RT Journal Article
SR Electronic
T1 Diagnosing abuse: a systematic review of torn frenum and other intra-oral injuries
JF Archives of Disease in Childhood
JO Arch Dis Child
FD BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health
SP 1113
OP 1117
DO 10.1136/adc.2006.113001
VO 92
IS 12
A1 Maguire, Sabine
A1 Hunter, Bruce
A1 Hunter, Lindsay
A1 Sibert, Jo Richard
A1 Mann, Mala
A1 Kemp, Alison Mary
YR 2007
UL http://adc.bmj.com/content/92/12/1113.abstract
AB Introduction: A torn labial frenum is widely regarded as pathognomonic of abuse.Methods: We systematically reviewed the evidence for this, and to define other intra-oral injuries found in physical abuse. Nine studies documented abusive torn labial frena in 30 children and 27 were fatally abused: 22 were less than 5 years old. Only a direct blow to the face was substantiated as a mechanism of injury.Results: Two studies noted accidentally torn labial frena, both from intubation. Abusive intra-oral injuries were widely distributed to the lips, gums, tongue and palate and included fractures, intrusion and extraction of the dentition, bites and contusions.Conclusions: Current literature does not support the diagnosis of abuse based on a torn labial frenum in isolation. The intra-oral hard and soft tissue should be examined in all suspected abuse cases, and a dental opinion sought where abnormalities are found.