The Dental Consequences Of Domestic Violence: Bilateral Mandible Fractures

• 2 in 5 women (39%) have experienced violence since the age of 15.4
• Men are more commonly the perpetrators of physical violence, sexual harassment and sexual violence.
• Women are more likely to experience violence from someone they know than by a stranger (35% vs 11%).
• On average, one woman is killed every nine days by a current or former partner.
• In the year 2021/22, 4,620 women aged 15 years and over (average of 13 women/day) were hospitalised due to family and domestic violence.
• 1 in 4 women (27%) has experienced violence, emotional abuse, or economic abuse by a cohabitating partner since the age of 15.
– OurWatch.org.au

Dental Fractures & Domestic Violence

A punch to the face by an enraged domestic partner can result in a mandible fracture. These are more commonly known as broken jaws. In the majority of cases males, being bigger and stronger, inflict far more damage to their female domestic partners. In addition, men are much more likely to resort to physical violence during domestic disputes than their female intimates. Dentists see the results of domestic violence all too often in their surgeries and clinics.

“Bilateral fractures of the mandibular angle are rare. They typically cause an anterior open bite malocclusion and are usually the result of interpersonal violence.”
– Surgery Reference

“Dental Practitioners must be aware of state and territory laws with respect to the reporting requirements of family and domestic abuse and violence.
2.3. Dental Practitioners are in a position to detect, support and provide advice to patients who present suffering from abuse and violence.
2.4. Dental Practitioners should attempt to provide a safe and compassionate environment for patients affected by abuse and violence to discuss issues of abuse and violence with them and have appropriate referral pathways in place. “
– ADA.org.au

In most states in Australia, it is only mandatory to report domestic violence to the police when it involves a child as the victim. One of the reasons we have so much domestic violence still being perpetrated against women is outdated laws that do not reflect 21C values regarding human rights for individuals of both genders. For centuries in Australia, husbands were within their legal rights to physically discipline their wives. Christian cultural norms, at the time, were patriarchal and promoted the male as the head of the family. These hangovers from our past pervade institutions, families and relationships. For way too long bystanders, work colleagues, and neighbours have looked the other way when it comes to domestic violence in Australia.

Domestic Violence Perpetuated On Children

“The aetiology of mandible fractures can be categorised as intentional (e.g. as a result of assault, peer-to-peer violence, family violence) or non-intentional (e.g. as a result of falls, motor vehicle crashes, sporting incidents).”
– Online Library

Breaking someone’s jaw is not something that happens without strong intention.

“In a forensic medicine context, it is important to be able to discern if an injury was caused by an intentional or non-intentional aetiology. It is especially important in the paediatric population to be able to recognize peer-to-peer or family violence. Intentionally inflicted injury often involves the head and neck area. In a case where the child does not disclose the cause of the injury practitioners should be able to recognise characteristics related to intentional aetiologies as the child might be exposed to family violence and mandatory reporting to child protection might be required.”
– KL. Dal Santo, 7 June 2024, Australian Dental Journal.

There is little more disturbing in life than acts of violence committed upon children by adults, especially those adults who are in positions of responsibility toward that child. To break a kid’s jaw is a criminal act of the worst possible kind. Family violence is, unfortunately, more pervasive in communities than many might imagine. Alcohol abuse is never far away from these gross assaults against vulnerable members of our community. Drug and alcohol issues have long resided hand in hand with economic poverty in communities around Australia. Social workers see the impact that these have upon families and individuals. Our gaols contain offenders who have perpetrated acts of domestic violence upon partners and family members and this is a growing male cohort. Dentists confront the results of such family violence when they see the child for dental treatment and they must be vigilant and report their concerns to the relevant authorities.

Treatment Procedure For Bilateral Mandible Fracture

About half of mandibular fractures are bilateral. In the treatment of these rigid fixation of the body/parasymphysis fracture is achieved via an inferior border plate with tension band or reconstruction plate. This converts effectively the bilateral injury to a unilateral injury at the angle. The management of teeth along the line of fractures is a contested topic to some degree. Fractured teeth, infected teeth, and those that interfere with the reduction of the fracture are best removed. Angle fractures mean that third molars should be evaluated as their removal could destabilise things and make fixation more difficult.

Men Killing Women & Children In Australia

Australians have been confronted with the heinous crimes of vengeful ex-partners murdering their former spouses and their children.

“The Australian Institute of Criminology’s Homicide in Australia report shows 49 per cent of female victims of homicide were killed by a former or current intimate partner in the 2022-23 financial year.”
– ABC.net.au

“Twenty-six women have been allegedly killed in Australia at the hands of their partners or former partners so far this year, 12 more than this time last year.”
– Daily Mail

When men kill their families and former partners it strikes us as the perfect time to remind us all that we do not own our children.

Our kids are not our private property like houses and cars. We are entrusted with their care and upbringing like stewards. There is never any time where the decision to end young lives is a justified one. Once a parent crosses the line into criminality via committing acts of domestic violence their parenting rights have been compromised according to the law. Domestic Violence Orders (DVOs), Apprehended Violence Orders (AVOs), Intervention Orders and Restraining Orders are all intended to protect a person or persons from violence. Unfortunately in many of the murders committed in Australia recently they have not been able to achieve that. When one person considers their rage more important than the lives and safety of their former intimate and children a tragedy usually occurs. There is no excuse for these heinous acts of violence and never any just cause in any circumstance. Dentists know a bit about pain via their necessary procedures taking place within a sensitive part of the body. However, nobody knows the level of pain these acts of domestic violence can render – apart from the victims and their families. 

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