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Trauma-informed care: Stop shaming your dental patients!

Updated: Oct 11



One way or another, we’re all dealing with our own form of trauma. In fact, about 70% of adults in the US have experienced some kind of traumatic event at least once in their lives. That’s a lot of damage! No matter the severity of the trauma, experiencing overwhelming fear and helplessness in extremely stressful circumstances can have permanent effects, going so far as to affect one’s mental, emotional, and physical wellbeing.



What is trauma-informed care?


Because of this, trauma-informed care (TIC) is becoming increasingly important. It’s wrong to assume that everyone who walks into your dental office will have the same level of comfort. On the other hand, treating each patient with a dose of understanding and sensitivity can positively impact the person and their treatment outcomes.


Trauma-informed care recognizes that everyone has experienced trauma in their lives. Whether from adverse childhood experiences, domestic violence, combat history, other traumatic experiences, or even secondary traumatic stress, it acknowledges the symptoms of trauma and the many ways it can impact one’s existence. Using trauma theory concepts helps promote a safe environment of healing and recovery, preventing or reducing the risk of re-traumatizing the patient.



Impact of trauma on health


Many studies point towards trauma having a direct impact on physical health. It is known to lead to chronic health conditions such as depression, cancer, diabetes, or even early death. There is also evidence linking childhood trauma to poor oral health, leading to higher chances of tooth decay and gum disease. This could be because those dealing with trauma are often more likely to engage in risky behaviors that can jeopardize their health, such as neglecting their diet, smoking, or substance abuse, putting even more strain on their overall wellbeing.


When we go through a traumatic experience, our bodies trigger physiological responses to adapt to these events. Unfortunately, we aren’t in control of these responses. Although they are vital to our survival and keeping us safe, sometimes, they can go into overdrive, which becomes more harmful than helpful as time progresses.



Re-traumatization


Re-traumatization refers to any situation that can trigger an individual’s trauma, conjuring up painful and distressing feelings from the past. It can occur anywhere and is of significant concern since those who are traumatized multiple times frequently experience worse symptoms. Therefore, one of the main reasons for adopting trauma-informed principles is to prevent re-traumatization allowing the healing process to begin.



What are the 5 principles of trauma-informed care?


Five Guiding Principles serve as a roadmap for trauma-informed care so that care systems and providers can know what to do to reduce re-traumatization. The trauma-informed principles are safety, choice, collaboration, trustworthiness, and empowerment.


The very first step of trauma-informed care is to provide assurance that the patient is in good and safe hands. Next, they need to know that the person who will look inside their mouth while it stays wide open for a long time is trustworthy. So, show your patient they can trust you by being mindful of their boundaries and managing their expectations about what will happen.


Be sure to include the patient throughout the consultation by giving them choices on healthcare strategies so that they feel a collaborative effort and are interested in participating throughout the process. Empowering the patient may help them feel more motivated to take the driver’s seat in the management of their own oral hygiene. By making the individual feel at ease, you’ll have the opportunity to build rapport and help them understand the importance of practicing good oral hygiene.


Of course, not all patients will willingly disclose their history of trauma to dentists; after all, they are not usually the first person you go to for ranting about your problems. But, some might. Better to be prepared than surprised!



Creating a trauma-informed practice setting


For trauma-informed care to be effective and sustainable, it must exist not only at the clinical level but also at the organizational level. This allows support systems to be put in place at every corner. I’m talking about cultivating a culture of care and understanding for every staff member so that each patient who enters your clinic feels safe and welcomed. Essentially, you want your patients to know they are in a safe space to ease their already heightened anxiety.


People with trauma often have trust issues and may even fear dental visits. They are often stressed, and many become impatient. If you don’t approach them in an understanding manner, it will likely be the last time they walk through your door and possibly any other dental office, for that matter.


Create awareness amongst all staff members, clinical and non-clinical, from receptionists to security personnel, as they too often have significant interactions with patients. Conduct trauma-informed care training and run trauma-informed coaching sessions for all employees so that they know the direction you are heading, the thinking behind introducing a safe space for those suffering from trauma, and the importance of doing so.


Adopting a trauma-informed practice approach creates an opportunity to engage with patients in a more comfortable and reassuring way. By working to break down any barriers, the patient is more open to listening and accepting medical advice, which results in favorable treatment outcomes.


Basically, for trauma-informed care to work, we simply have to care just a little bit more. After all, it’s our duty since it ultimately leads to better lives for our patients. So, would you consider making some simple changes in your dental clinic to become a trauma-informed care safe environment?


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