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Dental Surgeon Leslie Halpern | Meeting the minds

She uses dentistry to help fight abuse

Dr. Leslie Halpern says dental surgeons are uniquely positioned to combat domestic abuse. Dr. Leslie Halpern says dental surgeons are uniquely positioned to combat domestic abuse. (JONATHAN WIGGS/GLOBE STAFF)

The day Dr. Leslie Halpern discovered her calling was the day a woman walked into the emergency room at Lincoln Hospital in the Fort Apache section of the Bronx, her face slashed with a box blade.

"Her husband had come home and didn't like what she had served for dinner," said Halpern, then an oral surgery resident. "I fixed her up. Three days later, I went back into the trauma room and she had a sheet over her. He had finished the job."

Today, Halpern, 54, an oral maxillofacial surgeon and assistant professor at the Harvard School for Dental Medicine, sits on the steering committee of the American Medical Association's National Advisory Council on Violence and Abuse, trying to guide policymaking on domestic violence. She says that it's natural for dental surgeons to be at the forefront of combating the problem.

"Dentistry is the front line," said Halpern, who practices at Harvard Vanguard Medical Associates, Beth Israel Deaconess Medical Center, and Brigham and Women's Hospital. "If you look at the injuries to victims of domestic violence, the most common are to the head, neck, and face," more than 75 percent, in fact, according to the Massachusetts Dental Society. In addition to treating those wounds, Halpern and Dr. Thomas Dodson, of Massachusetts General Hospital, have collaborated on a short questionnaire that can be administered to patients to find out whether they have been abused.

"There's a stigma attached to domestic violence," Halpern said. "We don't ask people about it. Victims often say, 'I only wish someone had asked me about it!' "

The questionnaire asks patients standard questions, such as "Have you ever been hit by your partner?" and "Do you feel safe in your relationship?" But since victims are often unwilling to talk about abuse, it also poses questions that are less direct, such as: "Is there tension in your relationship?"

Halpern says victims of domestic violence are what healthcare providers call "frequent fliers" -- they tend to have a lot of chronic health issues. Dentists are in a key position to pick up on these chronic problems, and tie them to abuse, she says.

"The oral cavity is a window into systemic disease," she said.

Halpern believes that healthcare providers often miss signs of domestic violence because they're too rushed or because they're not trained to spot them. "Sometimes, they don't see the forest for the trees," she said. "That's why it's so important to educate them in identification and prevention."

They also need some legal encouragement, she says.

"If you don't report child abuse, you'll be fined," she said. "We need the same for adults. That's the cure."

Dr. David Keith, an oral maxillofacial surgeon at Harvard Vanguard, says that Halpern's efforts "have really raised awareness of [the issue] in our professional community. It's not something that you see every day in a general practice environment, so you have to keep it in front of people to get their attention."

According to the Massachusetts Coalition against Sexual Assault and Domestic Violence, the state issued 28,500 restraining orders in 2005. Abuse is also a global issue.

"The challenge," says Halpern, "is getting people to wake up to the problem."

Fact sheet

Hometown: Weymouth.

Family: Sons Seth, 25, and Noah, 22. "The apples of my eye."

Past life: Halpern was a biology professor at Brooklyn College before switching careers to dentistry. "My sister-in-law was a dentist, and she said it was a good career if you had kids because you can make your own hours."

Hobbies: Competitive ballroom dancing. "Smooth and Latin. I do the fox-trot, the tango, the waltz. I was a disco queen in the 1970s."

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Fact sheet

Hometown: Weymouth.

Family: Sons Seth, 25, and Noah, 22. "The apples of my eye."

Past life: Halpern was a biology professor at Brooklyn College before switching careers to dentistry. "My sister-in-law was a dentist, and she said it was a good career if you had kids because you can make your own hours."

Hobbies: Competitive ballroom dancing. "Smooth and Latin. I do the fox-trot, the tango, the waltz. I was a disco queen in the 1970s."

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