Intimate Partner Violence for Dental Professionals

The dental community can play a vital role in identifying and halting the cycle of IPV by simply offering screening services to every single patient. However, one study of dental professionals found that “…61.5% of participants reported being unprepared to appropriately screen for IPV and 64% felt they could not correctly refer patients to local support services.”¹⁸ Not only is preparedness a barrier for screening for IPV, but some practitioners fear losing a patient because of asking “taboo” questions or a potential lawsuit, the dental health professional being uncomfortable with the topic, and, if male, assuming that patients would more likely disclose to a female practitioner.¹⁹ However, more than half of victims surveyed in 2009 in Texas had seen a dentist when physical signs of their abuse were visible and “…more than two-thirds indicated that they would have appreciated being asked” about the etiology of their injuries.¹⁹

If a patient reveals being a victim of IPV, the dental professional needs to offer empathetic support and referral options. Signs of IPV may be observable physical wounds or other marks. Almost 75% of IPV victims have injuries to their head and neck regions, which is exactly the area of specialty for dental professionals.^8,19 They could also include certain types of behavior or behavioral changes. Specific signs include:

• Public and private demeaning actions by intimate partner. The partner may be reluctant to leave her or him alone during the appointment, is domineering, or answers all questions for a patient who would otherwise be capable of answering for him or herself.

• Injuries to the neck, head, and face that may be in different stages of healing including:

  • intraoral bruising, patterned bruising around the neck due to strangulation;

  • abscessed, avulsed, or non-vital teeth;

  • lacerations or burns;

  • fractures to teeth, mandible, maxilla, or nose;

  • torn frenum or mucosal linings;

  • complaints of headaches;

  • bite marks;

  • multiple injuries in various stages of healing;

• Various types of behavior changes, either observed or reported, including:

  • chronic pain or inability to sleep,

  • personality changes,

  • frightened behavior when with the opposite sex,

  • afraid to return home,

  • report of injuries caused by intimate partner,

  • drastic behavioral changes in presence of intimate partner,

  • victim appears embarrassed, vague, anxious, or depressed,

  • low self-esteem,

  • blaming self or others for everything,

  • changes in the patient’s routine including patients who used to come in for regular check-ups and who suddenly stops.

  • exaggerated startle response

  • spontaneous tears

  • dissociation from eye contact (or a sudden fading out of the patient’s attention/responses to cues)

  • inability of patient to talk clearly due to breathing patterns or panic

  • reluctance or insecurity in answer questions posed by the dental professional