I have been engaged in developing and training on ACEs for Dentists, and allied dental personnel for the last few years (and related to trauma in general for many years). Our local college has a dental hygienist program and the program director has integrated a 2 hour lecture into student curriculum. I also presented at a state dental conference this summer. I utilize Futures without Violence material, substantial information on dysregulation of the immune system, as well as an array of existing research on specific dental and periodontal conditions association with trauma/stress. For example the following are cited:
1. Endocrine Changes: Alterations in the concentration of adrenal corticoids alter the response of oral tissues to bacterial toxins and other hormones involved in the general adaptation syndrome.
2. Neglect of Oral Hygiene
3. Dietary Intake and Nutrition
4. Gingival Circulation: Autonomic Nervous System increasing vasoconstriction of blood vessels decreasing O2 and nutrient supply to tissues.
5. Alteration in Salivary Flow and Components: Increase and decrease in salivary flow; Altered chemical composition – IgA.
6. Lowered Host Resistance
8. Acute Necrotizing Ulcerative Gingivitis (ANUG)
9. Aggressive Periodontitis
10. Systemic Inflammatory Diseases
11. Poor Wound Healing
12. Traumatic Injury: to Head, Neck or Mouth.
For many years I have believed this is an often over looked area with trauma. We have learned this for the past 50 years with domestic violence/IPV and so too with ACEs. With integration of healthcare (physical, behavioral, dental) the approach to integration of ACEs into dentistry is considered a part of integrated healthcare. However the content,connection as a 'risk indicator and risk factor' for dental health, and thus relevancy for dentists....must be specifically tailored and addressed for their field.
I have my PhD in Public Health and am not a dentist. I have pulled my training together on my own with the help/review of dentists, educators, and research in the field. I hope this helps. Feel free to contact me.