Contributed by Rebecca Cásarez, MA, for RAINN Consulting Group
Content Note: This article includes descriptions of how receiving dental care can retraumatize survivors of sexual assault or abuse.
About a year ago, I did something I’d been putting off for years. Something that caused me a tremendous amount of stress. Something I was frankly terrified to do. I went to the dentist. I’d been dreading this appointment for months and put it off even longer—and I know I’m not alone.
Many people find going to the dentist unpleasant, stressful, or scary. But for survivors of sexual assault, a routine dental visit can become a retraumatizing experience that prevents them from obtaining critical care.
“Dentist Anxiety” Is Real—Especially After Sexual Assault
I became familiar with the “dentist anxiety” many survivors face while I was working on RAINN’s National Sexual Assault Hotline. As a hotline support specialist, I spoke to a number of survivors who disclosed the anxiety that they felt around going to the dentist. These survivors were looking for ways to feel as safe and comfortable as possible while receiving dental care.
It’s Not About the Dentist. It’s About What Happens at the Dentist.
After hearing the same concerns from many survivors of sexual assault, I started to wonder: What are some of the mundane tasks and interactions that could be challenging—or even actively harmful—to survivors of sexual assault?
Dental care almost always includes one or more of these potentially retraumatizing triggers:
- Placing foreign objects in the patient’s mouth
- Preventing the patient from swallowing or closing their mouth
- Treatment causing jaw or mouth discomfort or pain
- Blocking the patient’s vision or shining bright lights in their face
- Standing or leaning over a reclining patient
Treatment steps that are commonplace to dentists and dental hygienists can be genuinely terrifying to survivors of sexual violence. The experience may remind survivors of things that happened during an assault or how they felt during an assault. Visiting the dentist can also revive feelings of vulnerability and powerlessness, two common sensations associated with traumatic events.
But these are more than just negative feelings. Triggers can have a retraumatizing effect on survivors, causing them to relive the traumatic experience with harmful mental health consequences.
Creating a Better Dental Experience for Survivors
First, keep in mind that every patient benefits from trauma-informed care.
While these tips I’m about to share specifically target reducing the discomfort of survivors of sexual assault during a dental appointment, they can be helpful and relevant for all dental patients—not just survivors.
A Better Dental Experience for Every Patient
Survivors may not be comfortable disclosing their past experiences, so dentists and dental offices should consider incorporating trauma-informed practices into their regular operating protocols.
Dental offices should evaluate the full lifecycle of their interactions with community members, patients, and customers and identify opportunities to make patient interactions more trauma-informed and supportive of survivors.
One way to think through some of these steps is to consider what a survivor may need before, during, and after an interaction. Dentists, hygienists, and other healthcare providers can take these steps to help ease the anxiety felt by survivor patients.
Before the Appointment
- Get informed. Educate yourself on topics related to providing better care to survivors of sexual trauma.
- Allow time for introductions. Give patients the option to meet with the dentist before they sit in the chair.
- Offer comfort items. Let patients know that they can bring a comfort item with them, like a fidget toy or a blanket. Keep a few comfort items on hand to loan to anxious patients.
- Welcome supporters. Inform your patient in advance if they’re permitted to bring a support person (such as a friend or family member) to their appointment.
During the Appointment
- Create a sense of security. Give your patient the option to have the door open or closed during the appointment.
- Encourage a support person. Ask your patient if they would like to have someone else in the room with them during their appointment.
- Describe every step. Explain each stage of the exam or procedure. Keep your patient informed about exactly what you’re doing.
- Show compassion. Check in with your patient throughout their appointment by asking how they’re doing and offering breaks at select intervals.
- Give guidance. Encourage your patient to use a sign or signal (like raising their hand) to request a pause in the treatment if they are unable to speak.
After the Appointment
- Request patient input. Seek feedback from patients about their dental experience and ask for suggestions about how future visits could be improved. Researchers in the UK found that when dental staff offered survivors more input into their appointment experiences, survivors experienced less retraumatization.
Trauma-Informed Dental Care
All of the above suggestions incorporate principles of predictability and choice, allowing patients to make the best decisions for themselves.
Predictability and choice are key elements of a trauma-informed approach, which is one that understands the impacts of trauma and incorporates that knowledge into service delivery.
Survivor-Centered Care Helps Everyone
At my own dentist appointment and at subsequent appointments, I benefited from some of these practices. Knowing that I was anxious about having dental work done, my dentist explained the procedures to me, told me how much time they would take, and offered me a weighted blanket to use during a particularly long procedure.
While some of these things may seem like very small changes, they can have a huge impact on helping everyone access the healthcare they deserve.
Sexual abuse, assault, and misconduct are sensitive, challenging issues, but every organization should be prepared to support survivors.