Perception of Women with Lived Experience of Domestic Violence and Abuse on the Involvement of the Dental Team in Supporting Adult Patients with Lived Experience of Domestic Abuse in England: A Pilot Study

Dentistry responding in domestic violence and abuse (DRiDVA) feasibility study: a qualitative evaluation of the implementation experiences of dental professionals

BACKGROUND

Domestic Violence and Abuse (DVA) is a persistent public health problem in the UK. Healthcare settings offer an opportunity to ask patients about DVA, either opportunistically or in response to the presence of injuries. However, it has been suggested that dental practices and dental teams have not been actively involved supporting adult patients when presenting with injuries that might have resulted from DVA. This qualitative study was conducted to satisfy the evaluative component of the Dentistry Responding in Domestic Violence and Abuse (DRiDVA) feasibility study.

METHODS

In total, 30 participants took part in the study; nine associate dentists and practice principals/owners took part in one-to-one interviews and 21 auxiliary staff took part across two focus group discussion sessions. Data were analysed using the seven step Framework Analysis process.

RESULT

Three key themes were identified from the data, focusing on barriers to enquiring about domestic violence and abuse, Facilitators of identification and referral of DVA in dental settings, and recommendations for further adaptation of intervention to dental settings.

CONCLUSION

DVA training coupled with robust referral pathways to a named specialist DVA advocate increases knowledge and awareness of the signs of DVA and confidence in making onward referrals. Further research is needed to understand how to increase dental professional willingness to ask patients about DVA.

Interpersonal violence education: An analysis of the Spanish oral health school's curricula and future requirements

INTRODUCTION

Interpersonal violence results in injuries that frequently affect oral, head and neck structures, the treatment of which must be carried out by Oral health practitioners with sufficient training to detect the problem and manage the victim's lesions and need for referral. The objective of this study is to know the academic preparation that Spanish dentistry students receive in learning outcomes related to interpersonal violence during undergraduate academic training.

MATERIALS AND METHODS

A survey was conducted through an online form with 9 questions (Survey Monkey platform). The link was sent by email to the deans of the 23 Spanish universities (public and private) offering dentistry degrees. The analysis of the results was carried out using Fisher's test and a chi-squared test.

RESULTS

95.63% of the deans (n = 22) responded. 85.7% of the universities report to carry on training in violence, according with Spanish legislation. Currently 33.3% dedicate less than 5 h to this training, whereas in the future study plans only 19% would dedicate less than 5 h to these learning outcomes. 85.7% of the respondents agree in consider this training as mandatory. The subjects in which learning outcomes on interpersonal violence were reported to be included were: legal and forensic dentistry (78%), psychology (55%), medical ethics (33.3%), paediatric dentistry (39%), surgery (5.5%) and 22% respondents cited other specialties. In future curricula, the competence areas in which such training is proposed to be imparted are: legal and forensic dentistry (80.9%), psychology and medical ethics (57.1%), paediatric dentistry (38.1%), surgery (14.2%) and in 23.8% also in other specialties. Significant differences were found between public and private universities only in the number of hours that would be dedicated to interpersonal violence learning outcomes in the future.

CONCLUSIONS

Interpersonal violence encompasses situations of abuse and neglect inflicted to different patients (women, children, elderly) that are perceived both by Oral Health students and practitioners to require a comprehensive training. Most of the respondent deans consider that in the future curricula both the hours and areas that teach interpersonal violence learning outcomes must be increased. To respond to victim's need for help and care, the future requirements for the Oral health workforce education must encompass interprofessional undergraduate as well as postgraduate training in interpersonal violence.

Dentists as Primary Care Providers: Expert Opinion on Predoctoral Competencies

Dentistry and medicine traditionally practice as separate professions despite sharing goals for optimal patient health. Many US residents experience both poor oral and general health, with difficulty accessing care. More efficient collaboration between these professions could enhance health. The COVID-19 pandemic disclosed further disparities while underscoring concerns that physician supply is inadequate for population needs. Hence, enhancing healthcare provider education to better meet the public's health needs is critical. The proposed titles “Oral Physician” or “Oral Health Primary Care Provider” (OP-PCP) acknowledge dentist's capacity to diagnose and manage diseases of the orofacial complex and provide some basic primary healthcare. The US Surgeon General's National Prevention Council and others recommend such models. Medical and dental education already overlap considerably, thus it is plausible that dental graduates could be trained as OP-PCPs to provide primary healthcare such as basic screening and preventive services within existing dental education standards. In 2018, 23 dental and medical educators participated in an expert-opinion elicitation process to review educational competencies for this model. They demonstrated consensus on educational expansion and agreed that the proposed OP-PCP model could work within existing US Commission on Dental Accreditation (CODA) standards for predoctoral education. However, there were broader opinions on scope of practice details. Existing CODA standards could allow interested dental programs to educate OP-PCPs as a highly-skilled workforce assisting with care of medically-complex patients and to helping to reduce health disparities. Next steps include broader stakeholder discussion of OC-PCP competencies and applied studies including patient outcome assessments.