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Results

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.

 

Overall results

  • Of 171 studies reviewed (four foreign language articles), five studies were included 1-5
  • Study designs: all case studies
  • Total data: data on five children
  • Ranking of abuse was one (4/5) or two (1/5)
  • Age: ranging 0-18 years for the group, as a whole
  • Four cases were aged less than 30 months
  • The fifth case was in their late teenage years
  • Gender: two boys, three girls
  • No study addressed disabled children

 

Influence of ethnicity and socio-economic group

  • One child noted to be white, no details on the other cases
  • No detail on socio-economic group

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References

  1. Fulton PR. Child abuse and a bite mark. A case report. Journal of Forensic Odonto-Stomatology. 1984;2(2):53-55 [Pubmed citation only]
  2. Gold MH, Roenigk HH, Smith ES, Pierce LJ. Human bite marks. Differential diagnosis. Clinical Pediatrics. 1989;28(7):329-331 [Pubmed]
  3. Lee LY, Ilan J, Mulvey T. Human biting of children and oral manifestations of abuse. A case report and literature review. Journal of Dentistry for Children. 2002;69(1):92-95 [Pubmed]
  4. 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]
  5. MacDonald DG, MacFarlane TW. Forensic odontology. Report of a case involving bitemarks. Glasgow Dental Journal. 1972;3(1):16-19 [Pubmed citation only]

Details of included studies

In all included cases children had suffered physical abuse and the bite was confirmed by a forensic dentist

 

Case 1

  • Child noted in foster care to have a vivid discoloured bite mark to the abdomen 1
  • Clinical photograph taken; although the photo did not contain the appropriate measuring device, it was still possible to derive the width, central ecchymotic area and lengths of linear marks from incisal edges 1
  • Examination of three potential suspects confirmed the grandmother to be the only possible perpetrator 1
  • This case highlights the importance of early accurate photography 1

 

Case 2

  • 30/12 old child with four day history of annular lesions, initially diagnosed as ringworm 2
  • Dermatologist confirmed the lesions were bites due to their shapes and patterns 2
  • Dental impressions excluded family members; nursery staff were suspected. This resulted in a forensic dental assessment 2
  • This case highlights the importance of seeking further opinion and dental casts by forensic dentists 2

 

Case 3

  • 10/12 old child with lesions to back of the tongue, characteristic arc shape with concave surface pointing labially.  This case could, therefore, not have been self induced 3
  • Intercanine distance was consistent with an adult bite from six days earlier 3
  • Associated injuries included multiple fractures and intracranial injury 3
  • This case highlights the importance of noting exact contours and measurements 3

 

Case 4

  • A six-week-old murdered infant, noted to have three lesions with oval marks, central sparing with slight ecchymosis and no abrasions 4
  • Arch size and slightly oval bite pattern are consistent with a child’s dentition; absent permanent teeth and deciduous molars indicated it was caused by child aged 2 ½ – 6 years 4
  • A four and a half year old child was identified as the perpetrator out of 37 possible contacts 4
  • In the absence of the bite, the child would not have been considered as a possible perpetrator 4

 

Case 5

  • A teenage girl was assaulted and bitten on her hand 5
  • Distinguishing features of the bite: two arcs joined at a diffuse larger mark; one fairly continuous lesion with four separate components – two circular marks, two elongated next to each other. The elongated marks were caused by upper central incisors, the circular marks were caused by canines 5
  • The intercanine distance of 23mm suggests abnormal teeth, thus enabling identification of the suspect 5
  • This case was the first report of a bite on a child assisting forensic identification 5

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References

  1. Fulton PR. Child abuse and a bite mark. A case report. Journal of Forensic Odonto-Stomatology. 1984;2(2):53-55 [Pubmed citation only]
  2. Gold MH, Roenigk HH, Smith ES, Pierce LJ. Human bite marks. Differential diagnosis. Clinical Pediatrics. 1989;28(7):329-331 [Pubmed]
  3. Lee LY, Ilan J, Mulvey T. Human biting of children and oral manifestations of abuse. A case report and literature review. Journal of Dentistry for Children. 2002;69(1):92-95 [Pubmed]
  4. 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]
  5. MacDonald DG, MacFarlane TW. Forensic odontology. Report of a case involving bitemarks. Glasgow Dental Journal. 1972;3(1):16-19 [Pubmed citation only]

 

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