Dental care of patients exposed to sexual abuse : Need for alliance between staff and patients

The aim was to explore the experiences of sexually abused individuals as dental patients. Purposively selected were 13 informants (11 women) aged 19-56. All had experienced sexual abuse as children or adults and memories of this abuse had been triggered and expressed during a dental appointment. They were encouraged to relate in their own words their experiences of the dental appointment. The interviews were recorded digitally, transcribed verbatim, and analysed according to Qualitative Content Analysis. The overall theme illustrating the latent content was The dental appointment - a volatile base requiring predictability and a secure working alliance. The first category covering the manifest content was The dental care provider "assumes responsibility," with two subcategories: (i) contradictory disclosure, and (ii) alliance formation - a levelling of power. The second category was The patient is "in focus," with two subcategories: (i) alertness to signs of discomfort, and (ii) attention to obvious but subtle expressions of needs. On an understanding that the patient has been sexually abused, an individually tailored, patient-centered approach to treatment is suggested. Dental care providers may also need to be aware of and reflect on their position of power, in relation to the patient and its possible chairside implications

Dental care - an emotional and physical challenge for the sexually abused

The aim was to explicate persistent psychological and bodily memories of sexual abuse and how they are expressed during dental appointments. The participants comprised 13 sexually abused individuals (11 women), who recalled and expressed these experiences during a dental appointment. They were encouraged to describe, in detail, aspects of the appointment which triggered memories of the sexual abuse. The interviews were recorded, transcribed verbatim and analyzed using Qualitative Content Analysis. The identified overall theme illustrating the latent content was 'An echo of sexual abuse transformed into (dys) functional reactions'. The first category covering the manifest content was 'The inner invisible struggle', with two subcategories: (i) mental inscriptions of the abuse experience and (ii) consequences of the dental encounter. The second category was 'The discoverable manifestations', with two subcategories: (i) enigmatic communication; and (ii) expressions of bodily memories. The dental appointment arouses same similar psychological stressful reactions as the episodes of abuse; both implicit and explicit expressions are recognizable. Dental staff can contribute to disclosure by improved understanding of the strain a dental appointment can cause in patients who have been subjected to sexual abuse, and familiarity with the associated bodily expressions