence during dating, other forms of secondary risk
associated with dating violence included sexual intercourse (protected and
unprotected), attempted suicide, substance abuse, episodic heavy drinking,
and physical fighting.7, 8 (Figure 15.2).

15.5 Spouse Abuse (Intimate Partner Violence)

Spouse abuse (intimate partner violence) is a major cause of morbidity and

mortality in the United States. These data are supported by the Federal Bureau

of Investigation (FBI) Supplementary Homicide Reports, 1976 –2004.^9