Reframing Harm: Ethical Gaps in Trauma Informed Dental Care in India

Abstract

Domestic violence (DV) significantly impacts one’s oral and maxillofacial health, with patients experiencing it often presenting to dental settings with unexplained trauma and a confusing history. Most common clinical manifestations of the same may include visible bruises, lacerations, tooth fractures and even temporomandibular joint disorders. Injuries of the oro-facial regions may be the first visible signs and, ironically, the hidden indicators of abuse, thereby putting dental surgeons at the forefront in suspected DV cases. The Dental Council of India emphasises patient confidentiality in the information entrusted by the patient unless the laws of the state require a revelation for medicolegal cases. There is a lack of a specific code of conduct concerning known or suspected DV cases. There are a few law enforcement helplines available for reporting such cases, like the Domestic Violence Helpline (1091) and the National Commission for Women (NCW) Helpline. However, when compared with the mandatory reporting laws in countries like the U.S. and Australia, Indian protocols remain vague and optional. There is a significant knowledge gap among the Indian dental professionals regarding how to properly identify DV while diagnosing a patient, documentation of cases and reporting procedures worsened by insufficient training and the dentist’s agitation concerning legal implications. This article highlights the urgent need for incorporating structured information and awareness programs in dental curricula and continuing dental education. In conclusion, reinforcing dentists with knowledge and clear reporting channels is critical for timely intervention, ensuring that neither ethical compliance nor victim protection is compromised through the process.