National Association of Prison Dentistry UK

Conference – Birmingham3rd February 2012

Setting up a Dental Health Education Programme in

HMP Prisons

Alison WillisDental Health Co-ordinator

Worcestershire Health and Care NHS Trust

Worcestershire has two prison establishments:

HMP Hewell – is a male prison and holds category B, C, D & remand – operational capacity 1431

HMP Long Lartin -is a male adult prison in the high secure estate and holds both category A and B prisoners serving between 4 years and life. The prison operational capacity is 622 prisoners.

Prisoner ProfileIn HMP Hewell the prisoner profile is a

familiar one across the UK;

Mainly young men from deprived backgrounds

With low literacy and educational attainment

History of drug-taking and alcohol abuse Underlying poor nutrition and heavy

smoking

Overall maintaining good oral health is a challenge! - ‘Managing the

impossible’………?

The Challenges in Providing Dental Health Programmes in Prisons

Fieldwork Practicalities:• Security clearance – for high security prisons it can take months• Mandatory training/induction• Risk assessments• Efficient use of dental clinic time and skills, lack of space • Giving free samples of toothpaste and toothbrushes – security

General prison security issues, sessions shortened by security procedures Oral health promotion should a integral part of general health promotion, staff

cutbacks and lack of funds in Healthcare – Health Promotion not seen as a priority

Availability of dental care materials, even where these are available they may be prohibitively expensive to prisoners whose average wage may just be a few pounds a week

Prisoners lifestyle factors

Improving Oral Health Key Areas for Action

Increasing the use of fluoride to prevent tooth decay

Improving diet and reducing sugar intake Encouraging preventive dental care Reduce smoking Increasing early detection of mouth cancer Reducing dental injuries

Prison Toothbrush and Toothpaste

Dental Health Education Session:

• A discussion on a healthy and a unhealthy mouth

• Plaque – gum disease, tooth decay• Diet advice• Smoking, drugs and methadone• Disclosing and effective

toothbrushing technique.

What happens if we don’t remove the plaque?

Plaque Gum Disease

Calculus Mobile Teeth

Evaluation What would you change in your oral health routine after today’s session?

• Brush more effectively• Brushing systematically• Not rinsing after brushing• Reducing the frequency and amount of sugary

drinks and foods.• Eat more fruit and vegetables• Stop smoking or sign to smoking cessation

programme

The Way Forward

Improving the quality of free toothbrushes provided to prisoners

Availability of affordable dental care products on the canteen Ensure avoidable artificial sweeteners are available in the

canteen Linking oral health promotion to general health e.g. smoking

cessation – joint clinics Reduce waiting lists for smoking cessation Clarify the roles and skills of the dental team – extend the

roles of nurses & therapists Ensure that your future plans for the service include

improved oral health and hygiene. Particular attention should be paid to interventions where there is evidence of proven effectiveness.

Thank you for listening