DentaltownUK September 2017 - 58

Introduction
Have you ever encountered patients who
totally mystify you? As clinicians, we've likely
all seen patients who are noncompliant-
sometimes to the point of being negligent.
Even if they have insurance coverage,
such patients might frequently cancel their
appointments or attend only for emergency
dental care with advanced disease. Perhaps
they look as if they haven't brushed their
teeth since their last visit despite having
good manual dexterity, and defy our best
efforts to motivate them. Some of us might
be perplexed by patients who flinch in
anticipation before we touch them or even
dislike us on sight for no apparent reason. I
recently read the Handbook on Sensitive Practice
for Health Care Practitioners: Lessons from Adult
Survivors of Sexual Abuse1 and discovered that
it provides some insight into what might be
happening with these individuals.

Survivor issues can
impede attendance
Individuals with dental phobias are
often irregular attenders; they frequently
cancel scheduled appointments or just
don't show up. Dental phobia is classified
as a specific phobia within the Diagnostic
and Statistical Manual of Mental Disorders. 2
Dental phobias might be a consequence of
negative experiences with childhood dental
care or a history of being childhood victims
of violence or sexual abuse.
Survivors of abuse have experienced
violation of their personal boundaries;
they have been traumatized, betrayed,
and often are stigmatized and made to
feel powerless. Childhood sexual abuse,
particularly of young children, may also
be oral in nature, causing many survivors
to experience difficulties tolerating various
aspects of oral health care.
A history of being abused could lead to
depression or low self-esteem and feeling
unworthy of proper health care. Survivors

might also have an aversion to being touched
or having their personal space invaded;
some survivors find that even a gentle pat
on the shoulder is actually painful.
Certain aspects of a dental visit could
trigger flashbacks, making the survivors feel
as if they're being abused again. This can
manifest as distrust, anxiety, hypersensitivity,
irritability and a tendency to startle easily;
some individuals display anger or aggression.
Triggers vary greatly, from sights, sounds
and smells to something about a clinician's
appearance that reminds a survivor of his
or her abuser. For example, the view of the
ceiling while lying in the dental chair could
be a trigger, which reminds the survivor of
the position he or she was forced into while
being abused.
Some victims of abuse cope with the
violation of their body or personal space
by entering a dissociative state, to detach
themselves from the abuse they're powerless
to fight off. In this state, they experience
altered perception, sensation and sense of
time. These individuals have also learned
to ignore or dissociate from pain, which



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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