AI, Domestic Violence, and the Dental Chair

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Categories: Practice Management, HR and Accounting;
Posted: July 7, 2026
By Howard Farran, DDS, MBA

AI, Domestic Violence, and the Dental Chair

A patient sits in your operatory with a fractured incisor, a bruised lip, and a story that does not quite fit the injury. Maybe it was a fall. Maybe it was a door. Maybe the explanation changes between the assistant, the hygienist, and the dentist. A partner waits in the reception area, asks questions for the patient, controls the schedule, and seems a little too interested in what will be written down.

This is where dentistry lives, not in abstract policy debates, but in small clinical moments where the mouth tells part of a story the patient may not be ready or safe to tell.

A recent NIH Research Matters report described work from Mass General Brigham, led by Dr. Bharti Khurana, using artificial intelligence to identify patients at risk for intimate partner violence years before they seek help. The model reviewed electronic medical records, including diagnoses, medications, imaging, utilization patterns, clinical notes, emergency department documentation, and social factors. The combined model reportedly reached 88 percent accuracy and identified elevated risk an average of more than three years before patients sought help from a domestic abuse program.

That sounds powerful. It also sounds dangerous if used carelessly.

The promise is obvious. Intimate partner violence is common, underreported, and often missed. Many victims do not disclose abuse because of fear, shame, financial dependence, children, immigration concerns, lack of transportation, or surveillance by the abuser. Health care often sees the consequences before anyone hears the truth.

Dentistry is part of that front line. The U.S. Department of Justice Office for Victims of Crime, in Family Violence: An Intervention Model for Dental Professionals, notes that family violence frequently produces injuries to the head, face, mouth, and neck. Dentists may see chipped or fractured teeth, jaw fractures, black eyes, nasal injuries, bruising around the chin or ears, lip lacerations, bite marks, burns, or finger marks on the neck, wrists, and arms. The 2018 study Intimate Partner Violence Screening in the Dental Setting found that only 13 percent of surveyed U.S. dentists had screened for intimate partner violence in the prior year, and only 18 percent had received training.

That is the uncomfortable truth. Dentistry is well positioned to notice signs of violence, but often poorly prepared to respond.

The mistake would be thinking AI solves that gap. An algorithm can recognize patterns. It cannot know whether a patient is being abused. Chronic pain, anxiety, missed visits, frequent emergency care, opioid prescriptions, fractured teeth, and delayed treatment can be associated with abuse, but they can also occur for many other reasons. A risk score is not a diagnosis. It is not a disclosure. It is not consent.

The deeper issue is safety. In domestic violence, information itself can become dangerous. A chart note, portal message, printed after visit summary, referral, voicemail, text, or insurance explanation can be seen by the very person the patient fears. A well meaning system that automatically sends resources may feel harmless to a hospital committee. To a patient whose phone is monitored, it may be a threat.

That is why the MedPage Today commentary, Hospitals Are Using AI to Detect Intimate Partner Violence. That’s a Problem, is worth taking seriously. The objection is not that intimate partner violence should be ignored. The objection is that hidden detection can take control away from the survivor. Abuse is already about power and control. A health system should not quietly remove the patient’s control over when, how, and to whom they disclose.

For dentists, the practical answer is not AI first. It is protocol first.

Every dental office should know how to create privacy. A partner, family member, child, or friend should not remain in the room for a safety question. A companion should not serve as interpreter. The question should be calm, normalized, and nonjudgmental. “Because injuries like this can sometimes happen when someone is being hurt, I ask all my patients privately. Do you feel safe at home?”

If the patient says no, the dentist’s role is not to rescue, investigate, confront, or tell the patient to leave. The role is to listen, believe, assess immediate danger, treat urgent dental and medical needs, and offer resources. If there are signs of strangulation, such as neck bruising, petechiae, voice change, difficulty swallowing, or breathing trouble, the patient needs immediate medical evaluation.

Documentation matters. Record what you see, not what you assume. Describe injuries by location, size, shape, color, and stage of healing. Chart dental and radiographic findings. Quote the patient’s words when relevant. Take photographs only when appropriate, consented to, and consistent with office policy and law. Avoid speculative labels such as “abuse victim” unless the patient has disclosed abuse and the wording is clinically necessary.

Reporting rules must be understood before the crisis arrives. Suspected child abuse and abuse of vulnerable adults generally carry mandatory reporting duties. Competent adult intimate partner violence is different, and reporting requirements vary by state and may depend on the injury, weapon involvement, immediate danger, or local law. Every office should confirm its obligations with the state dental board, dental association, malpractice carrier, or health care attorney.

AI may eventually have a role as quiet clinical decision support. If it is used, it should never be an automatic diagnosis, portal alert, patient message, law enforcement trigger, or permanent scarlet letter in the chart. It should be human reviewed, trauma informed, prospectively validated, designed with survivor input, and used only to help a trained clinician ask safely and privately.

Dentists do not need to become social workers. They do need to recognize that a broken tooth can sometimes be more than a broken tooth. The win is not catching every case. The win is building an office where a patient can be seen, treated, protected, and offered help without being placed in more danger.

If AI can predict risk before a patient speaks, who should control what happens next?

Join the Conversation!



AI, Domestic Violence, and the Dental Chair


Artificial intelligence and intimate partner violence

AI Tool Predicts Patients at Risk of Intimate Partner Violence. National Institutes of Health.
https://www.nih.gov/news-events/nih-research-matters/ai-tool-predicts-patients-risk-intimate-partner-violence

Researchers Develop AI Tools for Early Detection of Intimate Partner Violence. Mass General Brigham.
https://www.massgeneralbrigham.org/en/about/newsroom/press-releases/ai-tools-for-early-detection-of-intimate-partner-violence

Hospitals Are Using AI to Detect Intimate Partner Violence. That’s a Problem. MedPage Today.
https://www.medpagetoday.com/opinion/second-opinions/121949

Dentistry, domestic violence, and clinical response

Roles of Dentistry in Identifying and Supporting Individuals Who Have Experienced Gender-Based Violence. BMJ Public Health.
https://bmjpublichealth.bmj.com/content/3/1/e001770

The Role of Dental Professionals in Identifying, Reporting, and Supporting Domestic Violence Victims. Dental Traumatology.
https://onlinelibrary.wiley.com/doi/10.1111/edt.12897

Enhancing Dental Professionals’ Response to Domestic Violence. Indian Health Service.
https://www.ihs.gov/doh/portal/feature/DomesticViolenceFeature_files/EnhancingDentalProfessionalsResponsetoDV.pdf

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