Recognizing Signs of Sex Trafficking in the Dentist’s Chair

In Impacting Patients, Print Issues, She's Touching Lives by Renee Dixon

What would you do if you went into your patient room for your next appointment and found a sex trafficking victim sitting there? Would you know that you were looking at a victim? If you did, would you know how to handle the situation without putting yourself or your patients in more danger?

Several years ago, one of our dental assistants was faced with those very questions. She was treating a new patient and saw visible scarring in the patient’s mouth. Our clinical staff had gone over possible indicators of sex trafficking as part of their ongoing training, so the
assistant knew how to handle what could have been a very dangerous situation. As it turned out, there was a good explanation for the patient’s condition and she was not being sex trafficked. Thankfully, she was OK; and we were all relieved to know that if she had been a victim, we were in a good position to recognize the warning signs and provide help quickly – without putting the victim, ourselves or our other patients in danger.

We’re in a unique position

At the time, I remember thinking to myself: “What if that had been my daughter?” It’s a scary, sobering thought. According to a study* by the UT School of Social Work, child sex trafficking is the fastest growing crime in the world, with 79,000 young people being sex-trafficked in the state of Texas alone. Because many indicators are found in the mouth, dental professionals are in a unique position to make a big difference in reducing those statistics – saving lives, one patient at a time.

Unfortunately, many dental professionals say they don’t know what to look for or how to help. With this in mind, I want to share some tips on what to look for, in the hope that dental professionals everywhere will join us in the fight to end child sex trafficking.

What to look for:

One of the most significant warning signs is the presence of visible injuries or scars in the mouth. Particularly bruising on the floor and roof of the mouth and/or a torn lingual frenulum that results from repetitive and/or forced oral sex. The lingual frenulum is the small fold of tissue that extends from the floor of the mouth to the midline of the underside of the tongue.

“If you have a child in your care with other warning signs of trafficking and she has visible injuries or scars in her mouth, then you can be pretty certain she is being trafficked, especially if she has a torn lingual frenulum,” notes Steven “Flyer” Phenix of The Refuge for Domestic Minor Sex Trafficking (DMST). “Call the hotline and/or 911 as quickly and covertly as possible, and make sure you aren’t discovered. If the pimp thinks you suspect the truth, he’ll go further underground, taking the victim with him and punishing her for it.”

Be cool and covert:

Victims and their companions become “spooked” easily and may make a run for it, putting the victim in even more danger. If you’re thinking about questioning a patient about an injury and are worried you’ll be too invasive, then don’t mention it. Be cool and covert. Find a way to call 911 or contact The National Human Trafficking Resource Help Center without being observed. If you do not think you can do so without being observed, find a way to flag down a fellow staff member. Create a symbol that you can use to communicate the situation to another employee so that they can make the call without raising suspicion. Make sure the symbol is something innocuous that won’t raise suspicion.

It’s also a good idea to save the help hotline number into your cell phone or tablet, so you can contact the authorities as quickly and unobtrusively as possible. Call 888-373-7888 or text HELP or INFO to 233733. Make sure everyone on your staff has access to these numbers at all times, but don’t post them where a predator might see them.

Other warning signs:

Additional warning signs may include tattoos of ownership, money symbols or emoticons. A patient who appears younger than the stated age. Or additional signs of abuse or neglect. These signs may include excessive bruising anywhere on the body, cigarette burns, extremely skittish behavior, evidence of untreated dental needs or even signs of malnutrition such as swollen or bleeding gums, tooth decay, low body mass index or extremely dry skin.

Every case is unique, and the victim may or may not display the same indicators. Even the same abuser can afflict different injuries on different victims. In addition, victims may feel ashamed or afraid to speak up. They may exhibit subordinate, hyper-vigilant or fearful behavior–which are also indicators. When asked about their personal or medical histories, the patient’s responses may sound scripted or rehearsed. Or the patient may have a constant companion (pimp) with him or her who speaks for the patient and holds all of the patient’s identification paperwork.

Trust your instincts:

It’s important to note: The presence of one or more of these indicators does not necessarily mean the person is a victim, but it is a cause for concern. Use your best judgment and trust your instincts. If something doesn’t feel right, contact the hotline or the police and ask for help. The experts can guide you through the next steps and provide much-needed support that doesn’t put you or the victim in more danger.

Details, details, details:

If you suspect a victim, recall as much detail as you can about both the victim and the pimp. Try to remember clothes, height, weight, race, hair and eye color, approximate age, visible scars or tattoos and vehicle make, model and color. Try to take photos–particularly
of the pimp and vehicle–but be covert.  “Remember as many details as you can and try to get photos, but be as inconspicuous as possible. Don’t approach the victim or the pimp. Call the police and the hotline and let the experts take it from there,” adds Phenix.

For more information, visit

* A two-year study by the University of Texas School of Social Work; Human Trafficking by the Numbers: The Initial Benchmark of Prevalence and Economic Impact for Texas, Final Report; December 2016.