Domestic Violence Toolkit and Continuing Education for Kentucky Dentists

The magnitude of the domestic violence crisis is recognized by local, state, national and international health organizations. (I) As early as 1985, the U.S. Surgeon General declared domestic violence as a leading public health issue. (I) Additionally, domestic violence is associated with 8 out of 10 leading health indicator for Healthy People 2010. (l) U.S. domestic violence data revealed the lifetime prevalence of physical and/or sexual abuse by an intimate partner is 25% for women. (2) Unfortunately, dental professionals are often overlooked as a means to identify these women. Currently, only one state in the U.S. requires mandatory domestic violence continuing education courses (CEU) for dental professionals; although, mandatory CEU are required for other health professionals. (3) Kentucky Revised Statute 209.030 requires physician, nurses, social workers and others having reasonable cause to suspect that an adult has suffered abuse, neglect, or exploitation to make a report to the Department of Community Based Services in the Cabinet for Health and Family Services. (4) CEU are mandatory for Kentucky physicians, nurses and social workers; however, the Kentucky Board of Dentistry has not established a mandatory CEU requirement for Kentucky dental professionals. (3, 5) With funding received from the Centers for Research on Violence Against Women, a University of Kentucky Domestic Violence Task Force surveyed Kentucky dentists regarding violence against women. (6) Data from the survey reflect results similar to previous surveys of D. S. medical and dental professionals. (6,7) A significant number of health professionals have identified the following barriers to screening, documentation and referral of victims of domestic violence (vdv): lack of knowledge and training to identify vdv: the lack of established protocols for referring these patients; concern of offending or embarrassing the patient; concern of patients' cultural norms; lack of privacy, anxiety about potential mistakes related to the identification of patients as vdv. (6,7,8,9) Seventy-one percent of Kentucky female dentist and 57% of Kentucky male dentists completing the survey indicated they would like more information and training regarding domestic violence. (7) The National Violence Against Women Survey (NVAWS) reported, of the adult female victims of intimate partner violence who received medical care, 18.4% of rape victims and 9.5% of assault victims received dental care. (II) In addition to the human cost of the 5.3 million intimate partner violence victimizations (IVP) occurring annually in the U.S., the estimated dental service cost for U.S. adult women was $309.90/unit for nonfatal physical injury; $71 0.46/unit cost per rape; dental costs were $308.90/nonfatal assault unit; and $1,359.16/assault, based on dental costs for 1995. (II) Dental professionals must join the efforts to reduce the burden of domestic violence in Kentucky. Le, et. aI., reported that 81% of vdv presented in the emergency room with maxillofacial injuries. The study's conclusions support the importance of the dental professionals' role in the domestic violence efforts. (10) We must enlist the help of the 2,233 dentists and 1,668 dental hygienists practicing in Kentucky to join in the fight against domestic violence in the Commonwealth.