Background Child physical and sexual abuse frequently involves the orofacial region, yet comprehensive forensic mapping of both traumatic and nontraumatic orofacial signs in children referred due to suspected abuse remains limited. Objective To comprehensively map extraoral and intraoral signs in children referred for forensic dental examination due to suspected physical or sexual abuse, describing injury types, anatomical distribution, and nontraumatic oral health findings across abuse types. Methods This retrospective cross-sectional study included 362 children aged 1–18 years referred to a Norwegian Children's House, an interdisciplinary forensic assessment center for children, between 2017 and 2021. Extraoral signs were identified through combined forensic dental and medical records, while intraoral signs were identified through dental examinations. Orofacial signs were classified as traumatic injuries or non-traumatic findings. Analyses were conducted at both case level (presence/absence) and the injury count level (number and anatomical distribution of injuries), stratified by suspected abuse type. Results Intraoral signs were identified in 76.1% of the children, and 45.6% had extraoral signs. Most children were aged 6–11 years (56.1%). Extraoral injuries were more common among children with suspected sexual abuse (40.7%) than among those with suspected physical abuse (34.4%), whereas intraoral injuries were similar (≈19%). Dental trauma accounted for nearly three-quarters of all intraoral injuries and was more frequent among physically abused children. Nontraumatic intraoral findings were common in both groups (∼63%), with poor oral hygiene and untreated caries occurring more often in the physical abuse group. Stress-related findings, such as tooth wear and headache, were slightly more common among children with suspected sexual abuse. Conclusions Children referred for forensic evaluation due to suspected abuse frequently presented with traumatic and nontraumatic orofacial signs. The integration of forensic dental and medical examinations strengthens the identification of head and neck injuries and highlights the pivotal role of dental professionals in multidisciplinary child protection.
Håkstad et al. (Wed,) studied this question.