Forensic Dentistry, Second Edition

374 Forensic dentistry

Notwithstanding the physical injuries suffered during violent intimate
partner relationships, there is also a significant financial burden placed upon
families. Estimates indicate that the annual medical expense associated
with domestic violence is at least $3 billion to $5 billion. Also, businesses are
reported to lose another $100 million in lost wages, sick leave, absenteeism,
and loss of productivity.^11
Crandall et al.^12 have reported that women who suffered intentional blunt
trauma exhibited very different injury patterns than those hospitalized for
motor vehicle accidents and falls. The risk for facial injury was much higher
among the domestic violence victims than was seen in other mechanisms of
injury. Head injuries were also more common in women victims of intimate
partner violence.^12
The author’s published thesis^13 also found that compared to women who
were victims of motor vehicle accidents, women who were intentional trauma
victims were more likely to:

•   Present for care on a delayed basis (not presenting immediately after

the incident causing the injuries associated with the chief complaint)

•   Have had a previous facial/dental injury

•   Have had a previous emergency department visit for injuries associ-

ated with intimate partner violence

Multiple injuries have also been reported to suggest intimate partner vio-

lence. One published study indicates that 85% of intimate partner violence

victims were found to have injuries on more than one area of the body. The most

common sites for injury were the eye, side of the face, throat and neck, upper and

lower arms, upper and lower legs, mouth, outside of the hand, back, and scalp.^14

Injuries to the shoulder and back were less common in intimate partner

violence cases than were injuries to the shoulder and back found in those

cases known to be caused accidentally. Of importance to dentists, 79% of the

injuries were in areas clearly visible (injuries to the head and hands).^14 Ve r y

similar patterns were found in a study by Sheridan and Nash^15 and a study by

Petridou et al.^16

Intimate partner violence often overlaps in families and those in inti-

mate relationships. An abused child often has an abused mother. An abused

mother often has an abused child. Abuse knows no age group limitations

and is seen in persons of all ages from the very young through the very old

(Figures 15.3 to 15.5).

15.6 Elder Abuse

It is difficult to know the exact number of individuals over the age of sixty-

five that are abused and neglected in the United States every year. However,