Understanding Trauma:

Understanding Trauma: What Dental Professionals Should Know

The term "trauma" is often used loosely in everyday conversation, applied to everything from stressful work situations to minor inconveniences. However, true trauma has a profound and lasting impact on those who experience it. As dental professionals, it’s crucial to differentiate between casual references to stress and the real, often debilitating, effects of trauma.

What is Trauma?

According to The Substance Abuse and Mental Health Services Administration (SAMHSA), trauma refers to events or circumstances that are deeply distressing or life-threatening, with lasting consequences on an individual's emotional, mental, and physical well-being. These events can range from abuse and violence to accidents and natural disasters.

Trauma is defined by the “Three Es”:

Events – Exposure to significant distress, whether it’s a one-time event like an accident or ongoing experiences such as abuse.

Experience – Each person processes traumatic events differently, meaning two people can undergo the same event but have vastly different reactions.

Effects – Trauma leaves both immediate and long-term impacts on how a person functions, including triggering behaviours in seemingly unrelated situations.

How Trauma Affects Patients in the Dental Chair

A traumatic event can rewire how a person processes experience. Unlike everyday stress, which is processed by the brain’s logical centres, trauma is stored in emotional parts of the brain, often as vivid images, sounds, or sensations that are easily triggered. This explains why some patients may exhibit strong reactions, such as crying or turning away, during a routine procedure.

These exaggerated responses may be linked to past trauma, triggered by something as simple as the smell of dental materials or the feeling of being reclined in a chair. The patient may not even consciously realize the connection to their traumatic experience.

Re traumatisation in Dental Care

Re traumatisation occurs when a situation mimics the original trauma, causing the patient to relive the event. In a dental setting, this could involve laying a patient back too quickly, placing instruments in their mouth without warning, or using a tone of voice that reminds them of a past negative experience. For some patients, these triggers result in emotional or physical distress, such as anxiety, anger, or withdrawal.

Understanding the signs of re traumatisation, such as avoidance, fear, or heightened emotion, can help clinicians navigate these reactions with empathy. Instead of labelling a patient as difficult or uncooperative, it’s important to approach them with patience and care, fostering trust.

Empathy vs. Toxic Positivity

Empathy means meeting patients where they are, seeing the world through their eyes, and understanding that their reactions are deeply rooted in past experiences. It is essential to avoid toxic positivity—the practice of downplaying emotions by insisting on optimism. Telling a patient to "just relax" or "think positive" can feel dismissive and may further alienate them. Instead, acknowledging their feelings with understanding can pave the way for healing and trust.

Communicating with Traumatized Patients

As dental professionals, we may not always know which of our patients have experienced trauma. However, we can adopt trauma-informed practices to create a safer, more supportive environment for everyone.

•  Be gentle and transparent – Explain each step of the process before performing it, ensuring the patient feels in control.
• Listen actively – Ask open-ended questions, allow the patient time to respond, and never rush them.
• Acknowledge their experience – Reassure the patient that their reactions are valid, and that you are there to help them feel safe and comfortable.

Approaching each appointment with empathy and awareness of potential trauma can make a significant difference in patient care, building trust and reducing the chances of re traumatisation.