Domestic abuse and oral health in women

Six studies were included in this review: one cross-sectional study, two systematic reviews, and three cohort studies, to assess the prevalence and impact of domestic abuse (DA) on oral health outcomes.¹⁴ The studies consistently found a higher prevalence of oral health issues, such as dental caries, periodontal disease, and traumatic dental injuries (TDI), among women who had experienced domestic abuse.

The themes identified are as follows.

1. Physical impacts of domestic abuse on oral health

Four studies highlighted the physical consequences of domestic abuse on oral health, reporting issues such as fractures, missing teeth, and intraoral injuries. These findings illustrate the direct physical damage that DA can inflict on the mouth and teeth. This trauma, often resulting from violent acts, can lead to long-term complications if not promptly addressed. These complications may include infections, tooth loss, and difficulty chewing, which can significantly impair a survivor’s ability to maintain good oral health and function daily.

2. Psychological impact of domestic abuse on oral health

Psychological violence, a key component of DA, was linked to poor oral hygiene practices, such as irregular tooth brushing and avoidance of dental visits. This aspect of abuse has a significant impact on the survivor’s ability to maintain oral health, exacerbating the challenges they already face. Psychological trauma related to DA, including anxiety, depression, and post-traumatic stress disorder (PTSD), can hinder self-care habits, and attending dental check-ups. As a result, neglecting oral hygiene leads to dental decay, periodontal disease, and a general decline in oral health.

The studies emphasised the crucial role dental professionals play in recognising and addressing the needs of abuse survivors.

3. Barriers to accessing dental care

Two studies focused on the challenges survivors face in accessing dental care, with financial constraints being the primary barrier. Other factors included social stigma, fear of judgement, and psychological distress. Survivors often avoid dental care due to these barriers, resulting in untreated oral health issues that can worsen over time. Anxiety, depression, and a lack of autonomy in abusive relationships were significant contributors to neglecting oral health. As a result, survivors may experience more severe dental conditions that impact their overall health.

4. Role of dental professionals in supporting survivors

The studies emphasised the crucial role dental professionals play in recognising and addressing the needs of abuse survivors. Two studies specifically highlighted the need for enhanced education and training for dental staff to help them identify signs of domestic abuse and guide patients toward appropriate support services. Improved awareness and sensitivity can empower dental professionals to make a meaningful impact on the lives of survivors. Dental therapists are positioned to recognising early signs of trauma and abuse, which allows for early intervention and more effective support.

5. Holistic, trauma-informed care

All six studies underscored the importance of dental practices offering holistic, trauma-informed care to survivors of domestic abuse. These findings suggest that dental professionals need to consider both the physical and psychological impacts of abuse when delivering care. Trauma-informed care involves recognising potential trauma, offering empathetic support, and ensuring that care is provided in a way that avoids re-traumatisation. This approach is essential for survivors of DA who may have experienced repeated emotional and physical trauma.