As domestic abuse incidents increase during the pandemic, dentists can take the lead in identifying possible victims and help them get the help they need, according to Sara Hurley, Chief Dental Officer England.
“There is never an excuse for domestic abuse, no matter what the circumstances are, and during the period of national restrictions, this issue is more important than ever,” Hurley said.
Hurley noted how dental professionals are likely to observe and identify injuries to the teeth and mouth as well as the head, eyes, ears, neck, and face, in addition to other welfare concerns.
“Combating domestic abuse is not just a medical mission. It’s a moral mission too,” Hurley said.
In the United States, dentists are required to report patients whom they suspect to be victims of abuse to the appropriate authorities, with regulations varying by state. Dentists in the United States are encouraged to consult their local authorities for specific regulations and guidelines.
Meanwhile, according to England’s National Health Service (NHS), anyone can be a victim of domestic abuse regardless of gender, age, ethnicity, socioeconomic status, sexuality, or background. Domestic abuse also is not limited to physical violence and can include:
- Coercive control and “gaslighting”
- Economic abuse
- Online abuse
- Threats and intimidation
- Emotional abuse
- Sexual abuse
In addition to general indicators of abuse, the NHS said, dentists specifically can look for patients who:
- Are always accompanied by a partner or family member who frequently speaks for the patient or cancels the patient’s appointments
- Display high levels of anxiety
- Delay in seeking treatment
- Present symptoms that don’t fit the explanation provided
Signs of abuse specific to the oral and facial regions include:
- Facial or intraoral bruising or laceration
- Teeth lost due to trauma
- Fractures to nose, cheek, or jaw
- Torn fraenum
- Bite marks
- Hair loss
“Sometimes a feeling or noticing something that just doesn’t seem right can play a vital part in the jigsaw that can make the difference to someone in a vulnerable position. In some cases of abuse, contacts with healthcare professionals could have made a difference at key moments in time,” said Sandra White of Public Health England.
“It is the duty of all citizens to call out abuse where they see it and act to protect those who are being harmed,” White said. “Dental teams should not feel inhibited to raise a concern. The dental team has a statutory duty of care to all patients and the wider public, which includes ensuring that safeguarding arrangements are in place and acted upon.”
Safeguarding concerns always should be recorded and accurate records should be kept, White said, nothing that Public Health England offers an online guide. Recommendations include:
- Each dental practice have a named safeguarding practice lead
- All members of the staff undertake the appropriate safeguarding training
- A safeguarding reporting system in place that all members of the staff are familiar with
- All members of the staff knowing how to access the NHS Safeguarding app for local contact details
The safeguarding guide also offers:
- Advice on when and how to report concerns
- Facial, oral, and body maps to help record domestic abuse signs
- Sample dental practice safeguarding policy
- Flowchart to use when suspecting safeguarding concerns
- A list of free safeguarding training opportunities
“All of us deserve to be safe and away from harm. We can all make a difference,” White said.