Between Scars and Silences: The Dental Perspective on Child Abuse and Human Vulnerabilities

Abstract

Introduction: Child abuse or maltreatment encompasses any act of physical, psychological, or sexual violence capable of compromising a child's health and development. Due to the vulnerability of children, many victims are unable to report abuse, especially when it occurs within the family environment. In this context, the dentist plays a fundamental role in the early identification of signs of violence, particularly through alterations observed in the orofacial region. Lesions such as hematomas, lacerations, palatal petechiae, bite marks, dental trauma, and manifestations of sexually transmitted infections may be associated with child sexual abuse. In addition to physical manifestations, emotional and behavioral changes should also be observed during dental care. Objective: This research aims to present the main orofacial manifestations related to child sexual abuse, highlighting the vulnerability of children and the importance of care, attention, and preparation of the dentist in the face of suspected cases. Methodology: The research was conducted using the Scielo, PubMed, and Google Scholar databases for the period of 2022 to 2025. After selection criteria such as language, theme, and access, 4 articles were selected. The aim was to refine and specify the theme of the analysis. Results and Discussion: The studies demonstrated that the head, neck, and oral cavity regions are frequently affected in cases of child abuse. Among the main manifestations observed are lacerations of the labial and lingual frenula, palatal petechiae, hematomas, bites, scratches, dental trauma, and signs of sexually transmitted diseases such as HPV, syphilis, gonorrhea, and herpes. Emotional changes were also identified in the victims, such as fear, anxiety, excessive shyness, and resistance to dental care. Therefore, the dentist must conduct a careful anamnesis, detailed clinical examination, and provide compassionate care, correctly recording the information in the patient's file and referring suspected cases to the appropriate authorities. Final considerations: In conclusion, dentists have an important responsibility in protecting children who are victims of sexual abuse. Knowledge of orofacial manifestations and professional preparedness to recognize, care for, and report suspected cases are essential, contributing to the safety and well-being of children.