ROSEMONT, Illinois – Oral and maxillofacial surgeon Deborah L. Zeitler, DDS, MS, recently treated a 16-year-old girl for facial pain. Dr. Zeitler asked the young patient a straightforward question and received a straightforward, albeit disconcerting, answer. Yes, someone had hurt her. Her father had punched her in the face with a closed fist two weeks ago.

If Dr. Zeitler hadn't asked, she may never have known that this youngster needed much more than treatment for temporomandibular pain. She provided standard facial pain treatment. But she also informed the child's pediatrician of the incident and connected her with social workers specializing in domestic violence. The family eventually went into counseling as a result of the intervention.

If Dr. Zeitler has her way, interventions such as these will soon become standard practice in the oral and maxillofacial surgery office. In a presentation at the American Association of Oral and Maxillofacial Surgeons (AAOMS) 87th annual meeting in Boston, Dr. Zeitler will urge OMSs to routinely screen facial injury patients for domestic violence and link victims with social service professionals who can help.

As specialists with advanced training in the diagnosis and treatment of head and neck trauma, oral and maxillofacial surgeons are often the first healthcare professionals to see domestic violence victims in trauma centers as well as private offices, says Dr. Zeitler, a former professor of oral and maxillofacial surgery at the University of Iowa in Iowa City and a former member of the American Medical Association's advisory council on family violence.

That proximity creates an excellent opportunity for oral and maxillofacial surgeons to link victims with resources and to play a role that goes beyond direct treatment of the injury itself.That means having the necessary steps in place in the office. Those steps can be as simple as asking patients with traumatic injuries if an intimate partner has hurt them, knowing the location and phone numbers of the appropriate social service agencies, and offering to call those agencies on the patient's behalf. OMSs should also train their assistants to screen patients and provide information as well, because some patients may feel more comfortable discussing the problem with a staff member than a doctor.

To illustrate the scope of domestic violence in this country, Dr. Zeitler's presents some eye-opening facts and statistics:

• One in three women will be assaulted by an intimate partner at some point in her life.
• Ninety-five percent of women who are the victims of domestic violence will sustain a head or neck injury.
• Domestic violence cuts across all socioeconomic and racial lines. The most common victims are 17-28 years of age, pregnant women, and women who abuse alcohol or drugs, or whose partners do.
• Child abuse is 15 times more common in families where domestic violence is occurring.
• Only 3 percent of domestic violence injuries occur in men, but they do occur.
• The period at which a woman is at highest risk of injury or death due to domestic violence is when she is leaving or after she has just left an abusive partner.p>

  According to statistics, a high proportion of women who come to emergency rooms are victims of domestic violence, but many are not immediately forthcoming about it. "They may complain of a urinary tract infection, headache or abdominal pain. In coming in, they are hoping, consciously or unconsciously, that someone will say 'Are you safe at home? Can we help you?'" she says. For that reason, most emergency rooms now routinely screen for domestic violence.

  The American Association of Oral and Maxillofacial Surgeons (AAOMS), the professional organization representing more than 7,000 oral and maxillofacial surgeons in the United States, supports its members' ability to practice their specialty through education, research, and advocacy. AAOMS members comply with rigorous continuing education requirements and submit to periodic office examinations, ensuring the public that all office procedures and personnel meet stringent national standards

  SOURCE: American Association of Oral and Maxillofacial Surgeons

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