Challenges in formulating an opinion on the category of hurt in injuries to deciduous teeth: Case study

Abstract

Background: Section 311 of the Penal Code of Sri Lanka defines a fracture, dislocation or subluxation of a tooth as a grievous hurt, but it does not specify whether this applies to deciduous or permanent teeth. This ambiguity presents challenges in cases involving children, especially where natural exfoliation may mimic or complicate traumatic dental injuries. Case report: A 9-year-old boy was presented for clinical forensic examination following an alleged assault by a mother of one of his classmates. The victim's mother claimed that the assailant had squeezed the mouth, which resulted in the avulsion of a tooth, although the tooth was not brought in during the admission. Clinical forensic examination on the next day revealed a missing tooth on the lower left jaw with no associated acute injuries on the adjacent lip or gingiva. There was no bleeding from the site, and the tooth socket was not visible. A pedodontics referral concluded that the missing tooth was the canine on the left lower jaw. However, the timing of the injury could not be precisely determined, and it was opined that a deciduous tooth may dislodge at this age even with minor trauma. It was further stated that the displacement of the deciduous teeth could also be due to the natural exfoliation process. On the lower right jaw, the corresponding deciduous canine had already exfoliated, and the process of eruption of a permanent tooth had commenced. Conclusion: This case highlights the complexity of formulating an opinion on the category of hurt in children with injuries to deciduous teeth due to the natural exfoliation process and difficulty in timing injuries. This case also emphasizes the need for early clinical forensic and dental examinations to detect injuries to deciduous teeth and exclude false allegations.