As dental professionals we are already tasked with a lot of responsibility. After all, we not only have to look after our practices and all of the admin that this entails, but we need to balance this with looking after our patients and their oral health, especially as we are often first in line to spot signs of various illnesses such as oral cancer.
However, it’s important to realise that our role extends further, and we need to be vigilant to notice signs of other disturbances to a person’s wellbeing – including any evidence of domestic abuse.
I was reading an interesting study the other day that outlined exactly why dentists could be the first line of defence in instances of domestic violence. The most important point in the report was that the majority of domestic violence (75%) that results in head or neck injuries, also ends in oral injury – something which is likely to result in a visit to the dentist.[i]
This gives dental professionals the opportunity to identify any injuries that may be caused by domestic violence and report them if you believe that your patient is at risk. But how common is domestic violence and what sort of injuries do you need to look out for?
Domestic violence in the UK is more widespread than you would expect. Statistics gathered in 2018 tell us that 2 million people reported cases of domestic abuse that year. Within this number, the split between genders is perhaps unexpected, and although the majority of those suffering were female, there were still 695,000 men who reported cases of domestic abuse.[ii]
Of course, these figures only represent the instances that were actually reported. It’s likely that there are thousands more cases of domestic abuse that go unreported. There’s also a significant possibility that a large number of individuals not reporting domestic abuse are men. This is perhaps because they don’t want to feel like they are weak, or they are worried that authorities won’t believe them – meaning that keeping an eye open for any suspicious oral injuries in both genders is paramount.[iii]
The type of injuries you need to watch out for are any tears, fractures, breakages or chipping to either or both the hard and soft tissues in the mouth which are inconsistent with the patient’s history. Tooth discolouration or pupal necrosis caused by previous trauma are particularly telling, but you need to ask about any fractures, breaks or even suspicious gashes in the soft tissue that may have been caused by a heavy impact. In doing so you open a dialogue that gives someone suffering the chance to tell you about their problems. If it’s likely the abuser is in the room with them, you can ask to see the patient privately for a moment if you believe something is awry.
In the end, dentists need to be aware of the sort of injuries that domestic abuse can cause and also offer a safe, protective environment where patients can speak freely about any harm they are suffering. By providing this support you can help people escape the clutches of abuse and ensure their future wellbeing.
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[i] Science Daily. Dentists Can Be The First Line Of Defence Against Domestic Violence. Link: https://www.sciencedaily.com/releases/2019/04/190425133034.htm [Last accessed May 19]
[ii] The Office for National Statistics. Domestic Abuse in England and Wales in the Year Ending March 2018. Link: https://www.ons.gov.uk/peoplepopulationandcommunity/crimeandjustice/bulletins/domesticabuseinenglandandwales/yearendingmarch2018 [Last accessed May 19].
[iii] The National Domestic Violence Hotline. Men Can Be Victims of Abuse, Too. Link: https://www.thehotline.org/2014/07/22/men-can-be-victims-of-abuse-too/ [Last accessed May 19].