< A providers guide to working with survivors of childhood sexual abuse

Oral care and exams

  • Activities or statements that may trigger memories of past abuse include when patients are assured that although "the procedure may be painful or unpleasant, in the end it will be good for them." 38
  • Other aspects of treatment or exams that can trigger CSA memories is the fact that part of the body is touched or intruded on and the patient is expected to lie passively while the clinician works above him or her.
  • Reclining in a chair can also feel threatening to the survivor.
  • "[Getting oral care done], for me is, even on a good day, a total, absolute nightmare," said one participant. "I'll tell you why: number one, the gloves smell like condoms." 38

  • As one man describes the experience, "You are supine...with your head lowered...so you are really vulnerable physically, and many of us have been violated orally..." 38
  • Experiences that can trigger memories of past abuse include: Having to lie down for treatment
  • Having objects put into your mouth
  • Clinician’s hand(s) over your mouth or nose
  • Fear of not being able to breathe
  • Fear of not being able to swallow
  • Fear of severe gagging or being sick 39
  • One study found that having to remain still through a dental exam was as
    equally intensely stressful as a pelvic exam for survivors in the study. 33 40