Human trafficking is a pervasive issue in the United States that’s concealed by traffickers and overlooked by those in the health-care community. Between 50% and 80% of survivors report going to a health-care provider while in captivity, and 27% of those survivors went to the dentist while being trafficked.1
Dental professionals are uniquely positioned to recognize and respond to trafficking victims due to close interactions with patients during clinical care. Here is an introduction to how dental practitioners can play a crucial role in recognizing and reporting human trafficking through heightened awareness, trauma-informed care, and appropriate action.
Understanding human trafficking
Human trafficking involves the exploitation of individuals through force, fraud, or coercion for purposes such as forced labor or commercial sex. Labor trafficking is the exploitation of people into physical work or domestic servitude. Labor-trafficked individuals are often promised a better life but are instead subjected to excessive work hours and expectations with little or no pay. Many labor-trafficked individuals report physical abuse from their traffickers.
Sex trafficking involves the “recruitment, harboring, transportation, provision, or obtaining of a person for a commercial sex act, including pornography, through means of force, fraud, or coercion.” Any person under the age of 18 involved in a commercial sex act is considered a trafficked person, regardless of whether force, fraud, or coercion is present.2
Dispelling common myths about human trafficking is crucial for effective identification and intervention. One prevalent misconception is that individuals must be kidnapped or transported across borders to be considered trafficked. In reality, human trafficking does not require movement; it can occur anywhere, including rural areas, suburbs, and urban centers … even in someone’s home.3
Many victims know their traffickers; often, they’re family members, romantic partners, or acquaintances someone meets online. Cases of individuals being kidnapped by strangers into trafficking in the US are relatively rare compared to the number of victims who are familiar with their perpetrator.4
Statistics from the US Department of State in 2024 estimate that millions of people are trafficked globally every year, and many cases go unreported. Traffickers exploit vulnerabilities such as economic instability, immigration status, homelessness, or prior trauma. These vulnerabilities highlight why health-care providers should be prepared to identify signs of trafficking.5
Who is trafficked, and who are the traffickers?
Who is trafficked? Victims represent all genders, races, ethnicities, and ages, but specific vulnerable populations are more at risk. These include children, young adults, individuals experiencing poverty, immigrants, LGBTQ+ individuals, and those with disabilities.5 Traffickers exploit their unmet needs, such as housing, job opportunities, or emotional support, to gain control over their lives.6
While females are disproportionately affected, males are also trafficked, particularly in labor settings such as agriculture, construction, and service industries.5 Males are also subjected to sex trafficking, and research indicates that a significant number of these people identify as LGBTQ+.7
Who are the traffickers? Traffickers can be a person with money, power, and prestige, all the way to a street pimp. They can be family members, intimate partners, employers, and organized criminal networks.2 They often blend into society, which makes them hard to identify.4 A trafficker might present as a caregiver accompanying a victim to a health-care appointment, or as a seemingly legitimate employer. This makes it difficult for a dental clinician or law enforcement officer to identify them.8
Recognizing human trafficking in the dental setting
Signs of trafficking might become evident in a dental setting. Due to the physical proximity and time spent with patients, dental professionals can notice indicators that others might miss. Physical and behavioral indicators, as well as communication barriers, can provide critical clues in identifying victims of human trafficking in the dental setting.
Physical indicators include untreated dental issues or advanced decay caused by neglect. Victims may also present with signs of physical abuse, such as bruises, scars, or burns around the mouth or face. Oral trauma, such as broken teeth or bruising of the floor of the mouth or soft palate, offer more clues to dental professionals to help identify abuse.9-11
Behavioral indications may be unusually anxious, withdrawn, or fearful patients, particularly in the presence of a controlling person who accompanies them. The companion may insist on answering questions, refuse to leave the room, or control the patient’s documents. This is one of the number one signs of a trafficked person. Victims may also lack basic knowledge about their personal information, such as their address or employment history.9-11
Screening patients with a trauma-informed lens
Trauma-informed care requires a clinician to adopt a broad lens when interacting with patients. This perspective shows the provider understands the prevalence of trauma in society, its impact on people, and the importance of avoiding more trauma. The dental provider achieves this by approaching each patient as a potential trauma survivor. This trauma-informed lens helps a clinician remain focused on the patient’s needs and ensures actions are taken to prevent triggering a trauma response.12
Trauma-informed care shifts being a rescuer away from the provider. Instead, it focuses on creating a safe and trusting environment where the patient can feel seen and heard. Many survivors report that the simple act of a health-care provider listening without judgment or unsolicited advice helped encourage them to seek resources or take a step toward leaving their trafficking situation.
Principles of trauma-informed care12
Safety: Create a welcoming and nonthreatening environment.
Trustworthiness: Be transparent about your intentions and respect the patient’s boundaries. Be honest about what resources you can or cannot offer.
Empowerment: Focus on the patient’s autonomy and ability to make decisions.
Screening practices in trauma-informed care
Conduct interviews in private settings to ensure patients can speak freely, which is the number one priority when screening patients. Use open-ended and neutral statements and questions, such as, “I notice that he answers all the questions for you. Are you OK with that?” Avoid judgmental language or assumptions about their situation. Listen without judgment and resist the temptation to interject your own opinion or ideas.12
Building trust is critical to address potential trafficking situations. Patients who view health-care professionals as nonjudgmental and compassionate are more likely to disclose their circumstances. Even if a patient does not confirm that they’re being trafficked, offering them information about available resources can plant a seed for future help. For trauma-informed providers, the primary goal is to serve as a source of support and helpful information, not to take on the role of rescuer.12
Report human trafficking
In many jurisdictions, reporting suspected trafficking cases is a legal and ethical responsibility. Dental professionals must familiarize themselves with local laws and procedures for reporting.
Steps for reporting
Observe and document: Record detailed notes about physical, behavioral, and contextual indicators. Avoid making judgements but note objective observations.
Consult with team members: Share concerns with colleagues or supervisors to determine the best action.
Contact authorities or hotlines: Contact law enforcement, child protective services, or the National Human Trafficking hotline (888-373-7888) for guidance about the next steps. If the patient is a minor, follow your state’s mandatory requirements for reporting abuse. For adults, be aware of your state’s trafficking reporting laws while recognizing that involving law enforcement may not always be the best first step. Engaging law enforcement could potentially escalate a victim’s situation. It’s often best to consult a hotline for advice unless someone appears to be in imminent danger or explicitly requests law enforcement involvement.13 Never pressure an adult to call a hotline or seek help unless they want to.
There may be challenges when you report. There can be fear of retaliation or harm to the victim, lack of concrete evidence, and patient reluctance to disclose or engage with law enforcement. Also, the person who is accompanying them may refuse to leave. Always air on the side of safety for the patient and office staff before reporting.13
Resources for dental professionals
- The National Human Trafficking hotline offers confidential advice and resources at 888-373-7888.
- Report to Homeland Security at the Blue Campaign at 866-347-2423.
- Local antitrafficking organizations often provide training and support for health-care providers.
- Continuing education courses on human trafficking can enhance awareness and skills.
The first step in preparing to identify and support a potentially trafficked person is to ensure that the entire office team is trained. Training courses are available online or at dental conferences. Each office should establish a plan of action that includes the following:
- Display the National Human Trafficking hotline number in a visible location in the office where patients can easily see it.
- Ensure team members are trained and comfortable asking screening questions to identify potential victims.
- Maintain knowledge of local and national resources that can be offered to patients who need assistance.
- Provide printed resources that patients can take with them. (Note: Only offer printed materials if a patient agrees to take it. If the trafficker discovers it, these materials could lead to further abuse.)
- For guidance on creating a plan for your office, visit HEALtrafficking.org. A free tool kit is available for download.
Awareness is a strong first step. Ongoing education, collaboration with local organizations, and advocacy for victims are essential to improving outcomes for trafficked individuals. Together, the dental community can take meaningful steps toward addressing this crisis.
Editor's note: This article appeared in the March 2025 print edition of RDH magazine. Dental hygienists in North America are eligible for a complimentary print subscription. Sign up here.
References
1. What is human trafficking? Polaris. 2025. https://polarisproject.org/human-trafficking/
2. Understanding human trafficking. US Department of State. December 12, 2023. https://www.state.gov/what-is-trafficking-in-persons/
3. Myths and misconceptions. US Department of Homeland Security. https://www.dhs.gov/blue-campaign/myths-and-misconceptions
4. The misconceptions of child trafficking. US Department of State. July 30, 2024. https://www.state.gov/the-misconceptions-of-child-trafficking/
5. 2024 trafficking in persons report. US Department of State. https://www.state.gov/reports/2024-trafficking-in-persons-report/
6. Vulnerabilities and recruitment. Polaris. https://polarisproject.org/vulnerabilities-and-recruitment/
7. Sex trafficking and LGBTQ youth. Polaris. https://polarisproject.org/wp-content/uploads/2019/09/LGBTQ-Sex-Trafficking.pdf
8. Human trafficking and the health care industry. Polaris. https://polarisproject.org/human-trafficking-and-the-health-care-industry/
9. Burkhart NW. Human trafficking: exploring the dental implications. Dental Resource Center. February 16, 2024. https://www.drcdental.com/compliance/human-trafficking-exploring-the-dental-implications
10. Identifying victims of human trafficking: what to look for in a medical exam. National Human Trafficking Resource Center. https://humantraffickinghotline.org/sites/default/files/What%20to%20Look%20for%20during%20a%20Medical%20Exam%20-%20FINAL%20-%202-16-16_0.pdf
11. Syme SL, Camardese S, Mehlman-Orozco K. Identifying victims of human trafficking. Dimensions of Dental Hygiene. August 8, 2017. https://dimensionsofdentalhygiene.com/article/identifying-victims-of-human-trafficking/
12. Substance abuse and mental health services administration (SAMHSA). Trauma-informed care toolkit. https://ncsacw.acf.hhs.gov/
13. What is human trafficking? National Human Trafficking Hotline. https://humantraffickinghotline.org/en
