How Can Dental Services Better Support Patients With Trauma History?

What you need to know

• Up to 20% of girls and 10% of boys experience childhood sexual abuse, and trauma symptoms can make dental visits particularly challenging
• Dental procedures can trigger trauma responses due to physical proximity, horizontal positioning, and feelings of powerlessness
• Training dental staff in trauma-informed care can help create a more supportive environment for trauma survivors

Understanding Trauma’s Impact on Dental Care

Imagine feeling intense anxiety just thinking about going to the dentist. For many trauma survivors, this fear goes far beyond normal dental anxiety. Simple procedures that most people take for granted can trigger powerful memories of past trauma, making routine dental care feel impossible.

Psychological trauma results from experiences that are so emotionally or physically harmful that they overwhelm a person’s ability to cope. While many people associate trauma with dramatic one-time events like accidents or assaults, it can also come from ongoing situations like abuse or domestic violence that are difficult to escape.

How Trauma Affects the Dental Experience

For trauma survivors, several aspects of dental care can be particularly challenging. The close physical contact, having to lie back in the chair, and having instruments placed in their mouth can remind them of past abuse. This is especially true for survivors of sexual abuse, who may experience intense anxiety or even dissociation - a feeling of being disconnected from their body - during dental procedures.

Some patients may appear outwardly calm while internally experiencing severe distress. This “freeze” response is a common trauma reaction that can make it difficult for patients to speak up when they’re uncomfortable or in pain. Additionally, trauma survivors often struggle to trust authority figures, making it harder to build the necessary rapport with dental professionals.

The Role of Trauma-Informed Dental Care

Trauma-informed care means understanding how trauma affects patients and adjusting practices to help them feel safe and in control. This approach includes:

• Recognizing signs of trauma responses
• Offering choices and control during procedures
• Using clear communication
• Being sensitive to physical positioning and touch
• Creating a supportive, non-judgmental environment

When dental staff understand trauma, they can better support these vulnerable patients and help prevent re-traumatization during dental visits.

Training Dental Staff in Trauma-Informed Care

A pilot program in Scotland showed promising results in training dental staff about trauma. The training covered:

• Understanding different types of trauma
• Recognizing trauma symptoms
• Learning how to respond supportively
• Discussing real case examples
• Supporting staff wellbeing when working with trauma

After training, staff reported doubled confidence levels in their ability to identify and respond to trauma symptoms. They particularly valued learning through case studies and group discussions.

What This Means for You

If you’re a trauma survivor:

• Know that your reactions to dental procedures are normal and valid
• Look for dental providers who understand trauma-informed care
• Communicate your needs and concerns when possible
• Consider bringing a trusted support person to appointments

If you’re a dental professional:

• Learn about trauma-informed approaches
• Create an environment where patients feel safe and in control
• Listen carefully to patient concerns
• Be willing to modify procedures when needed
• Access available trauma training resources

Conclusions

• Trauma-informed dental care is crucial for making services accessible to all patients
• Simple changes in approach can make a significant difference for trauma survivors
• Ongoing training and support for dental staff is key to implementing trauma-informed practices effectively