ABSTRACT
This child was brought to the emergency department by her mother. Her mother stated she had been bitten by her sibling on both her cheeks and chest (Image 51a). https://s3-euw1-ap-pe-df-pch-content-public-p.s3.eu-west-1.amazonaws.com/9780429170423/e1d751c1-a9c7-4bb9-9d59-53742c84031a/content/fig51a.jpg"/>
What does the image show?
What can be done to identify the person who bit the child? How does this affect the case?
118 https://s3-euw1-ap-pe-df-pch-content-public-p.s3.eu-west-1.amazonaws.com/9780429170423/e1d751c1-a9c7-4bb9-9d59-53742c84031a/content/fig51b.jpg"/>Two impressions in the skin overlying an area of erythema were apparent. The impressions were not continuous or uniform, suggesting patterns left by small teeth. A paediatric bite is smaller overall and displays spacing between the teeth from diastemas present in the primary dentition. It is difficult to determine a paediatric from adult bite, especially in the mixed dentition. The upper arch is superior in the image. The size and number of teeth can be used to differentiate young children from adults. 1
When a potential biter can be identified, it can be helpful to compare images of the mouth/teeth with the bite. Differences in angle of photography can prevent a precise match, but generally the number of teeth and relative intercanine distance can be determined. Ideally, a plaster cast of the biter’s teeth could be fashioned and compared to the bite; but this is usually not possible or desirable. In a bite from another child which is not serious, there may not be child abuse per se but there can be child supervisory neglect. In this case, note the dentition of the biter (Image 51b) has diastemas present which were exhibited in the bite mark together with a small size of the incisal edges of the teeth. The biter was 6 years old.
