Overcoming Trauma: Tips for Navigating Dental Visits After Sexual Violence
Hey Sweet-one.
I’ve got a doozy of a blog for you today, and I get the feeling it's going be one of those that you’re going to want to read and not going to want to read at the same time.
It’s about dentists, explicitly going to the dentist when you are a person who has been subject to sexual violence.
In actual fact, this blog will help you if you have experienced any trauma and, as a result, find going to the dentist really uncomfortable. When I say really uncomfortable, I mean triggering panic-inducing, putting off going, having a sore mouth or sore teeth and thinking maybe if I drink a bottle of vodka, I can forget about it instead of going to the dentist - uncomfortable.
I had to book an emergency appointment at the dentist a while ago. I was in agony. It felt like somebody had a sharp, pointy screwdriver and was jamming into my lower jaw. The pain was immense; I would say a definite number 11 on the pain Richter Scale.
And it all started with a conversation with a receptionist at my dentist’s surgery.
“I am in so much pain; please, please, please, can I see somebody.”
“You can have a pain appointment.”
“Brilliant ok; what happens as part of a pain appointment?”
And this is when my first point comes in. As somebody subjected to trauma, I need a sense of control or understanding to access everyday and ordinary things like the dentist. I know I’m not alone in this, and I also know that considering my past, it’s understandable.
I thought it was an understandable and ok question to ask; wanting to know what a pain appointment covers, how long it takes, what they might do and how much it costs sounds kinda reasonable to me.
“I don't know. I'm not a dentist.”
I wanted to strangle her through the phone, but I tried to reach for the humanity and empathy in her instead.
“I’m trying to find out if this appointment will help me or if all I really need to do is go down to the pharmacy and get some extra strong painkillers; please, could you give me a little bit more information?"
Her response was, “They might give you amoxicillin”.
Now I know what oxacillin is, but I did not have a clue at the level of pain and discomfort I was in. I could barely access what my brain knew about my postcode, let alone antibiotics. The information was not available, so I asked the receptionist.
“Please, could you explain to me what amoxicillin is? I can't remember at the moment”.
Her response was, “I don't know.”
As I sit here recalling this, I remember how much I wanted to punch this stupid b**** in the face. Obviously, I do not condone violence. I would never punch a receptionist who is cross, mean, nasty and unhelpful; all I'm saying is that the rage and anger are palpable. I was at the point of giving up, but I squashed down the huge fear, fight and flight responses I had and said.
“Okay, just give me an appointment.”
It's important to me to share why going to the dentist if you; have been subjected to sexual violence, are scared of dentists, or have been impacted by medical-induced trauma or other types of trauma - can be so scary and triggering.
Feeling out of control or helpless during the procedure
Not feeling informed about what is happening
Triggered by people touching you, being close to you and inserting items into their mouth
Not feeling able to say no, even if it hurts or scares you.
Feeling as though you don’t deserve dental treatment or are “too much” trouble.
Worried about the pain and injury
Triggered by being made to lie down on a bed
Worried about crying or not being able to cope with the appointment
Triggered by the setting, equipment, noises or smells that they cannot control
Unfortunately, the only way I can prepare for this dentist appointment is to shut down because I have no information about what it will look or feel like. Not having a clear understanding of what is happening reminds me of feeling out of control, not having authority, and not understanding. I didn't have any other choice, and not having an option, as you can imagine, for somebody who has been subjected to sexual violence is a pretty f****** big thing. I can't do anything. I can’t speak about it, I can’t try to process it, and I can’t try and ground myself because something unsafe that I have no control over is about to happen to my body. All I could do was numb myself with unhealthy coping strategies.
If you want to read more about coping strategies after trauma, both healthy and unhealthy, please have a look through my other blogs and free resources.
Let's skip to the part where the dentist greets me. Guess what? He's a man. A strange man is about to get physically close to me and put his hands inside my mouth. I am feeling very vulnerable and very triggered. I was subjected to sexual violence at the hands of men; I know you can imagine my utter fear and horror at this moment. It turns out that this particular male dentist was unlike any other dentist I had met before. Before asking me to sit in the dentist's chair or go anywhere near me, he explained everything and how he would do it. Honestly, I must have been looking at him like he was an alien because this has never happened to me before with a dentist; it's usually in and out; hurry up, get it done and remember to brush your teeth. At this point, I think it's important to say that I didn't feel that I wanted to share any information about myself and my background, the reason being that, yes, he was going to put his hands in his mouth my mouth, yes he was going to be close to me. Still, I knew that the appointment would be reasonably quick, and I didn't feel comfortable sharing personal details at this point. Anyway, long story short, the outcome was that I had to come back to get an emergency root canal. The MASSIVE difference between now and my interaction with the receptionist earlier was that the dentist was clear about what the procedure would look like and how long it would take.
Fast forwarding to the emergency root canal, which was planned for later in the day. This time knowing that the procedure would be much more invasive, I decided to share my diagnosis, triggers and the support I needed with the dentist. Here is what that looked like:
An explanation of my triggers that relate to or can be made worse by going to the dentist.
Pain
People being close to me.
Feeling out of control
Not knowing what's going on
Not feeling like I can say stop
Not knowing if I will be listened to if I want to stop
People touching me
Behaviours that I might display
Crying
Panic attacks
Needing to stop
Wanting to escape and get away.
What I need to feel safe
A signal that shows I want to stop
Her reassurance that she will stop every time I ask her to
A brief explanation of when a new part of the procedure, tool, or instrument is about to be used.
Ways that she can help me if I become too overwhelmed.
These are very personal. You may have a whole host of different ones. I aim to encourage you to seek support and the nervous system regulation needed to access the dentist. Your symptoms, triggers, and needs may be different.
On arrival to get the emergency root canal, the dentist (female this time, which I already knew because I had been given all the details at the previous appointment) explained the procedure to me. I told her and her assistant that I had something that I wanted to share with them, something that I wanted them to know about me and how the dentist impacts me.
I went on to briefly tell her that I have a diagnosis of complex PTSD As a result of sexual violence. I told her that because I was unsure of how trauma-informed she was, I wanted to be clear with her about my triggers and needs.
She listened, and she didn't pry. She reassured me that I could take as many breaks as needed, that I could stop whenever I wanted, that I could ask to stop anytime, and that she would stop immediately. She also reassigned the appointment after me to allow us more time.
Now I want to tell you that the appointment went swimmingly, the procedure was over in 20 minutes, and it was easy peasy lemon squeezy, but we both know that’s not how these things go. I had a massive panic attack within the first 3 minutes of lying in the chair. That meant sitting back up and trying not to feel like a dick in front of these two people I had never met before. It's really hard having a panic attack in front of strangers and feeling the weight and pressure of the voices in your head telling you that t you should hurry the f****** up and get on with it.
The appointment, which usually takes around 20 minutes, took over 40 minutes. I signalled for her to stop probably over 30 times, and she stopped every time. Because of the particular work she was doing, she had to start again from scratch every time. Not once did she huff, roll her eyes, or say a single thing about needing to hurry up and pull myself together or that she wouldn't be able to do the procedure. She was unwaveringly kind, gentle, and accommodating and explained every step. (without explaining the ins and outs of a ducks arse) *
This is the part where I blow my own trumpet. Yes, I needed to stop a billion times, but in between the billion times, I was thinking of the wonderful, amazing and supportive women in Healing School and how they would be showing up for me at that moment. To find out more about Healing School, follow this link. I was practising the somatic and grounding exercises taught by the excellent Claire Diane, who you can find right here. So I was trying. Despite my best effort, every single muscle in my body was tighter than the hardest rock in the world - which, by the way, is a diamond. When I think about my muscles being as hard as diamonds, it feels kinda special - like I’m made of diamonds inside. I'd also like to add that there was also a moment of pure wonder and bliss because I wasn't in pain anymore.
At the end of the procedure, the dentist informed me that there were certain parts she couldn’t carry out without making my experience harder. To have the actual root canal treatment, I would have to allow the dentist to work without stopping and use a particular piece of equipment. Without this, it might mean having my tooth removed.
On top of everything, this upset me and stayed with me the most. If I hadn't been subjected to sexual violence, I wouldn't have these triggers and symptoms around going to the dentist. I could have this procedure with ease and keep my tooth. My teeth are important to me. I don't want to lose my teeth because of what those men did.
My closing note to you, darling, is that you are not responsible for getting it right. It should be standard practice that the people providing healthcare to us are trauma-informed. Look at it this way, if reported cases of sexual violence in the UK equate to one in three women, trauma-informed Healthcare should be standard. If you are going to the dentist and you are worried about sending them this information or asking about their trauma awareness, especially through the lens of sexual violence. I and I genuinely mean this from the bottom of my bottom, would be more than happy to contact your dentist surgery for you. I wouldn't even mention your name. I would simply reach out to them and be a pain in their ass until I knew they had read and understood how to support women subjected to sexual violence. I do it because I care, I do it because I give a s***, I do it because I know how hard it is to do it yourself sometimes, and I do it because I think you deserve love, kindness, support, and alllllll the information and knowledge. Sometimes, trauma makes us feel like we're not strong. While you are regaining yours, I am happy to share mine with you, and I mean that.
You can find out more about the dentist practice I used and the dentists I saw here and here.
Dr Jessica Taylor also writes a fantastic document that you can share with your dentist to help them understand how women subjected to sexual violence can be better supported to access dentistry. The link is here.