*The following article refers to domestic violence. Please take care while reading.*
SASKATOON — A research study at the University of Saskatchewan in Saskatoon hopes to educate dental professionals and future dental professionals on the signs of domestic violence and how to help their patients who are experiencing domestic violence.
Dr. Liran Levin is a periodontist who also does clinical and research work in dental trauma-related issues.
“The dental trauma aspect was something I was dealing with for a long time,” said Levin.
This is where the idea for this project came from after getting to know someone who was a survivor of domestic abuse.
“Through that, I became more aware of the complexity of this situation,” said Levin. “I realized that as dental professionals we have the opportunity to identify and detect things like this, both from the physical aspects, but also their behaviour.”
“We see patients who come several times a year or sometimes every week. We can see who is coming with them and hear their phone calls. So, we can see some red flags that may direct us to domestic abuse,” continued Levin.
Dentist Ana Cantao was an undergraduate student three years ago in Brazil when she and Levin first talked about doing a project combining dentistry and domestic violence.
At the time, Cantao could treat some patients, and many were survivors of domestic violence.
“They had some common signs like bruises and some behavioural signs (such as) the kids were anxious and fearful of dentists,” said Cantao. I noticed that my colleagues and I, and professors, could learn the signs of abuse and learn how to approach the survivors.”
Last year, Cantao, now a master’s student, moved to Canada and started working alongside Levin. When Cantao approached Levin about wanting to do a master's, this topic came up, and they decided that the ways dentistry and domestic violence coincide would be Cantao’s project.
Levin and Cantao started looking at the prevalence of domestic violence.
“We witnessed they had oral and facial traumatic dental injuries,” said Cantao. “We could notice the prevalence of traumatic dental injuries is underestimated and could be related because dentists do not know how to diagnose this and recognize victims.”
This echoed the findings of a study Levin previously did.
“With another student at USask, I just completed another project with a survey among dental professionals, and most professionals don’t think that they have ever seen someone who was a victim,” said Levin. “But if we look at the statistics, it's one in four women. So, when you think about that, if you see 10 or 12 patients a day, you just missed it.”
Cantao thinks this topic might not be talked about in dental school due to its sensitivity.
“It’s not taught because it's a delicate subject,” said Cantao. “Sometimes people don’t want to talk about it because they don’t know how to approach it. But it should be part of the dental school curriculum.”
This study is also filling in the gaps that dental professionals have been asking for.
“In the other survey, the dental professionals we asked said they wanted to know what to do, and how to approach (someone), but they didn’t have a lot of tools,” said Levin. “We are not educating people about this in dental schools and getting the proper training.”
In the beginning, it was not easy to get their study off the ground.
“In the beginning, we had problems because usually people in academia do not think this is an important topic,” said Cantao. “They are focused more on oral cancer research and research of that sort, but we are showing them how important this is.”
Levin and Cantao are doing their study in two phases.
In the first phase, they talked to 25 professionals, such as psychologists, social workers, and lawyers, from all over the world.
“They can help us to identify the behavioural signs in our clinical observations, how to approach them, and what kind of referrals we can do and what their rights are. The idea is to figure out how we can do it in our clinical settings,” said Cantao.
In the second phase, Levin and Cantao are speaking with those who are survivors of domestic abuse.
“The more we advanced with that, we thought yes, we can talk to all the professionals we want, but we are missing the most important part, which is the actual victim or survivor,” said Levin.
This will help dental professionals help their patients.
“This is to know what they want from us as dental professionals,” said Cantao. “It doesn't make sense to just develop it from our experience. We don’t know what they are going through, so we need to include them.”
It will then take a few months to analyze the data.
“The idea is to try and find ways and create guides for dental professionals on how to identify domestic abuse,” said Levin.
“As we look into this, it becomes more complex. It’s not only about identifying what you need to know what to do next. How can you approach and talk (to the person)?” said Levin. “Then if you discover something is happening, what do you do with that, and where do you refer them, and what is the best way to support them?”
Levin and Cantao are hoping to interview 10 to 15 people in this portion of the study.
“If we feel that we are still discovering new things, we will expand that,” said Levin.
Instead of doing this as a classic research project where there is a paper in a scientific journal, Levin and Cantao have also collaborated with the School of Arts at the University of Saskatchewan.
“At the end of the process, we want to create something that is approachable and will be disseminated on socials and online platforms,” said Levin. “The idea is to create something that can be broadly disseminated to dental professionals and to the public to make it accessible.”
They are also hoping to make a product that is shareable on YouTube or other formats for students.
“This will be part of their training in dental school,” said Cantao. “We aim to do animations with the data.”
Those interested in learning more or participating in the study can reach Cantao at ab.cantao@usask.ca.
Those participating in the study must
• be 18 or over
• self-identify as a victim/survivor of domestic abuse (this also includes familial abuse, and other forms of coercive control)
• must be able to provide informed consent
• be willing to participate in a 25-minute audio-recorded interview either in person or over Zoom
• Survivors worried about their identity should note interviews will be stored in a password-protected system, only Cantao or Levin can access and identifying information will be removed, with only anonymous information used.
