Given the prevalence of child abuse in the United States, a busy pediatric dental practice may treat several patients per week who have been victims of abuse. The abuse may affect the child's behavior in the dental office, which may range from being quiet and withdrawn to being unruly and uncooperative. Dental staff should be aware that approximately two-thirds of the cases of physical abuse of a child involve visible injuries to the head and neck. Dentists should be attentive to injuries in questionable locations, multiple injuries, and injuries that are in various stages of healing, as well as those that are not age-appropriate, i.e., facial injuries on children that are not yet walking or crawling. Also suggestive of abuse are finger, ligature, burn, or bite marks, and marks possibly caused by a belt, strap, or cord. If the dentist suspects physical abuse of a child patient, he/she should have another member of the staff also witness the injuries and assist in their documentation. A written description with diagrams should document the locations, shapes, sizes, etc., of injuries. Injuries inside the mouth might require dental X-rays for documentation. Photographs should be taken of the injuries. When reporting the suspected abuse, dentists should advise child protective services and law enforcement authorities and indicate the nature of their documentation. Dental staff are not required to participate in the investigation itself, other than to provide the documentation. This article also discusses the specific role of forensic odontologists in child abuse cases, along with the dentist's roles in identifying missing children and in preventing child abuse. 5 references