Family Violence: Implications for Dental Patients and Practice, 2nd edition

About the Course
Family violence includes child abuse and neglect as well as intimate partner violence (also referred to as domestic violence or spousal abuse). Family violence may also include abuse and neglect of disabled persons (persons with significant physical disabilities or mental or functional impairments), vulnerable adults, and the elderly. Individuals of all age groups can be affected by family violence because multigenerational abuse frequently occurs. In 2009, a Department of Justice (DoJ) study reported that more than 25% of U.S. children had been exposed to family violence in their lifetimes (DoJ, 2017). From 2003 to 2014, more than half of the murders of women in the U.S. were related to intimate partner violence (Petrosky et al., 2017). Approximately one in ten people age 60 and over have experienced some form of abuse with most of the abuse being perpetrated by family members (National Council on Aging, 2021). In 2015, of violent crime victimizations of people age 65 and older, 44% were committed by someone the victim knew, often a relative or intimate partner (National Center for Victims of Crime, 2017).

Approximately 60% to 75% of physical abuse involves injuries to the head, neck, and mouth (Singh & Lehl, 2020). Orofacial injuries resulting from family violence should be easy to identify in the dental setting. Dental professionals also have an advantage over other healthcare professionals because almost two-thirds of all adults in the U.S. have regularly scheduled dental visits at least once a year (Centers for Disease Control and Prevention [CDC], 2017). Healthcare providers in the medical field do not have this unique opportunity because victims of family violence often avoid medical appointments. Historically, however, many in the dental profession have been unable or unwilling to properly identify these injuries. Equally disconcerting are cases in which a provider may suspect maltreatment but is uncertain of how to properly intervene. The steps in dealing with abuse or neglect are easy to learn and even easier to incorporate into the dental practice.

All members of the dental team should be knowledgeable about the physical and behavioral signs and symptoms of family violence. They should also know how to assess whether symptoms are indicators of trauma as opposed to normal conditions or accidental injuries. Just as important is the knowledge of how to provide appropriate intervention for victims of any age. Although dentists are required to report suspected child abuse and neglect in every state, and to report elder abuse and neglect in most states, there is no universal requirement to report adult victims of intimate partner violence. It is important to note that in 30% to 60% of families experiencing intimate partner violence, child maltreatment also takes place (U.S. Department of Health and Human Services, n.d.).
Members of the dental team must become more aware of the problem of family violence to help prevent abuse and neglect. Clinical protocols can easily be modified to include identification and intervention for cases of suspected abuse and neglect. By applying the knowledge of symptomatology obtained in this basic-level course and providing appropriate intervention, every member of the dental team can help stem the epidemic of family violence. 

The parallels between the four types of abuse should not be lost on the practitioner. Although an abuser may target different victims, the abuse—be it of a child, an intimate partner, a disabled person, or an elderly individual—follows a pattern, and it is a chain that must be broken. The dental healthcare team is in an excellent position to detect such injury and help prevent future harm.

Learning Outcomes
  • Discuss the demographics, contributing factors, and reporting protocols of child abuse and neglect.
  • Discuss the demographics, contributing factors, and reporting protocols of intimate partner violence.
  • Discuss the demographics, contributing factors, and reporting protocols of abuse of people with disabilities.
  • Discuss the demographics, contributing factors, and reporting protocols of elder abuse and neglect.
  • Differentiate the physical signs of family violence from accidental injuries or other physical conditions.
  • Describe education and prevention efforts to combat family violence.
About the Author
About the Author: Mark J. Szarejko, DDS, received his dental degree from the State University of New York at Buffalo in 1985 and received a fellowship from the Academy of General Dentistry in 1994. He has been in private practice for 16 years, with the balance involved in correctional (county jail) dentistry. In 2007 he received the Certified Correctional HealthCare Professional (CCHP) designation from the National Commission of Correctional Healthcare. He has authored and edited several dental continuing education courses and has given presentations on varied topics to local, regional, and national audiences. He has been an examiner for the dental and dental hygiene licensure exams for the Northeastern Regional Boards (NERBS), now the Commission on Dental Competency Assessments, since 1994. He has reviewed standard-of-care cases for the state of Florida and for private companies.

How to Receive Credit
  • Read the entire course online or in print.
  • Complete a mandatory test (a passing score of [75% - choose for profession] is required). Test questions link content to learning objectives as a method to enhance individualized learning and material retention.
  • Provide required personal and payment information.
  • Complete the mandatory course evaluation.
  • Print your Certificate of Completion.
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The information provided in this activity is for continuing education purposes only and is not meant to substitute for the independent medical judgment of a healthcare provider relative to diagnostic and treatment options of a specific patient’s medical condition.
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