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Questions and Answers
What should be done when documenting bite marks?
What should be done when documenting bite marks?
What distinguishes human bite marks from animal bite marks?
What distinguishes human bite marks from animal bite marks?
Which measurement of inter-canine distance raises suspicion for a human bite?
Which measurement of inter-canine distance raises suspicion for a human bite?
Why is interpreting bite marks challenging?
Why is interpreting bite marks challenging?
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Who is ideally suited to evaluate bite marks for forensic analysis?
Who is ideally suited to evaluate bite marks for forensic analysis?
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What percentage of cases of physically abused children report injuries to the head and neck?
What percentage of cases of physically abused children report injuries to the head and neck?
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What was the confirmed number of abused or neglected children in Massachusetts in 2018?
What was the confirmed number of abused or neglected children in Massachusetts in 2018?
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What factor contributed to the increase in physical child abuse during the Covid-19 pandemic?
What factor contributed to the increase in physical child abuse during the Covid-19 pandemic?
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Which age group was included in the retrospective study reviewing physical child abuse patients?
Which age group was included in the retrospective study reviewing physical child abuse patients?
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What percentage of total trauma patients comprised physical abuse injuries during the Covid-19 period?
What percentage of total trauma patients comprised physical abuse injuries during the Covid-19 period?
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What trend was observed over the past 20 years regarding child abuse incidence?
What trend was observed over the past 20 years regarding child abuse incidence?
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What is one of the main vulnerabilities for certain children regarding abuse?
What is one of the main vulnerabilities for certain children regarding abuse?
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What is the potential annual death toll from child abuse as mentioned?
What is the potential annual death toll from child abuse as mentioned?
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What is the purpose of using a double swab technique in bite mark evidence collection?
What is the purpose of using a double swab technique in bite mark evidence collection?
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Which material is recommended for creating a 3-dimensional model of a bite mark?
Which material is recommended for creating a 3-dimensional model of a bite mark?
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What should be ensured when collecting and documenting evidence of a bite mark?
What should be ensured when collecting and documenting evidence of a bite mark?
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What distinct feature identifies immersion burns in children?
What distinct feature identifies immersion burns in children?
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What degree of temperature does the lit end of a cigarette produce?
What degree of temperature does the lit end of a cigarette produce?
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How do new bruises typically present themselves?
How do new bruises typically present themselves?
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What common misconception might someone have about the healing process of bruises?
What common misconception might someone have about the healing process of bruises?
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Which of the following is NOT considered a form of physical abuse?
Which of the following is NOT considered a form of physical abuse?
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What is the responsibility of law enforcement when it comes to bite mark evidence?
What is the responsibility of law enforcement when it comes to bite mark evidence?
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What is a sign that a child is at risk for dental neglect?
What is a sign that a child is at risk for dental neglect?
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What factor differentiates a bruise's appearance during healing?
What factor differentiates a bruise's appearance during healing?
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Which factor must be considered to determine if dental neglect should be reported?
Which factor must be considered to determine if dental neglect should be reported?
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What should be explained to parents when discussing dental treatment options?
What should be explained to parents when discussing dental treatment options?
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What characterizes Munchausen Syndrome in the context of child care?
What characterizes Munchausen Syndrome in the context of child care?
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What action should be taken if a caregiver fails to seek treatment after being informed about risks?
What action should be taken if a caregiver fails to seek treatment after being informed about risks?
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What role does understanding dental care play in assessing neglect?
What role does understanding dental care play in assessing neglect?
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What should be ensured about the family when barriers to healthcare exist?
What should be ensured about the family when barriers to healthcare exist?
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Which situation does NOT indicate the need for reporting dental neglect?
Which situation does NOT indicate the need for reporting dental neglect?
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What is the primary characteristic of Epidermolysis Bullosa?
What is the primary characteristic of Epidermolysis Bullosa?
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Which medical condition is characterized by a lack of proper blood clotting?
Which medical condition is characterized by a lack of proper blood clotting?
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What role do dentists have regarding suspected cases of child abuse?
What role do dentists have regarding suspected cases of child abuse?
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What is a symptom associated with Staphylococcal scalded skin syndrome?
What is a symptom associated with Staphylococcal scalded skin syndrome?
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Which factor contributes to children with Hemophilia being more likely to present with bruises?
Which factor contributes to children with Hemophilia being more likely to present with bruises?
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What percentage of suspected abuse cases are reported by dentists compared to other professionals?
What percentage of suspected abuse cases are reported by dentists compared to other professionals?
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What can trigger the symptoms of Epidermolysis Bullosa?
What can trigger the symptoms of Epidermolysis Bullosa?
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Which of the following is NOT a reason for dentists to familiarize themselves with signs of child abuse?
Which of the following is NOT a reason for dentists to familiarize themselves with signs of child abuse?
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Study Notes
Introduction
- Child abuse is a major problem and can affect all socioeconomic segments of society.
- Over 1,500 children die from abuse each year, and underreporting is estimated at 50%.
- Massachusetts has one of the highest rates of abused and neglected children.
- 65-75% of physically abused children have head and neck injuries.
- Children with special health care needs are at higher risk for abuse.
- Abuse has increased dramatically over the past 20 years.
- Confirmed cases of abused and neglected children in MA have risen from 31,089 in 2015 to 84,399 in 2021.
Covid-19 and Child Abuse
- A study at the John Hopkins Children’s Center in Maryland found that physical abuse injuries in children accounted for 13% of total trauma patients during the Covid-19 pandemic.
- The research suggests restrictions on access to childcare and increased exposure to perpetrators at home may have contributed to the increase.
Signs of Physical Abuse
- Bruises, broken bones, and burns.
- Multiple injuries at different stages of healing.
- Injuries inconsistent with characteristics of the injury or the child's capabilities.
Bite Marks
- Bite marks from animals tend to tear flesh, while human bite marks compress flesh and may cause abrasions, contusions, and lacerations.
- An inter-canine distance measuring more than 3.0 cm is suspicious of an adult human bite.
- Forensic professionals should ideally analyze bite marks, but dentists can examine them if other experts are unavailable.
- Documentation of bite marks should include photographs, double swabs (to collect epithelial cells) and polyvinyl siloxane impressions.
Other Forms of Physical Abuse
- Hitting, slapping, ear pulling, hair pulling, choking, or strangulation.
- Immersion in scalding liquid can cause “sock burns” (both feet immersed) or “glove burns” where part of the fingertips are spared from the burn due to the child making a fist during immersion.
- Cigarette burns leave distinct marks due to the high temperature of a lit cigarette.
- Bruises change color as they heal, with new bruises appearing red and swollen, and older bruises turning green, yellow, or brown.
Dental Neglect
- Dental neglect is a form of child abuse.
- This can occur when a caregiver fails to provide necessary dental care for the child, even with access to healthcare and understanding of the child’s needs.
- Dentists are responsible for report suspected cases of dental neglect.
- If a caregiver understands the explanation of the child’s dental needs, their risks and benefits, and refuses to seek treatment then the case should be reported to the appropriate child protective services agency.
- When reporting dental neglect, a dentist should document efforts to assist the family with resources like financial aid and transportation.
Munchausen Syndrome
- This is a mental illness and a form of child abuse, where a caregiver, typically a mother, intentionally makes up or causes symptoms to make the child appear sick.
Predisposing Medical Conditions
- Epidermolysis Bullosa, Hemophilia, and Staphylococcal Scalded Skin Syndrome (SSSS) can mimic signs of abuse.
- Epidermolysis Bullosa: This is a genetic condition resulting in fragile, blistering skin that can easily blister after minor injury.
- Hemophilia: This disorder prevents blood from clotting properly, causing spontaneous bleeding and bruising.
- Staphylococcal Scalded Skin Syndrome (SSSS): This skin infection causes peeling skin over a large area of the body, potentially resembling burn injuries.
Dentist's Role in Reporting
- Dentists are mandatory reporters in all US states.
- They are legally obligated to report suspected cases of child abuse and neglect to social services or law enforcement agencies.
- Dentists reported only 32% of suspected cases of abuse.
Dental Responsibilities to Report
- Dentists must be familiar with signs of child abuse and neglect.
- They must understand the legal requirements for mandatory reporting.
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Description
Test your knowledge on the critical issues surrounding child abuse, including statistics, contributing factors, and signs of physical abuse. This quiz includes information from recent research highlighting the alarming trends during the Covid-19 pandemic. Understand the impact of child abuse on various socioeconomic segments and learn to identify potential signs of abuse.