Role of Dentist and Forensic Odontologist in Child Abuse Cases

and Jasdeep Kaur1

(1)

Earth and Life Sciences Vrije Universiteit Amsterdam and ILEWG, Amsterdam, The Netherlands
 
Abstract
Child abuse is defined as those acts or omissions of care that deprive a child from the opportunity to fully develop his or her unique potentials as a person physically, socially, or emotionally. The overall incidence of child abuse is not really clear. Statistical data do not show the actual rate because of the unreported cases. The purpose of this chapter is to review the forms of child abuse and neglect with their clinical signs, together with a step-to-step guide for identification of suspected cases and the role of physicians and forensic odontologists, such as dentists, in evaluating such conditions.

19.1 Introduction and Background

Maltreatment of infants and children has been traced far back in history, and, tragically, it is still too prevalent in our “modern” world. Good efforts have been made in the different parts of the world, including India, in recent decades in the areas of child abuse recognition and prevention. Many dedicated people today work diligently and tirelessly to educate not only mandated reporters of child abuse but also the general public as well. Child abuse is defined as those acts or oversights of care that divest a child from the opportunity to fully develop his or her unique potentials as a person physically, socially, or emotionally. It can also be defined as any nonaccidental trauma, failure to meet basic needs, or abuse inflicted upon a child by the caretaker that is beyond the acceptable norm of childcare in our culture (Kenney and Spencer 1995; Misawa 2001). Abuse may cause serious injury to the child and may even cause death. To date, the incidence of child abuse is not really clear. Statistical data do not show the actual rate because of the unreported cases. Forensic dentists and oral physicians are in a strategic position to recognize and report children being abused because they often see the child and parents interacting during multiple visits and over a long period of time.

19.2 Child Abuse Scenario

19.2.1 Child Abuse Across the Globe

The United Nations’ Secretary-General’s Study on Violence against Children (Pinheiro 2006) has given the following overview of the situation of abuse and violence against children across the globe:

1.

The World Health Organization (WHO) estimates that almost 53,000 child deaths in 2002 were due to child homicide.
 
2.

In the Global School-Based Student Health Survey carried out in a wide range of developing countries, between 20 % and 65 % of school-going children reported having been verbally or physically bullied in school in the previous 30 days. Similar rates of bullying have been found in industrialized countries.
 
3.

An estimated 150 million girls and 73 million boys under 18 have experienced forced sexual intercourse or other forms of sexual violence involving physical contact.
 
4.

UNICEF estimates that in sub-Saharan Africa, Egypt, and Sudan, three million girls and women are subjected to female genital mutilation (FGM) every year.
 
5.

The International Labor Organization (ILO) estimates that 218 million children were involved in child labor in 2004, of whom 126 million were engaged in hazardous work. Estimates from 2000 suggest that 5.7 million were in forced or bonded labor, 1.8 million were in prostitution and pornography, and 1.2 million were victims of trafficking.
 
6.

Only 2.4 % of the world’s children are legally protected from corporal punishment in all settings.
 

19.2.2 Child Abuse in India (India Committee of the Netherlands 2007)

This section describes child abuse specifically within India.

19.2.2.1 Physical Abuse

The following data have been reported regarding physical abuse of children in India:

General
 1.

There is very little research on physical abuse in India. Only two earlier studies are mentioned; two out of three children were physically abused.
 
 2.

Of 69 % children who were abused, 54.68 % were boys.
 
 3.

Over 50 % of children in all 13 sample states were subjected to one or more form of physical abuse.
 
 4.

Most children did not report the matter to anyone.
 
 5.

The states of Andhra Pradesh, Assam, Bihar, and Delhi have almost consistently reported higher rates of abuse in all forms compared to other states.
 
 6.

In different age categories, the highest percentage of physical abuse was reported among younger children (5–12 years).
 
Family
 7.

Of those children physically abused in family situations, 88.6 % were physically abused by parents.
 
School
 8.

Sixty-five percent of schoolchildren reported facing corporal punishment; that is, two out of three children were victims of corporal punishment in public and private school.
 
 9.

Sixty-two percent of the corporal punishment occurred in government and municipal schools.
 
10.

NGO-run schools also reported a high percentage of corporal punishment.
 
Working Children
11.

Boys and girls were being abused equally and run a high risk of abuse.
 
Institutions
12.

The percentage of abuse of boys in correctional institutions was very high, at 56.37 %.
 
13.

Physical abuse of girls in institutions was also very high.
 
Street Children
14.

Physical abuse was reported by 66.8 % of street children.
 

19.2.2.2 Sexual Abuse

The India Committee of the Netherlands (2007) also found that

1.

More than half the children surveyed (53.22 %) reported having faced one or more forms of sexual abuse.
 
2.

Andhra Pradesh, Assam, Bihar, and Delhi reported the highest percentages of sexual abuse among both boys and girls.
 
3.

Severe forms of sexual abuse were reported by 21.90 % of child respondents, while 50.76 % reported other forms of sexual abuse.
 
4.

Of the child respondents, 5.69 % reported being sexually assaulted.
 
5.

Children on the street, children at work, and children in institutional care reported the highest incidences of sexual assault.
 
6.

Half of the reported abusers are persons known to the child or in a position of trust and responsibility.
 
7.

Most children did not report the matter to anyone.
 

19.2.2.3 Emotional Abuse and Girl Child Neglect

Every second child reported facing emotional abuse, and an equal percentage of both girls and boys reported facing emotional abuse. In 83 % of the cases, parents were the abusers. Finally, 48.4 % of girls wished they were boys.

19.2.2.4 Child Labor in India

The SRO is united national based authority which offers technical support to countries in Eastern, Southern and Anglophone West Africa for the development of policy responses and action plans, strengthening the knowledge base, and building institutional capacity for effective and sustainable impact. Recently it is also focused on the design and implementation of comprehensive national action plans aimed at eliminating the worst forms of child labour within the shortest possible time (SRO, 2000). According to (SRO 2000), there were 1104000000 child labour in India, and the world’s highest number of working children is in India.

19.3 Child Maltreatment

Child maltreatment is defined as all forms of physical and/or emotional ill-treatment, sexual abuse, neglect or negligent treatment, or commercial or other exploitation, resulting in actual or potential harm to the child’s health survival, development, or dignity, that occurs in the context of a relationship of responsibility, trust, or power.
Child maltreatment can be of four types:

1.

Physical abuse
 
2.

Sexual abuse
 
3.

Emotional and psychological abuse
 
4.

Neglect
 

19.3.1 Definitions

Physical abuse is exacting physical injury upon a child. This may include hitting, slapping, kicking, beating, or otherwise harming a child.
Sexual abuse

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Oct 18, 2015 | Posted by in General Dentistry | Comments Off on Role of Dentist and Forensic Odontologist in Child Abuse Cases
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