Dentists should be aware of signs.

The small boy sitting in the dentist's chair has a chipped tooth, and his mother explains that her three-year-old son fell off his bike. However, isn't three a little young to be riding a bicycle? What about the barely noticeable bruises on his arm? These are the type of questions Patricia Simon, assistant professor of oral and maxillo-facial surgery at the University of Texas Southwestern Medical Center at Dallas, wants dental professionals to ask more often. Such inquiries, she believes, might end up rescuing an abused child.

Simon, who works with the national group Prevention of Abuse and Neglect Through Dental Awareness, is a regional leader in the effort to increase awareness among dentists, dental assistants, and hygienists of signs of child abuse or neglect. For more than three years, she has been making presentations before professional societies in the area and offering advice on what to look for and what to do when abuse is suspected. "When you know what you're looking for, it's amazing how much you can see. As dentists, we are right up next to the patient and we know how things should look. We know how particular injuries occur. We should be ready to take action if we see something suspicious and we should know how to ask the parents very pointed questions to determine if abuse has occurred."

While awareness of child abuse has increased substantially among physicians in recent years, many dentists still have little or no training in how to spot the warning signs, she maintains...