Domestic violence awareness prepares dental hygienists to intervene on behalf of a patient who is a victim. Dental hygienists should know the different forms of domestic abuse, and must be able to identify signs of domestic violence in order to provide appropriate interventions to assist patients.
Here are some of the facts about this unfortunate crime and what you can do as a dental hygienist to help your patients feel safe at home.
Domestic violence is defined as a violent or aggressive behavior within the home, typically involving the violent abuse of a spouse or partner. The victim may also be a child or an elderly person. There is rarely a single incident. The National Coalition Against Domestic Violence states that abuse is often "part of a systematic pattern of power and control." It is important to know that domestic abuse is not just physical. There are many different forms, including sexual, emotional/psychological, coercive, financial, spiritual and stalking.
There are many opportunities during a dental appointment for the dental hygienist to observe and question the patient to determine if they may be a victim of domestic violence.
Before the appointment even begins, patients must fill out a health history. Incorporate questions that give patients an opportunity to share if they are a victim of domestic abuse. For example, your medical history form could include a yes-or-no question like, "Do you feel safe at home?" Some patients may pass right over this question and may be a little confused why the dental office is asking. But, for those who are being abused, this may be the first opportunity they are offered to help escape their situation.
Below are some signs that dental hygienists may observe that may indicate domestic violence:
- When performing a head and neck exam you find bruising or the patient becomes extremely nervous or hypersensitive.
- You notice bruising that is in different healing stages.
- The patient has an injury, but the story behind it does not seem to match the injury.
- The adult patient's spouse or partner insists on being in the room during the appointment.
- The patient is wearing clothing that is inappropriate for the weather.
If you suspect abuse may be occurring, you must talk to your patient. Explain to your patient that you are concerned by your observations. Be honest, be patient and listen to what your patient has to say.
If a patient tells you they are being abused, offer to contact the authorities on their behalf. Cathy Terhune Alty, RDH, writing for RDH Magazine, notes that there are 38 states that require dental hygienists to report suspected abuse. You must check with your state to determine your legal obligation. Document everything: your observations, if the patient refused intervention and anything you discussed. Use an intraoral camera to take photographs, if relevant. All of this evidence and testimony is extremely helpful to authorities.
Keep in mind that what you may interpret as red flags for physical abuse may just be injuries from a moment of clumsiness. Or perhaps an adult patient has a dental phobia and asked their spouse to attend the appointment. Do not make any assumptions based on your findings. Talk with your patient to ensure that you have all the facts before you proceed with contacting authorities to report abuse.
Domestic violence awareness begins with education. Sign up for the free continuing education course available at the Colgate Oral Health Network: Stop The Violence: Exploring Domestic Violence, presented by Lisa Mayo, RDH, BSDH.
If you suspect or report domestic violence, offer resources to the patient if they choose to seek help on their own, as well. Safe Horizon and The National Domestic Violence Hotline offer support to victims of domestic violence.
- Learn to identify the signs of domestic violence.
- Document thoroughly and report your findings to the proper authorities.
- Take CE courses and offer resources to spread domestic violence awareness.
Domestic violence awareness is key among dental hygienists. It is your legal obligation to report violence to the appropriate authorities. On top of that, helping your patients is a moral duty. Not only do you care for their oral health, you can look out for their physical and psychological well-being and their safety.