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The following is a summary of the systematic review findings up to the date of our most recent literature search. If you have a specific clinical case, we strongly recommend you read all of the relevant references as cited and look for additional material published outside our search dates.


Review last updated in June 2014

Bites are a relatively common injury to children, with approximately 1/600 children attending A&E having been bitten by humans 1,2. Many of these will be caused by other children. An abusive bite, however, is unique among physical injuries since it can potentially identify (or exclude) a specific perpetrator, occasionally enhanced by DNA retrieval 3,4,5. This review aims to characterise the clinical features of an abusive bite so that it can be recognised by clinicians, to enable appropriate forensic dental referral.


Recent years have seen publications detailing forensic evaluation of bites in adults and children. Unfortunately these have not provided detailed information on the abusive bites of children in isolation 6. No new studies have sought to characterise the features of bites in children.


The review seeks to answer the following review question:

  1. Is this an abusive bite?

Click here to open


  1. Baker MD, Moore SE. Human bites in children. A six-year experience. American Journal of Diseases of Children. 1987;141(12):1285-90 [Pubmed]
  2. Schweich P, Fleisher G. Human bites in children. Pediatric Emergency Care. 1985;1(2):51-53 [Pubmed]
  3. Fischman SL. Bite Marks. Alpha Omegan 2002;95(4):42-46 [Pubmed]
  4. Lovell MA, McDaniel NL. Association of hypertrophic maxillary frenulum with hypoplastic left heart syndrome. Journal of Pediatrics. 1995;127(5):749-750 [Pubmed]
  5. Wagner GN. Bitemark identification in child abuse cases. Pediatric Dentistry. 1986;8(1):96-100 [Pubmed citation only]
  6. Page M, Taylor J, Blenkin M. Reality bites--A ten-year retrospective analysis of bitemark casework in Australia. Forensic Science International. 2012;216(1-3):82-87. [Pubmed]

  7. Levine LJ. The solution of a battered-child homicide by dental evidence: report of case. Journal of the American Dental Association. 1973;87(6):1234-1236 [Pubmed citation only]
  8. American Board of Forensic Odontology (ABFO). Bitemark guidelines [ABFO website - bitemark guidelines]


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