A scheme that delivers free dental care to women who have suffered domestic abuse is helping them get their lives back on track.
Dentist Elizabeth Murphy is clinical lead for the Plymouth-based scheme that helps victims of domestic violence.
The initiative is designed to address cases of dental trauma, injury and poor oral health that can lower self-esteem for the women long after they have escaped the violence.
Visually, broken smiles can serve as a visible reminder.
Peninsula Dental Social Enterprise (PDSE) is a service provider for the University of Plymouth that works with award-winning charity, Trevi, to deliver life-changing dental treatment to women affected by domestic violence.
For Elizabeth, the experience of treating the women has been an eye opener.
‘It is awful to see what some of our patients have been exposed to,’ she says. ‘Quite often, the treatment plan involves having teeth out and dentures fitted, which for young women can be difficult.
‘It is up to us to ensure there is no shame associated with their dental treatment. We are here to help them and provide them with what they need to restore and maintain their oral health. No one is immune to this happening in their lives.’
Real need
Domestic abuse is the most prevalent form of violence against women and girls.
The Crime Survey for England and Wales (CSEW) estimates that 5% of adults (6.9% women and 3% men) aged 16 years and over experienced domestic abuse in the year ending March 2022 with one in five adults aged 16 years and over (10.4 million) experiencing domestic abuse since the age of 16 years [1].
The project initially grew from an oral health education event held for residents at a residential recovery centre for women, Jasmine Mother’s Recovery, a residential rehabilitation unit in Plymouth run Trevi.
Elizabeth says: ‘Karen Burn, lead of the dental outreach team, had been delivering some oral health education to residents. She identified a real need for operative dentistry.’
Sadly, stories such as this from one of the women who have accessed the service is all too familiar. ‘For years, I was in a very violent relationship where my ex-partner literally pulled some of my teeth out with a pair of scissors damaging other teeth,’ she recalls.
‘The controlling nature of the relationship, never being allowed to leave the house alone, and also poor mental health meant I was unable to get treatment for my teeth over the years. Every time I look at myself in a mirror, it’s a constant reminder of the domestic abuse I suffered for so many years.’
‘Talented and dedicated professionals’
As clinical lead for the service, Elizabeth is assisted by two dental nurses – Rebecca Hurle and Hayley Bowden. The operations are overseen by clinical educator and dental nurse, Lisa Griffiths. She is part of the dental outreach team and Rebecca Anderson, clinical governance and operations manager.
‘One of the key successes of this service is the strength of our team,’ Elizabeth says. ‘I am incredibly fortunate to work with talented and dedicated professionals. Within our service, we are also able to refer patients to the oral surgeon at PDSE, Ayisha Davies-House, should they require treatment, such as wisdom teeth extractions.
‘The residents are there for approximately 14 weeks. So if they needed any oral surgery that was to be referred to secondary care, we would miss the opportunity for the treatment. We are very fortunate to have Ayisha supporting us with this as it is an invaluable service to offer patients.
‘Residents are referred to us for an assessment. We aim to get them as dentally fit as possible prior to leaving the centre and returning home to elsewhere in the country. We have successfully completed the lengthier types of dental treatment, such as dentures, despite the time constraints, because we have dedicated time to this service.’
The service is self-funded by PDSE and the Chief Executive, Rob Witton, is very supportive of the work. It is due to this support that the service is kept on track.
‘The challenges are ensuring treatments and appointments required can be completed. Support worker Hannah Cann brings the residents to the appointments so the system works efficiently – she is a key part of our success.’
Extending the services
Elizabeth is now planning to extend the dental services to women who work on the streets. She is working alongside Lisa Griffiths and Abigail Nelder, both part of the Dental Outreach Team, to ascertain what treatment is needed.
‘We were given the contact from Martha Paisi, research lead at PDSE, who is very active in supporting vulnerable groups in Plymouth. The aim is to establish how much need and the type need that is out there. For some of these women, their teeth are a barrier to their confidence to access the support they need to get away from working on the streets.’
So, just how key is it to establish a foundation of trust with patients such as the women at Jasmine and those working on the streets?
For Elizabeth, it is the foundation on which effective relationships are built.
‘We want to break down the barriers to accessing dental care. Going out and meeting vulnerable women prior to their appointments helps them feel more comfortable. We have a minimal DNA rate. We appreciate these women have been through many challenges. So we aim to deliver the service in a trauma informed way,’ she says.
Elizabeth has always been enthusiastic about dental provision for those who have difficulty accessing it via the usual channels. She says she feels ‘really fortunate to find an organisation that supports this type of work’.
‘It can be really tough at times. But it is incredibly rewarding. In a lot of cases, patients’ teeth can be a barrier to their recovery or also a trigger to their trauma.’
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