Many of the patients you see on a daily basis may have a history of abuse and trauma. Figures from the Office for National Statistics show that as many as 1 in 5 adults has been sexually, physically or emotionally abused in childhood.1
Unfortunately, there can be many similarities between sexual abuse and dental appointments – on a physical, psychological and emotional level.
Some parallels between dental appointments and sexual assault 2
- Lying down by a trusted adult and having your mouth filled up
- Penetration of hands, fingers, instruments
- Focus on a sexual organ, the mouth
- Fingers used to pull the cheek or mouth
- The smell of latex
- Staying open for a long time
- Close proximity of faces, bodies, the sound of breathing in front of you
- Feeling a lack of control, being powerless and vulnerable
- Not being able to move
- Being/feeling unable to speak
- Feeling under someone else’s control: they can do anything they want to you
- Infliction of pain
- Fear of being judged or criticised
- Dissociating during the experience
- Closed room, no escape
What is trauma-informed care?
A trauma-informed approach to understanding human distress is a way we can explore the trauma responses without medicalising the person. Instead of seeing the trauma responses as mental illnesses, disorders and abnormal behaviours, a trauma informed approach sees the trauma responses as normal, rational and purposeful. – Dr. Jessica Eaton
The very fact that you are here suggests that you are keen to understand and empathise with your patients who may have histories of abuse.
Not many patients will disclose their histories, so the easiest way to implement trauma-informed care into your practice is to treat all your patients with the same care and consideration. Moreover, there is a substantial overlap between strategies for supporting patients who have a history of abuse and strategies that work for anxious or fearful patients more generally.
It’s a win-win situation – everyone appreciates kindness and thoughtfulness, including patients who are not at all nervous.
Resource pack for dental professionals
VictimFocus have published an excellent PDF guide to trauma-informed practice for dental professionals, with easy-to-implement advice and ideas:
Practical tips on topics including:
- how to support your patients
- how to help them communicate with you
- responding to a disclosure of trauma, rape or childhood abuse
- what to do if someone has a panic attack or becomes very distressed.
This free-to-use patient form, designed for dental practices, helps collect data about patients’ triggers and trauma responses and how best to help them during an appointment.
In addition to leaving the patient forms on tables or offering them to new patients, you can use this poster in the waiting room or at reception.
Dentists Sharonne Zaks and Sonia Sonia discuss trauma-informed care. Sharonne specialises in treating highly anxious patients, many of whom are survivors of sexual assault and trauma. Sonia is a survivor of domestic abuse herself, and when she started practising dentistry she recognised the signs of abuse in her patients.
Practical tips for managing trauma patients before, during and after appointments
You can find Part 1 and Part 2 of this series here: Videos for dentists
- Tips for Abuse Survivors and Their Dentists: An article written by a survivor of childhood sexual abuse.
- Avoiding psychological (re)traumatisation in dentistry when working with patients who are adult survivors of child sexual abuse (2022): The first UK study to present qualitative data from child sexual abuse survivors about their experiences of dental care is a must-read for the dental team. Open access.
- Being considerate every step of the way: a qualitative study analysing trauma‐sensitive dental treatment for childhood sexual abuse survivors (2019): Another really interesting qualitative study from Norway. Open access.
- Things I wish dentists knew: Another article written from the perspective of an abuse survivor.
- Understanding survivors of childhood abuse by Linda M. Douglas RDH.
- Trauma-informed care links, references and resources: A list of resources, videos and relevant literature (some of these are specific to Australia).
Sources of Information
- Child Abuse in England and Wales: March 2020. Office for National Statistics.
- adapted from Sharonne Zaks: “Selection of parallels between dental appointments and sexual assault”, https://zaksdental.com.au/trauma-informed-dental-care-adult-survivors-sexual-assault/links-references-resources-including-quoted-dentist-lecture-videos/, retrieved January 12, 2021