‘We are not just a body to fix’: dental care experiences of survivors of modern slavery and human trafficking
This qualitative study involving five survivors of modern slavery and human trafficking reveals that systemic barriers and dehumanizing experiences in dental care can be addressed through trauma-informed practices emphasizing trust, continuity, and the restoration of patient agency without requiring trauma disclosure.
Original paper licensed under CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). This is an AI-generated explanation of the paper below. It is not written or endorsed by the authors. For technical accuracy, refer to the original paper. Read full disclaimer
For many people, a visit to the dentist is a routine matter of hygiene, a brief appointment to fix a cavity or clean teeth. But for a specific group of people—survivors of modern slavery and human trafficking—the dental chair can feel like a place of danger rather than healing. Modern slavery involves the forced control of people through labor or exploitation, often leaving deep physical and psychological scars. When these individuals seek medical help, they carry with them a history of having their bodies treated as property, their voices ignored, and their autonomy stripped away. In this context, the standard medical environment, with its bright lights, invasive tools, and the necessity of lying still while someone else works inside one's mouth, can accidentally mirror the very conditions of abuse they survived. This creates a paradox where the place meant to heal becomes a source of fear, causing survivors to avoid care until pain becomes unbearable.
Researchers at the University of Bristol, working alongside a team of psychologists, dentists, and community advocates, set out to understand this specific experience. They did not ask survivors to recount the details of their trauma. Instead, they gathered five adults who had lived through modern slavery or trafficking to talk about their journeys through the dental system. The goal was simple but profound: to learn how dental care could be delivered in a way that respected their humanity without forcing them to relive their past. The team held a long discussion, recorded it, and carefully analyzed the words shared to find patterns in how these patients felt seen, heard, or ignored.
What emerged from these conversations was a clear picture of how the system often fails these patients, not just because of long waiting lists or confusing costs, but because of how the care itself is delivered. The participants described a feeling of being reduced to a problem to be solved or a body to be fixed, rather than being treated as a whole person with feelings and a history. One participant, who had been in pain for years, described waiting for an appointment scheduled for 2027, noting that the pain might kill her before then. This sense of precariousness was not just about time; it was about the feeling that their needs were secondary to the administrative machinery of the clinic. When they finally arrived, the experience often felt like a continuation of the powerlessness they had suffered elsewhere. They described walking into a room with a heightened state of alert, watching every movement of the staff, trying to gauge if they would be safe.
A central finding of the study was that trust does not begin in the dental office; it travels there from previous encounters with other parts of the healthcare system. If a survivor had been rushed, dismissed, or treated with suspicion by a receptionist or a general doctor, they arrived at the dentist expecting the same treatment. Conversely, when a professional took the time to listen, explain what was happening, and offer a genuine choice, it created a sense of safety. The research highlighted that the physical act of dental treatment—having one's mouth held open, being touched, and being unable to speak—can trigger a panic response similar to the loss of control experienced during exploitation. For some, this fear was so intense that they simply could not speak during the appointment, or they missed follow-up visits entirely because they were too afraid of the unknown.
The study also challenged a common assumption in healthcare: that patients must disclose their trauma to receive special care. The participants held different views on this. Some felt that telling the dentist about their past would help the staff understand their needs, while others felt that their trauma was private and that they should not have to reveal it to be treated with dignity. The researchers concluded that waiting for a patient to volunteer this information is a barrier. Instead, the best approach is to treat every patient with a set of universal practices that build safety for everyone. This means explaining every step before it happens, asking for permission before touching, and offering clear ways for the patient to signal if they need a pause. It means recognizing that a missed appointment might not be a lack of interest, but a reaction to fear.
Ultimately, the paper suggests that making dental care trauma-informed does not require a complex diagnosis or a detailed history of abuse. It requires a shift in how professionals interact with patients, moving from a model of fixing a body to one of respecting a person. By offering clear explanations, meaningful choices, and consistent kindness, dentists can create an environment where survivors feel they have control over their own treatment. This approach allows patients to receive the care they need without having to relive their trauma, ensuring that the dental chair becomes a place of healing rather than a trigger for pain. The study confirms that when survivors are treated as knowledgeable agents rather than passive subjects, the barriers to their health begin to fall away.
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