Invading Deeply into Self and Everyday Life: How Oral Health-Related Problems Affect the Lives of Child Sexual Abuse Survivors.

This paper presents the findings of a study on how oral health-related problems affect the lives of Child Sexual Abuse (CSA) survivors seen from the viewpoint of 12 women and 4 men sexually abused as children. Study methods followed the principles of grounded theory approaches. During analysis, the core concept of invading deeply into self and everyday life was constructed on the basis of seven categories: causing serious oral health symptoms, triggering trauma-reactions, increasing emotional distress, shaping the understanding of self, intruding daily life practices, restraining social interactions, and generating financial difficulties. These findings help us to understand how deeply oral health-related problems invade the understanding of self and the everyday lives of CSA survivors, and how these problems interact with their existing considerable problems related to the aftermath of CSA. Attention to these problems may help CSA survivors to understand more about themselves as well as helping professionals, family members and friends to understand the challenges CSA survivors face in everyday life. Increased understanding may also assist professionals to focus on how CSA survivors can be helped in handling challenges associated with dental treatment, daily self-care and other problems related to oral health.

Being considerate every step of the way: a qualitative study analysing trauma-sensitive dental treatment for childhood sexual abuse survivors.

This qualitative study aimed to obtain a deeper understanding of what makes adult dentistry possible for child sexual abuse survivors. Sixteen adult informants were recruited from four Centres against Sexual Abuse and interviewed. Qualitative analysis of the transcribed interviews was conducted consecutively until thematic saturation was reached at 16 informants. A conceptual framework was generated, and informants' experiences of what makes dental treatment achievable were summed as the dentist working in a trauma-sensitive way, captured by the core category: Being considerate every step of the way. The underlying categories are: (i) offering a good start; (ii) being competent; (iii) being aware of the influence of staff behaviour; (iv) building a safe relationship; (v) arranging a secure treatment situation; and (vi) exploring individual triggers. The findings revealed that dental staff should have adequate competence to build secure relationships and explore individual triggers in dental treatment situations when treating child sexual abuse survivors. Dentists should have a trauma-sensitive approach to all patients. When treating child sexual abuse survivors, dentists should demonstrate utmost consideration every step of the way, building long-term solid relationships, and discussing and testing coping strategies individually adapted to the specific needs of the child sexual abuse survivors, in a safe environment.

Preparing for attack and recovering from battle: Understanding child sexual abuse survivors' experiences of dental treatment.

OBJECTIVE: The aim of this paper was to explore child sexually abused survivors' experiences of dental treatment in order to obtain a deeper understanding of them as dental patients. METHODS: Data were drawn from qualitative semi-structured interviews with 16 adult informants recruited from four different Centres against Sexual Abuse in Norway. Data analysis was developed according to the principles of grounded theory suggested by Charmaz. RESULTS: A conceptual framework was generated, and a core concept was constructed from the informants' reports of their experiences of dental treatment: Preparing for attack and recovering from battle based on four main categories: (a) Expecting danger, (b) Battling anxiety, (c) Reliving abuse and (d) Struggling with the aftermath. CONCLUSIONS: The analyses increase the understanding of how child sexual abuse survivors prepare before-battle during-and recover after dental treatment. This study revealed child sexual abuse survivors' experiences of extensive anxiety, triggered by sensory stimuli such as sensations, movement, muscles, touch, sight, sound, smell and taste, associated with dental procedures per se, but also sensory stimuli similar to previous traumatic experiences. The findings suggest that child sexual abuse survivors' dental anxiety is primarily trauma-driven and possibly being one of the long-term effects of child sexual abuse. This may be an important contribution to the understanding of CSA survivors and should affect the approach of clinicians treating dental patients with such a history.