Consequences of childhood sexual abuse experiences on dental care.
OBJECTIVE
Around 20% of female patients seeking dental care may have experienced childhood sexual abuse (CSA). Several similarities between abuse situations and dental treatment lead to dental fear. Since dental fear hampers oral health, the long-term effects of CSA on dental care and the specific factors that lead to increased stress during dental treatment have been investigated in women exposed to CSA.


METHODS
A self-administered questionnaire, which was developed to investigate the objectives of the study, was distributed to 111 women recruited from support centers for women with CSA experiences. CSA was explored with a modified version of the questionnaire developed by Wyatt. Data from 85 women with CSA experiences were used for comparison to the data of 170 matching control women recruited, who were mothers of children attending kindergarten.


RESULTS
Compared to controls, women exposed to CSA exhibited several long-term effects on dental care in terms of major psychological strain during dental treatment (36.5%/18.8%; P<.005), a lower number of prophylactic controls (72.9%/89.4%; P<.005), and preference for a female dentist to a male dentist (29.4%/8.2%; P<.0001). Women with CSA experiences considered four of five defined stressors associated with dental treatment as more intense. Of these women, 28% suffered from memories of their original abuse situations during dental treatment, and 29.4% believed that the dentist should have known about their history of abuse.


CONCLUSIONS
CSA experiences may increase psychological strain during dental treatment. To improve dental care for women exposed to CSA, dentists should adjust their treatment plans to the specific needs of these patients.
Leeners
Brigitte
B
Department of Gynecology and Obstetrics, University Hospital Zurich, Zurich, Switzerland. Brigitte.Leeners@usz.ch
Stiller
Ruth
R
Block
Emina
E
Görres
Gisela
G
Imthurn
Bruno
B
Rath
Werner
W
D000328:Adult; D016022:Case-Control Studies; D015984:Causality; D002648:Child; D002650:Child Abuse, Sexual / Q000523:psychology* / Q000706:statistics & numerical data; D015897:Comorbidity; D016854:Dental Anxiety / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D003812:Dentist-Patient Relations; D005260:Female; D006801:Humans; D011939:Mental Recall; D008875:Middle Aged; D013223:Statistics as Topic; D013315:Stress, Psychological / Q000150:complications