A new Malmö University study shows that sitting in a dental chair can bring back powerful memories for those who have experienced sexual assault.

Allowing a dentist to conduct an oral examination can be a trigger for patients who are survivors of sexual assault. 

“I have previously done research concerning chronic facial pain and among these patients, research shows an overrepresentation of individuals who have been subjected to sexual and other types of abuse,” says Eva Wolf, dentist and associate professor of endodontics at the Faculty of Odontology.

We know that people who have been abused often avoid appointments, cancel last minute and sometimes leave the room during treatment. 

Eva Wolf

“Studies also show that people who have been sexually abused more often have impaired oral health and are at greater risk of substance use and premature death,” she adds.

“It’s important to keep in mind that these are people who often have feelings of shame and guilt surrounding the assault and may not want, or be able, to disclose their experience to others.”

Even among patients with dental anxiety, there is an over-representation of people who have been subjected to abuse.

“We know that people who have been abused and those with dental anxiety often avoid appointments, cancel last minute and sometimes leave the room during treatment. We also know that memories of abuse can manifest physically.”

Wolf’s study includes 13 individuals who have been subjected to sexual abuse and experienced these memories resurfacing during dental care visits. The patients were asked three main questions: Could you describe, in as much detail as possible, one or more dental visits where you were reminded of the abuse? How do you feel that your oral health has been affected by the abuse? How do you feel your health and life in general has been affected by the abuse?

Wolf’s study is mainly based on the tendencies she noted from the analysis of answers to the first question.

“Sitting in a treatment chair means surrendering to the dentist and how they choose to examine your mouth. For the people I interviewed, this often brought up the same feeling of powerlessness that they experienced in the abuse situation.

“For some, this is not just a reminder of the assault, but a recurrence of it. It may cause them to leave the situation altogether or avoid dental appointments.”

Eva Wolf believes that there are generally good routines within dental care for people with dental anxiety. However, she says, it may be necessary to expand on this so that dental care visits do not contribute to trauma.

Currently, there is national focus in Sweden on work against intimate partner violence. The National Board of Health and Welfare and the National Centre for Women's Rights recently completed a collaborative two-year government assignment to provide national and regional competency development. Scania’s national dental service has also recently implemented the possibility for dental staff to ask their patients questions regarding abuse.

"When it comes to patients who have been subjected to sexual abuse, I think it is necessary to be self-aware and critically examine how the dental care system works," says Wolf.

“This could mean shifting power relations in a way that allows the patient to feel in control. One must also be very careful not to violate patients’ boundaries.”

Wolf’s interdisciplinary study, which draws on both philosophical and psychological perspectives, is now proceeding through to in-depth analyses of the other research questions. Two master's student groups at the Faculty of Odontology have also expressed an interest in using parts of the collected data to study oral health and care.