By Timothy Hyland & Kelly Walker, M.S.
The direct health impacts of COVID-19 are now, unfortunately, well understood. The novel coronavirus that first hit China early this year spread worldwide, infecting approximately 20 million people and killing more than 730,000. (By comparison, past pandemic initial death tolls included: 1 million - 1968 influenza pandemic | 2 million - 1956 Asian flu | 20-50 million - 1918 Spanish flu.)
Societies worldwide are also coming to grips with a multitude of other downstream impacts of the pandemic.
Even as the scientific community scrambles to develop treatments and vaccines to mitigate the virus, societies worldwide are also coming to grips with a multitude of other downstream impacts of the pandemic—increased poverty and economic hardship, increased mental health challenges, and deferred care on critical medical conditions.
Recently, yet another negative spinoff effect of shutdowns and quarantines has been noted by researchers—and experts say dentists may have a somewhat unexpected role to play in helping address the problem.
Just a couple of months into the pandemic, researchers, medical professionals and public health officials began warning of a troubling rise in domestic violence and abuse, first in China, then in Europe, and eventually to all corners of the globe. The spike in incidents—which was tied to lockdown restrictions that left women and children isolated with abusive partners and parents—was so dramatic that the United Nations put out a statement calling on all governments to "put women's safety first" in the pandemic response.
That call came in April, but the abuse continues to rise. As was noted in June by researchers writing in the British Dental Journal, the myriad disruptions caused by COVID-19 are all driving this spike in abuse.
"Children are particularly at risk in the 'pressure cooker' of family life in isolation without the usual external oversight of teachers, general medical practitioners and others," the researchers wrote. "There has been international recognition of the unintended negative consequences of the COVID-19 global pandemic management measures, including a spike in [domestic violence] along with psychological health risks, loneliness, school closure, economic vulnerability and job losses."
The limitations that COVID-19 has placed on dental practices have also contributed to this growing issue, the researchers noted. Governments worldwide put lockdown restrictions in place, many of which limited access to dental care. While those limits were problematic from a dental health and hygiene perspective, they also removed from the front lines another important group of professionals: dentists and their staff members, who, like teachers, could have otherwise been playing a critical role in identifying and reporting cases of domestic violence or abuse.
Now, as restrictions to dental practice loosen, industry leaders are calling on dentists to embrace precisely that role, and to be vigilant and focused in their efforts to help stop this worrying trend.
As the British research team wrote, by the nature of their work, dentists are "well placed to observe and identify injuries to the head, eyes, ears, neck, face, mouth and teeth”—all signs of domestic violence and abuse. And though they conceded that some dentists may be uncomfortable inquiring about suspicious injuries, they also wrote that if dental professionals fail to ask patients difficult questions, "they will be doing little to help the patient who is experiencing [domestic abuse or violence].”
“Early intervention and referral to a DVA advocate can prevent an abusive situation becoming worse with more intense violence,” they wrote. “It can save lives.”
Indeed, additional studies have come to the same conclusion—even dating to the days before the pandemic. A 2019 article in the Journal of Aggression, Maltreatment and Trauma, for instance, concluded that because, "as much as 75 percent of head and neck trauma associated with domestic violence occurs with oral injury," dentists were in the "unique position to be the first line of defense in identifying evidence of assault, and then reporting potential cases of domestic violence."
A clear hurdle to dentists playing this kind of active role is a general lack of training about domestic violence in the industry. The researchers acknowledged that challenge, but like the British team, emphasized that it is essential for dentists to step up, perhaps now more than ever. They called for additional training for all in the industry, and encouraged industry leaders to continue efforts to raise awareness about the issue going forward.
Numerous resources are available for dentists and others in the industry who are interested in learning more. Among them are the following:
- Enhancing Dental Professionals’ Response to Domestic Violence (from the Family Violence Prevention Fund)
- The ‘Ask, Validate, Document, Refer (AVDR)’ Tutorial for Dentists (from the National Resource Center on Domestic Violence)
- Medical Responses to Child Abuse and Neglect (from the Child Welfare Information Gateway)
Author: Contributing writer Timothy Hyland has more than 20 years' experience as a writer, reporter, and editor. His work has also appeared in Fast Company, Roll Call, Philadelphia Business Journal, and The Washington Times.