Forensic aspects of child protection practice
Any situation where a child has been harmed as a result of abuse or neglect potentially involves a criminal offence against that child. The responsibility for carrying out any criminal investigations rests with the police and will usually be carried out by the local police child protection team. Other agencies have a responsibility to cooperate with the police in their investigations. Comprehensive, contemporaneous and accurate record keeping is essential to this process (see
Best practice in record keeping). You may be requested to assist the police by providing a statement, copies of records or by carrying out particular forensic examinations or tests where you are qualified to do so. You need to obtain consent and should consider taking advice from your defence organisation in all such situations.
Diagrams and clinical photographs
You should consider whether your notes should include a diagram of your findings or be supplemented by clinical photographs. These should be:
clearly labelled with the child’s identity
marked with the date and time
referred to in the clinical notes
annotated with descriptions and measurements of any injuries
Other than for medical record purposes, it is not the role of the dental team to attempt to take photographs of forensic quality. There are very precise requirements for such photographs. A rigid, right-angled measuring scale (see clinical photograph below) must be incorporated and multiple views may be required when marks involve different parts of curved body surfaces.
face map proforma
Human bite mark - note use of a rigid, right-angled measuring scale (reproduced with kind permission of Professor GT Craig)
Where a child has been assaulted, it may be possible to obtain forensic evidence, including DNA sampling.20 You may be asked to assist the police in obtaining such samples, for example through taking swabs of a bite mark or other injury. Strict procedures must be followed in order to ensure the validity in court of any samples (e.g. a clear, documented “chain of evidence” where a sample is passed from one person to another with no possibility of contamination).
Documenting and interpreting the significance of bite marks must be carried out by someone with training and experience in forensic odontology. Certain features of the injury may help to distinguish animal from human bites and adult from child bites. It may also be possible to match the impression left with the dentition of a suspected perpetrator.
Assessment of these cases may involve:
See also discussion of the
clinical presentation of bite marks.
examination of the injury and provision of diagrams, documentation and forensic photographs obtained according to a clear procedure;
examination, photographs and impressions of the victim’s own dentition;
examination, photographs and impressions of any alleged perpetrator or other family members.
Dental practitioners should be clear about their own limitations and only offer opinions within their level of expertise. Local police may have a preferred expert. Alternatively, the
British Association for Forensic Odontology can supply contact details of suitably qualified members who can be approached to advise and undertake such work.