DOMESTIC VIOLENCE SUMMARY

WHAT IS INTIMATE PARTNER VIOLENCE?

Also known as domestic violence or abuse, battering, intimate partner abuse,
dating violence
IPV is a pattern of coercive control involving physical, sexual, psychological,
cultural and/or economic abuse.
IPV is perpetrated in the context of a current or former intimate relationship.
Power/Control + Fear = Abuse

LEGAL DEFINITION OF ABUSE
Attempting to cause physical harm
Causing physical harm
Placing another in fear of imminent physical harm (threats, verbal abuse
etc.)
Sexual assault
Economic and emotional abuse
SOCIOLOGICAL DEFINITION
One person systematically abusing another to gain power and control in a
relationship.
PREVALENCE OF IPV
Anyone can be a victim and anyone can be a perpetrator, regardless of
age, race, sex, income, education level, gender, ability, and sexual
orientation
Around the world AND in the United States, at least 1 in 3 adult women
has been physically or sexually abused by a husband or boyfriend at
some point in her life.
One in four gay men and lesbian women have experienced domestic
violence.
While men can be the victims of abuse, women are more likely to be
assaulted and killed by an intimate partner, and they sustain far more
frequent and far more serious injuries than men who have been
assaulted by a woman.
MEDICAL ISSUES
Among women who are physically assaulted or raped by an intimate partner, one in
three is injured. Each year, more than 500,000 women injured as a result of IPV
require medical treatment.
Nearly two-thirds of women who reported being raped, physically assaulted, or
stalked since age 18 were victimized by a current or former husband, cohabiting
partner, boyfriend, or date.
And about half of all injuries are in the head and neck areawhich obviously means
that in your practice, you will be one of the most likely people to see the physical
signs of violence.

IPV IS NOT
A loss of control or uncontrolled anger
The victims fault or responsibility
An isolated incident or accident
Caused by substance use or mental illness
Limited to certain cultural, races, or classes
Pre-destined or unavoidable

WHY IS IPV A PUBLIC HEALTH ISSUE?
Prevalence
Leading cause of injury and death, associated with numerous negative health
conditions
Incurs significant cost to society, affecting individuals, families and the
community
Some groups are at higher risk and have less access to help due to language,
cultural, economic, physical, and other barriers
It is Preventable

WHY IS IPV A DENTAL HEALTH ISSUE?
65-75% of injuries from family violence are visible in the head, face and neck
region.
Abuse impacts oral health in many ways.
Oral health and overall health and well-being are inseparable.
Dental professionals are legally and ethically required to respond to and/or
report abuse of vulnerable patients.

HEALTH EFFECTS OF IPV
FATAL
Homicide
Suicide
Maternal and Infant Mortality
Any death resulting from issues at right

NON-FATAL
Physical injury, disability
Chronic conditions
Mental Illness
Reproductive health problems
Negative/Harmful Health Behaviors

ORAL HEALTH EFFECTS OF IPA
Injuries to the teeth, soft tissue, jaw, face, head, neck
Difficulty eating
Dependency on pain medication
Non-compliance, neglect of oral hygiene
Dental fear resulting from trauma

TYPES OF ABUSE/VIOLENCE
Physical
Overt or threatened: against victim or others
Cultural
Racial slurs, prohibiting someone from practicing
their cultural traditions, immigration status
Emotional/Verbal
Isolation, humiliation, intimidation, deprivation
Sexual
Coerced sex, rape, forced prostitution
Financial
Interference with work/school; ruined credit

CYCLE THEORY OF VIOLENCE
Tension-Building
criticism, yelling, swearing, using angry gestures, coercion, threats
Violence
physical and sexual attacks and threats
Seduction
apologies, blaming, promises to change, gifts
MAKE CLEAR that this is just one way of thinking about an abusive
relationship, not all relationships or individual experiences are the same,
cycle changes over time (i.e., seduction phase gets shorter or disappears
altogether) Relationships usually start in the Seduction phase, making it
confusing to victim when first violence occurs.
Tension Building
Victim
Walking on eggshells, tries to compensate, appeases to prove trust/love,
hypervigilant
Abuser
Has dramatic mood swings, accuses jealous, paranoid, monitors victims behavior,
intimidates
Violence
Victim
Feels trapped, at most vulnerable, self-medicates/punishes, shame, self-defense
Abuser
Direct verbal/emotional/ physical abuse, violence is more intense than the last time,
rape, may be drunk/high
Seduction/Honeymoon/Hearts and Flowers
Victim
Tries to understand, to reconcile the 2 personalities, forgives, focuses on good
traits, feels paranoid (maybe it didnt happen the way s/he remembers), minimizes
Abuser
Apologizes, shows remorse, Ill never do it again, it was the drugs/alcohol/job,
tells partner how to handle him/her the next time s/he loses control, minimizes
(you really thought I was going to hurt/kill you?)


SIGNS OF ABUSE
Depression
Suicidal thoughts
Eating disorders
Bruises/cuts
Choke marks
Unseasonable clothing
Drug & alcohol abuse
Medical/dental problems
Absences/tardiness (appointments, work, school)
Low self-esteem
Isolation
Obsessive compulsive behavior
Fear of partner
Personality change

WARNING SIGNS OF ABUSIVE BEHAVIOR
Entitled
Self-centered
Controlling
Extreme jealousy
Possessiveness
Blaming others
Unrealistic expectations
Isolation
Blaming others for feelings
Cruelty to animals/children
Using sex as a way of power and control
Mood swings
Past relationship violence
Breaking or striking objects
Using force in arguments

WHY MIGHT VICTIMS STAY?
Financial or physical dependence on abuser
Loss of benefits or immigration status for self or children
Love, hope, confusion, shame, believe abuse is their fault
Unaware of legal rights, fear that protection will be inadequate
Fear of retaliation by abuser (separation violence)
Cultural pressure to keep marriage and family together, language
Fears and barriers related to racism, homophobia, etc
Co-occurring addictions or mental illness, trapped in cycle

DENTAL PROVIDERS ROLE
Educate yourself about IPV and local resources
Inquire about abuse as part of the dental exam
Respond in a sensitive way when violence is disclosed
Learn techniques to lessen the negative impact of the dental visit on patients
with a history of trauma
Refrain from judgment or telling clients what to do
Advocate for laws and policies that empower victims and hold batterers
accountable
Collaborate with trauma and IPV experts