‘Extraction-only service’: Accessing dental care in prison

Poor dental care has been identified as a significant issue in prisons across Australia.

People in prisons around Australia are pulling out their own teeth due to being unable to access any form of dental care.

A number of recent reports and investigations have shone a spotlight on the poor dental care offered in Australian prisons, something which is plagued with long delays and a focus on the extraction of teeth rather than preventative measures.

The Office of the Custodial Inspector Tasmania’s report into adult healthcare in prisons, released last month, found that dental care was “woefully inadequate” and regularly described as “dreadful”.

“The dental service provided is considered as an extraction-only service,” the report found.

“There is no oral screening or routine dental examination on reception, and there is no oral hygienist provided. Access to non-urgent care is glacial, and access to preventative dental care non-existent.

“Some prisoners told us that they resorted to pulling their own or each other’s teeth out.”

The Inspector found that under the current system, it would take about 14 months for all people being held at the Risdon Prison Complex to receive dental care, and nine months for those being held at the Ron Barwick Prison.

It also found that dental care is completely denied in Tasmania for those in custody for less than six months or who are being held on remand.

The indictment on dental care in prisons reflects the findings of several other investigations into prisons across the country.

In a submission to the state government last year, the Western Australian Office of the Inspector of Custodial Services said that in the previous five years there had been 333 complaints made by independent visitors on behalf of those in prison relating to dental care.

These complaints related to lengthy wait times, deterioration of untreated oral health and a failure to manage pain.

Following an investigation into dental care in WA prisons in 2021, the inspector made nine recommendations to the state government, and all but one of these were supported. But the Inspector said that there has been “few tangible improvements” in the years since.

That previous review revealed that there were only 2.7 full-time equivalent dental teams operating across the prisons in WA, which incarcerate about 4000 people. Of these people, about 1385 people are on dental wait lists, and nearly 400 have been waiting for more than a year.

The Inspector found that due to these long wait times, people were resorting to pulling their own teeth out.

In the previous year, the investigation found that just 3 percent of dental treatment offered was preventative, while nearly a quarter of all services were extractions.

Earlier this year the Victorian Ombudsman’s investigation into healthcare provision for First Nations people in prison found that poor access to and low quality dental care was creating long delays, leading to teeth needing to be extracted.

The NSW Inspector of Custodial Services in 2021 found that dental care in prisons was a particular area of concern, and that about a third of those in prison may have tooth decay.

The Australian Institute of Health and Welfare has also identified dental health as a major area of concern in the prison population.

Of those leaving prison in 2022, just under 40 percent reported dental issues, and nearly a quarter of people said they had been diagnosed with dental issues for the first time while they were in prison.