Dentists’ Competence and Knowledge on Domestic Violence and How to Improve It—A Review

Round 1

Reviewer 1 Report

The systemic review focuses on dentists’ knowledge on and attitude towards domestic violence and argued necessity of education on DV for the registered dentists and dental students. The manuscript is well written, and the proposition of recommendation will be useful for dentists who involve the patients suffered from DV.

 

Minor revision

The word “DV” and “domestic violence” are mixed.

Table 2. The statements “see table 2” in parentheses look like strange, because the statements are in table 2.

Please discuss about difference between medical doctor and dentist regarding knowledge on ,  attitude towards, and education on DV.

Author Response

The systemic review focuses on dentists’ knowledge on and attitude towards domestic violence and argued necessity of education on DV for the registered dentists and dental students. The manuscript is well written, and the proposition of recommendation will be useful for dentists who involve the patients suffered from DV.

Thank you very much for your positive feedback and your valuable remarks.

Minor revision

The word “DV” and “domestic violence” are mixed.

We rechecked the manuscript and changed the mix of DV and domestic violence by constantly replacing it with DV.

Table 2. The statements “see table 2” in parentheses look like strange, because the statements are in table 2.

We corrected the statements in table 2 as they were referred to table 8. Thank you for pointing this out.

Please discuss about difference between medical doctor and dentist regarding knowledge on, attitude towards, and education on DV.

We amended the discussion about the difference between medical doctors and dentists regarding DV.

Regarding the gap in knowledge and lack of mandatory DV training, there isn´t any major difference between dentists and medical doctors. Studies revealed that for medical doctors there is also a lack of training and knowledge how to deal with victims [1]. Also, many physicians did not know how to interact with special victim groups or have often overlooked males [2] and children [3] as victims don´t know how to support them well. It has been shown that medical doctors alike dentists are often too afraid to ask patients about DV [4]. Lack of time and not feeling competent to identify and support seems to be a major hurdle for medical doctors to taking further steps after DV has been disclosed [4]. DV as a topic is not a mandatory topic among Europe`s medical profession groups [4], which needs to be changed.

References: 1. Szilassy, E.; Roy, J.; Williamson, E.; Pitt, K.; Man, M.-S. and Feder, G. Reaching everyone in general practice? Feasibility of an integrated domestic violence training and support intervention in primary care. BMC Family Practice 2021, 22:19, https://doi.org/10.1186/s12875-020-01297-5

2. 2. Huntley AL, Potter L, Williamson E, Malpass A, Szilassy E, Feder G. Helpseeking by male victims of domestic violence and abuse (DVA): a systematic review and qualitative evidence synthesis. BMJ Open. 2019; 9(6):e021960.
3. Larkins C, Drinkwater J, Hester M, Stanley N, Szilassy E, Feder G. General practice clinicians’ perspectives on involving and supporting children and adult perpetrators in families experiencing domestic violence and abuse. Fam Pract. 2015;32(6):701–5
4. Sondern, L., & Pfleiderer, B. (2021). The Challenge of Involving Medical Doctors as Important Frontline Responders in Fighting Domestic Violence. European Law Enforcement Research Bulletin, (21), 141 - 150. Retrieved from https://bulletin.cepol.europa.eu/index.php/bulletin/article/view/414

Reviewer 2 Report

The title is too wide and does not reflect the content of the report.

The issue dealt with in the paper is very important, however the connection between the 3 aims is far from clear: first is the knowledge of dentists in the field, the second is the issue taught in dental schools (where? In the same place where the dentists knowledge is partial or elsewhere?) and the third is recomendations to whom? dentists? dental students? 

The article is too long, not easy to read. Consider dividing in 2 separate articles which will deal separately with dental education and continuous education. 

Author Response

The title is too wide and does not reflect the content of the report.

First of all, we would like to thank you for your helpful review.

Since the manuscript deals with the topic of DV in the dental field the title needed reflect this. Regarding the importance of this topic and the little that had been done so far, we wanted to include as much information as possible on the topic to give an overview on which further research can be based. We have therefore, after in-depth discussion- decided to not change the title.

The issue dealt with in the paper is very important, however the connection between the 3 aims is far from clear: first is the knowledge of dentists in the field, the second is the issue taught in dental schools (where? In the same place where the dentists knowledge is partial or elsewhere?) and the third is recommendations to whom? dentists? dental students? 

We are sorry that the connections of our 3 aims were not clear. Based on your remarks we have done our best to make it clearer.

The recommendations are for dentists, teachers at medical schools, researchers, everyone being involved with DV either directly or indirectly and its teaching. We have specified this in the text.

The article is too long, not easy to read. Consider dividing in 2 separate articles which will deal separately with dental education and continuous education. 

Thank you for this suggestion. We discussed your suggestion and decided not to split the manuscript into two. The manuscript should provide an overview of all themes that needs to be researched in further projects. We find that it is important to show the gaps in medical education in dental schools to get a better understanding what needs to be done to close this gap. Only with proper medical education dentist are sufficiently trained to identify and support victims.

Reviewer 3 Report

Thank you for submitting this manuscript for review. This is a very important topic and dentists can be the “front line” to identify DV and it is vital that we document what we find in detail. You have clearly stated your aims in the introduction.

Overall, please review grammar and sentence structure.

Line 352: “The University of Illinois in Colorado”, do you mean Chicago or the University of Colorado?

The review was very well done and the conclusions supported by the literature. DV is an important topic and should be taught in dental schools, progressing from the 1^st year to the last year. I hope this group will venture into conducting their own DV study of dental schools.

Author Response

Thank you for submitting this manuscript for review. This is a very important topic and dentists can be the “front line” to identify DV and it is vital that we document what we find in detail. You have clearly stated your aims in the introduction.

Thank you very much for your positive feedback and your helpful suggestions.

Overall, please review grammar and sentence structure.

Thank you for the remark, we checked the language to improve grammar and sentence structure.

Line 352: “The University of Illinois in Colorado”, do you mean Chicago or the University of Colorado?

Yes, it was the University of Illinois in Colorado in Chicago. This was amended accordingly.

The review was very well done and the conclusions supported by the literature. DV is an important topic and should be taught in dental schools, progressing from the 1^st year to the last year. I hope this group will venture into conducting their own DV study of dental schools.

Thank you!

 

 

Reviewer 4 Report

Dear authors,

I think it is a very interesting topic and one that should be researched further. But, there are some comments about your paper.

General aspects:

1. Check the reference list that follows the template of the journal.

Introduction section:

1. In line 46 revise the sentence: '...all reported DV incidents of DV are on women'. Can the 2nd DV be deleted?
2. Usually when you put an author's name, the reference number is put right after it. Furthermore, it is usually written et al and not and al. That is why I suggest that you change both and write Ochs et al. [7] in lines 53-54 and, just in case, check the text to make sure that in the rest of the document this error does not appear again.

Results section:

1. On line 124 you refer to table 7, when I think you mean table 2. Please check it and if so, make the change.
2. In table 2 in some authors there is a comment (see also table 2). Check it, because maybe it should be deleted as it is already table 2 or if you refer to another type of table, change the number.
3. Tables 3-7. To make the text and tables easier to read, I would put each table next to the text that explains it, as it is much easier to review and read.

Author Response

I think it is a very interesting topic and one that should be researched further. But, there are some comments about your paper.

Thank you for your very valuable feedback. Please find our responses to your suggestions below.

General aspects:

1. Check the reference list that follows the template of the journal.

Thank you for pointing this out. We rechecked the reference list and altered it to follow the template of the journal.

Introduction section:

1. In line 46 revise the sentence: '...all reported DV incidents of DV are on women'. Can the 2nd DV be deleted?

As suggested by you, the 2^nd DV needs to be deleted and it is altered in the text.

1. Usually when you put an author's name, the reference number is put right after it. Furthermore, it is usually written et al and not and al. That is why I suggest that you change both and write Ochs et al. [7] in lines 53-54 and, just in case, check the text to make sure that in the rest of the document this error does not appear again.

Thank you for this feedback. We corrected this as suggested in the entire text accordingly.

Results section:

1. On line 124 you refer to table 7, when I think you mean table 2. Please check it and if so, make the change.

We checked and changed to number of the referred table. Thank you for the remark.

1. In table 2 in some authors there is a comment (see also table 2). Check it, because maybe it should be deleted as it is already table 2 or if you refer to another type of table, change the number.

It was checked as suggested and we changed the numbers of the referred tables. Thank you for pointing this out.

1. Tables 3-7. To make the text and tables easier to read, I would put each table next to the text that explains it, as it is much easier to review and read.

Thank you for the most helpful suggestion. We placed the tables next to the text according to the template formats of the journal.

Reviewer 5 Report

The Authors must see my remarks

Comments for author File: Comments.pdf

Author Response

Thank you very much for your kind review and your suggestions marked in the text. This facilitated improving this review further! (We have included the line numbers in the PDF file in our response to make it easier to see which part the reviewer's suggestion referred to).

• Please replaced by “contribution”: (line 4 following)

We replaced the authors listing by contribution and sorted the order according to your suggestion.

• Please remove to the end of this section (line 21 following)

The marked passages in the abstract was put to the end of the section.

• Do not state questions in scientific articles (line 69 following)

The marked questions were replaced by sentences as you suggested.                         

• Remove this collum (table 2)

We removed the column regarding journal names in table 2.

• How do we know that? (line 176 following)

According to the JBI tool for cohort studies, the risk of bias was rated moderate as table 3 shows. In the studies reviewed with this tool the participants were described as independent of the outcome of interest. As it was not reported why and partly how many participants dropped out, which was then marked with “not applicable” or “no” according to the used tool.

• References (lines 96, 97-100, 327, 346, 382, 389, 394)

Missing references were added to text.

• Please do not state personal opinions or conclusions (lines 394 following)

These are not our personal opinion or conclusions; this is a short summary of the results of the paper by Raja et al. and presented as such.

• Replace by a comma (line 236)

In line 236 the point was replaced by a comma.

• Do not state subtitles in this section (lines 413-497)

The subtitles in the discussion were removed as suggested.

• Remove this section (lines 498-530)

We discussed your suggestion to delete the recommendations from this review, however we decided to keep the recommendations in the text as they are important to help dentists and dental students identifying victims of DV and to find appropriate sources. One reviewer of this review explicitly stated that the recommendations are very helpful. Many dental practitioners never had any education on domestic violence. We also believe that our recommendations will facilitate and motivate others to embark on related research or include domestic violence as topic in trainings.

Reviewer 6 Report

This review study is well-organized and well-written. The authors used standard criteria and procedures to collect, screening and select the published studies and made a wonderful review. This study added knowledge to the filed of interventions for domestic violence.

 

I have some suggestions for the authors to improve their manuscript.

 

1. In Introduction, the authors emphasized the sex difference in the victims of domestic violence. I would like to suggest to add some introduction regarding the age. Children and elders who are victims of domestic violence are also have teeth injury easily.
2. Error: “Ochs and al.” please also recheck the manuscript thorough.
3. Please adjust the contents of tables to make the words appearing on the same lines.

Author Response

This review study is well-organized and well-written. The authors used standard criteria and procedures to collect, screening and select the published studies and made a wonderful review. This study added knowledge to the filed of interventions for domestic violence.

Thank you very much for your positive feedback and helpful suggestions to improve our manuscript further.

I have some suggestions for the authors to improve their manuscript.

1. In Introduction, the authors emphasized the sex difference in the victims of domestic violence. I would like to suggest to add some introduction regarding the age. Children and elders who are victims of domestic violence are also have teeth injury easily.

Thank you for the remark. We have tried to take your suggestions into account and have included some information about children. However, we have refrained from adding anything about older people as this would have been pure speculation; dental trauma in older people seems to be quite rare, most have already lost their teeth (3).

We amended it in the introduction as follows:

There are studies showing that young age (childhood till the age of 19) is a risk factor for dental trauma [1,2] due to e.g. accidents, Still, dentists should also consider the presence DV as one possible cause for this kind of trauma.

References:

1. Lam, R. Epidemiology and outcomes of traumatic dental injuries:a review of the literature. Australian Dental Journal 2016; 61: 4-20. Doi: 10.1111/adj.12395
2. Levin L, Day PF, Hicks L, et al. International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: General introduction. Dent Traumatol. 2020;36:309–313. https://doi. org/10.1111/edt.12574
3. Zhou HH, Ongodia D, Liu Q, Yang RT, Li ZB. Dental trauma in patients with maxillofacial fractures. Dent Traumatol. 2013 Aug;29(4):285-90. doi: 10.1111/j.1600-9657.2012.01169.x. Epub 2012 Jul 12. PMID: 22783913.
4. Error: “Ochs and al.” please also recheck the manuscript thorough.

Thank you. The manuscript was rechecked and if needed corrected accordingly.

1. Please adjust the contents of tables to make the words appearing on the same lines.

The adjustments of the tables will be made according to the journal guidelines after the final changes to its content.

Round 2

Reviewer 2 Report

Dentists receive dental education in dental schools (lines 85,89).

The title is too wide and misleading. The research is not dealing with the role of the dental sector in detecting DV. The role or rather the opportunity for the role is described in the introduction. The research is inquiring dentists' competence and knowledge to fulfil this role and includes recommendations how to improve this knowledge and competence.

Author Response

Dentists receive dental education in dental schools (lines 85,89)

Thank you for the picking this up, this is important to correct. We changed ‘medical education’ by replacing it with ‘dental education’.

The title is too wide and misleading. The research is not dealing with the role of the dental sector in detecting DV. The role or rather the opportunity for the role is described in the introduction. The research is inquiring dentists' competence and knowledge to fulfil this role and includes recommendations how to improve this knowledge and competence.

Thank you for your recommendation. We took your suggestion into account and changed the title into “Dentists’ competence and knowledge on domestic violence and how to improve it - a review “ (lines 3-4). We agree that this is a better match to the content of our paper.