DentaltownUK September 2017 - 59

could lead survivors to ignore symptoms
of disease and delay seeking help, thus
delaying an accurate diagnosis.

Prevalence of childhood abuse
The incidence of child abuse, especially
sexual abuse, is underreported because the
victims are usually coerced into secrecy with
threats of harm; many survivors maintain
this secrecy into adulthood, partly out
of shame. A 2003 study found that 32.3
percent of women and 14. 2 percent of men
reported sexual abuse in childhood, and 21
percent of adults who reported histories of
childhood sexual abuse also experienced
other physical maltreatment.3 Research has
shown that child abuse occurs in all countries
studied4 and is not limited by demographic
or socio-economic status. Children with
disabilities are more likely to be abused
than children without disabilities.5 Studies
suggest that sexual abuse of male children by
adult females occurs more frequently than
was previously thought. Sadly, this is often
taken less seriously-as an experience any
boy should be glad to have or could have
prevented, when boys are just as vulnerable
and experience as much violation and trauma
as other survivors.

Survivor issues can
also impede self-care
Survivors of sexual abuse are often
stigmatized, feeling hate, shame and guilt
about their bodies that can lead to a distorted
sense of self and low self-esteem. This could
contribute to a failure to care for oneself,
manifesting as risky behaviors, self-harm,
poor health practices and
poor hygiene.

Survivors who became dissociative
during episodes of abuse might continue to
dissociate whenever they are under stress. If
they consider visits for dental care stressful,
they might be inattentive during oral health
counseling or appear apathetic.

What can we do to help?
These nine principles of "sensitive
practice"are crucial to facilitate feelings
of safety for our patients; they form the
framework of The Umbrella of Safety:
1 Providing respect. Acknowledging the
inherent value of each individual and
suspending critical judgment. Respect
means a great deal to survivors
of abuse; we can show respect by
listening to patients and heeding their
concerns.
2 Taking time. Making patients feel
genuinely heard and not rushed.
3 Fostering rapport. Display caring,
concern and empathy; use "active
listening" techniques.
4 Sharing information. Advise patients
of their choices so they can give us
their informed consent. They also
need to know what to expect during
their treatment, and the rationale for
each procedure. Follow up verbal
oral health counseling with written
materials.
5 Sharing control. Helping patients feel
a sense of control during treatment by
working with, not just on the patient
addresses abuse-related fears and
facilitates compliance. We should
ask them what they can tolerate.
In addition to obtaining informed
consent before a procedure, we should
reaffirm consent at different stages
of the appointment. Patients should
be assured that they can stop for a
break at any time and that they can

indicate if they're not comfortable by
communicating with previously agreed
hand signals.
6 Respecting boundaries. The total
disregard of personal boundaries
during abuse teaches victims that
their wants and needs are of no
consequence. We should ask for
consent before entering a patient's
personal space, as well as before
beginning a procedure.
7 Fostering mutual learning. Abuse
survivors may need encouragement to
assert autonomy and participate fully
in their own health care. Clinicians
can also learn from the patients how
best to manage their care.
8 Understanding nonlinear healing.
A patient's ability to tolerate examination and treatment might vary from
one visit to the next as they experience
good days and bad days.
9 Demonstrating awareness and
knowledge of interpersonal violence.
We can do this by having educational
brochures on this topic in the office;
this also shows survivors they're not
alone and helps them to feel more
comfortable about disclosing their
history to us.

dentaltownuk.com \\ SEPTEMBER 2017

59


http://www.dentaltownuk.com

Table of Contents for the Digital Edition of DentaltownUK September 2017

Cover
On Dentaltown.com
Editorial with Mike Gow
Meet the Team
Howard Speaks
Thinking Implants
John Zamet Memorial Prize in Peridontal
Euro Dental Depot
Berkeley Referral Colleague
Message Board: Over-Drying
Message Board: The Inman Aligner
Care Quality Commission
Love Dental
Message Board: Seating Crowns
Poll: Marketing
The Freelancing Trap
Understanding Survivors of Childhood Abuse
The BACD 14th Annual Conference 2017
Bluephase Style Review
Lifestyle
Students Section
Wishlist
DentaltownUK September 2017 - Cover
DentaltownUK September 2017 - Cover2
DentaltownUK September 2017 - 3
DentaltownUK September 2017 - 4
DentaltownUK September 2017 - On Dentaltown.com
DentaltownUK September 2017 - Editorial with Mike Gow
DentaltownUK September 2017 - 7
DentaltownUK September 2017 - Meet the Team
DentaltownUK September 2017 - 9
DentaltownUK September 2017 - Howard Speaks
DentaltownUK September 2017 - 11
DentaltownUK September 2017 - Thinking Implants
DentaltownUK September 2017 - 13
DentaltownUK September 2017 - 14
DentaltownUK September 2017 - 15
DentaltownUK September 2017 - 16
DentaltownUK September 2017 - 17
DentaltownUK September 2017 - 18
DentaltownUK September 2017 - John Zamet Memorial Prize in Peridontal
DentaltownUK September 2017 - 20
DentaltownUK September 2017 - Euro Dental Depot
DentaltownUK September 2017 - Berkeley Referral Colleague
DentaltownUK September 2017 - 23
DentaltownUK September 2017 - Message Board: Over-Drying
DentaltownUK September 2017 - 25
DentaltownUK September 2017 - 26
DentaltownUK September 2017 - Message Board: The Inman Aligner
DentaltownUK September 2017 - 28
DentaltownUK September 2017 - 29
DentaltownUK September 2017 - 30
DentaltownUK September 2017 - Care Quality Commission
DentaltownUK September 2017 - 32
DentaltownUK September 2017 - 33
DentaltownUK September 2017 - 34
DentaltownUK September 2017 - Love Dental
DentaltownUK September 2017 - 36
DentaltownUK September 2017 - 37
DentaltownUK September 2017 - 38
DentaltownUK September 2017 - 39
DentaltownUK September 2017 - 40
DentaltownUK September 2017 - 41
DentaltownUK September 2017 - 42
DentaltownUK September 2017 - 43
DentaltownUK September 2017 - 44
DentaltownUK September 2017 - Message Board: Seating Crowns
DentaltownUK September 2017 - 46
DentaltownUK September 2017 - 47
DentaltownUK September 2017 - 48
DentaltownUK September 2017 - 49
DentaltownUK September 2017 - Poll: Marketing
DentaltownUK September 2017 - 51
DentaltownUK September 2017 - 52
DentaltownUK September 2017 - The Freelancing Trap
DentaltownUK September 2017 - 54
DentaltownUK September 2017 - 55
DentaltownUK September 2017 - Understanding Survivors of Childhood Abuse
DentaltownUK September 2017 - 57
DentaltownUK September 2017 - 58
DentaltownUK September 2017 - 59
DentaltownUK September 2017 - 60
DentaltownUK September 2017 - The BACD 14th Annual Conference 2017
DentaltownUK September 2017 - 62
DentaltownUK September 2017 - 63
DentaltownUK September 2017 - Bluephase Style Review
DentaltownUK September 2017 - 65
DentaltownUK September 2017 - Lifestyle
DentaltownUK September 2017 - 67
DentaltownUK September 2017 - 68
DentaltownUK September 2017 - 69
DentaltownUK September 2017 - 70
DentaltownUK September 2017 - 71
DentaltownUK September 2017 - 72
DentaltownUK September 2017 - 73
DentaltownUK September 2017 - 74
DentaltownUK September 2017 - 75
DentaltownUK September 2017 - 76
DentaltownUK September 2017 - 77
DentaltownUK September 2017 - 78
DentaltownUK September 2017 - 79
DentaltownUK September 2017 - 80
DentaltownUK September 2017 - 81
DentaltownUK September 2017 - Students Section
DentaltownUK September 2017 - 83
DentaltownUK September 2017 - 84
DentaltownUK September 2017 - 85
DentaltownUK September 2017 - 86
DentaltownUK September 2017 - 87
DentaltownUK September 2017 - Wishlist
DentaltownUK September 2017 - Cover3
DentaltownUK September 2017 - Cover4
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