The meeting was about Intimate Partner Violence (IPV). Why was the meeting room almost empty? Because the session wasn’t about making money?
As part of the American Academy of Cosmetic Dentistry’s (AACD) outstanding program in New Orleans this year, its charitable foundation included two sessions of note: the first was Family Violence: Implications for Patients and Practice, conducted by Dr. Lynn Mouden and Domestic Violence — Prevention and Recognition in the Dental Office, led by Drs. Barbara Gerbert and Linda Niessen. For a time, the speakers outnumbered the attendees. When some of the slides started appearing before me on the big screen in full HD, I wished I’d made a different selection.
Dentists and dental office personnel have a unique opportunity to address the problem of domestic violence. Dental professionals are often the first healthcare providers that a victim of domestic violence sees when seeking care for a violence-related injury.
At least 75 percent of physical abuse involves injury to the head, neck and mouth yet less than nine percent of reports come from healthcare professionals including dental and medical personnel. Studies suggest that 70-81 percent of victims of intimate partner violence (IPV) would like to have had their healthcare provider ask them privately about IPV. Consider:
• In Canada, in 1986, there were approximately 235 women’s shelters; in 2006 there were more than 550.
• In Canada, the federal government estimates the annual cost of violence against women is $1.1 billion in direct medical costs alone.
• The Unites States has 3,800 animal shelters but only 1,200 domestic violence shelters.
A 2006 YWCA report, Effective Practices in Sheltering Women: Leaving Violence in Intimate Relationships reports that “of significant concern is that more than a third (38.5% of women surveyed) responded that their partner had prevented them from getting medical aid for injuries resulting from the abuse at least once.”
Dental professionals may face barriers to identifying victims of violence but education about IPV can help eliminate these challenges.
Dr. Gerbert and her team at the University of California San Francisco, along with Dr. Niessen, have authored a brief tutorial for oral healthcare professionals on how to identify the signs and symptoms of IPV and provide an effective response.
The tutorial is entitled AVDR: Ask about abuse; Provide Validating messages; Document presenting signs; and Refer victims to domestic violence specialists.
Intimate partner violence is one of our nation’s most serious public health issues. Head and neck injuries are considered a ‘marker’ for domestic violence. Given that you routinely examine patients’ heads and necks, you have an ideal opportunity to recognize abuse and intervene.
You have an opportunity, not to mention an ethical obligation, to identify and refer. Dental professionals should note that, according to IPV survivors, any kind of compassionate response from a healthcare provider helps alleviate shame and denial.
So, don’t forget to ask, “How are things at home?”
