Caries experience in suspected physical child abuse: A comparative analysis with register-based controls

Background

Child Abuse and Neglect (CAN) is a severe threat to children's health and well-being worldwide. Since oral and dental health are indicators of general health, dentists and dental hygienists are in a favorable position to identify potential cases of CAN.

Objective

This study aims to investigate the caries experience in primary and permanent dentition in children where physical abuse was suspected compared to controls.

Participant and setting

All cases were police-reported cases of suspected physical abuse, examined from 2020 to 2023 at the Child Advocacy Centre (CAC) in Copenhagen. Control groups were established using annual reports from the Danish Health Authority of children examined in pediatric dental clinics from 2020 to 2023.

Methods

The children underwent a comprehensive and systematic forensic medical and dental examination. The control group was matched by age and geography. The main outcome was caries experience, defined as decayed, extracted, or filled primary teeth (def-t) and decayed, missing, or filled permanent teeth (DMF-T). Logistics regression analyses were used to predict the caries experience in cases compared to controls.

Results

Overall, significantly higher caries experience was found in primary dentition among cases (Chi-square, p < 0.05). Stratified by age, higher caries experience was found in the primary dentition in the 5-year-old (OR: 2.5-3.0; 95% CI 1.1-7.2) and in the permanent dentition of the 11-year-old (OR: 2.9-3.9; 95% CI 1.4-13.9) across all study years.

Conclusions

Certain age groups of suspected physically abused children exhibit significantly higher caries experience than matched controls.