Human bite marks are identified by their shape and size.They may appear only as bruising, or as a pattern of abrasions and lacerations.Such injuries are rarely confined to the orofacial structures.
They may be caused by other children, or by adults in assault or as an inappropriate form of punishment.
Sexually orientated bite marks occur more frequently in adolescents and adults.
In those cases where the skin is broken, the borders or edges will be apparent for several days depending on the thickness of the tissue. A bite mark presents a unique opportunity to identify the perpetrator Periorbital bruising in children is uncommon and should raise suspicions, particularly if bilateral.
Ocular damage in child physical abuse includes acute hyphema (bleeding in the anterior chamber of the eye), dislocated lens, traumatic cataract and detached retina.
Bizarre-shaped bruises with sharp borders are nearly always deliberately inflicted.
If there is a pattern on the inflicting implement, this may be duplicated in the bruise — so-called tattoo bruising.In contrast, accidental fractures occur more commonly in children of school age.Facial fractures are relatively uncommon in children.It is important to state that there are no injuries which are pathognomonic of (that is, only occur in or prove) child abuse although some injuries or patterns of injury will be highly suggestive of it.Accidental falls rarely cause bruises to the soft tissues of the cheek but instead tend to involve the skin overlying bony prominences such as the forehead or cheekbone.Burns from hot solid objects applied to the face are usually without blister formation and the shape of the burn often resembles the implement used.