Traumatic dental injuries in child, adult and elderly: Domestic violence—physical abuse hidden in plain sight

Abstract

In its 2002 report, the World Health Organization (WHO) has indicated the dramatic worldwide increase in the incidence of intentional injuries affecting people of all ages and both sexes, but especially children, women, and elderly. The report also suggested that most physical abuse (e.g., 90% of the cases in children) went unnoticed despite extensive efforts. Hence, raising awareness and reducing its prevalence are global challenges.

Any kind of non-accidental injury inflicted in an individual is defined as physical abuse. Child physical abuse is an important and constant problem. The largest data compiled and published by the United Nations Children's Fund (UNICEF) suggested that around 6 in 10 children between the ages of 2 and 14 worldwide (almost a billion) are subjected to physical punishment by their caregivers on a regular basis. Particular attention must be directed to children with disabilities, as the records indicate they are three times more likely to be abused than their able-bodied counterparts.

In the Global Status Report on Violence Prevention by the WHO (2014), it was stated that a quarter of all adults report having been physically abused as children; one in three women had been a victim of physical or sexual violence by an intimate partner at some point in their lifetime; and one in seventeen older adults reported abuse in the past month.

Whether the violence occurs in the family, school, institution, or workplace, dental professionals can be one of the front-line responders. Dental professionals are in a unique position for not only to treat but also to diagnose and report cases of dental trauma resulting from physical abuse.¹ Valuable information and assistance can be provided to physicians about oral and dental aspects of physical abuse, especially in vulnerable population groups.

Studies show that almost 50% of all physical abuse is related to injuries in the head and orofacial region.² The relationships between traumatic dental injuries and interpersonal violence, namely child maltreatment, youth violence, intimate partner violence, and elder abuse have long been recognized by the dental community. Hence, Dental Traumatology has sought to increase the dental knowledge base by adding systematic reviews, research, and case series in this regard. I am pleased that the researchers from various disciplines have responded positively to the call and contributed to this special issue of Dental Traumatology which now includes reports on orofacial and dental trauma and its recognition by the dentist^{1, 2}; injuries in physically abused children³; oro-dental and facial manifestations of physical abuse in adults^4-7; sexual abuse⁸; medicolegal aspects of dental trauma in children,⁹ and the Munchausen syndrome by proxy.¹⁰

I would like to end here by expressing my gratitude to Editor Emeritus Prof. Paul V. Abbott whose support brought the idea up to the level of consideration. My special thanks goes to the Editor-in-Chief, Prof. Liran Levin, who helped on the project with superb guidance. Finally, I cannot thank and appreciate enough the members of the great Wiley Editorial Team, Zora Ma, Charulatha Nagarajan, Shivi Sharma, Mie Bak, and Hannah Watson for their diligent work throughout the submission, review, and publication processes.

It is my sincere hope that this special issue will help further serve dental trauma victims of all ages who have suffered from interpersonal violence.