Carceral Systems and Oral Health Access

The United States has the highest per capita incarceration rate among democracies, with over 1.8 million people in prisons and jails as of 2024.¹ A review of studies worldwide on the oral health of people who are incarcerated found that a high proportion of incarcerated people suffer from untreated dental caries, periodontal disease, and other oral pathologies, which are often exacerbated by limited access to preventive care, restorative treatments, and oral hygiene education prior to and during incarceration.²

Many incarcerated individuals lack dental insurance prior to incarceration and often come from communities with limited access to dental care.³ They experience higher rates of dental disease compared to the general population, with half reporting dental issues while in custody. Prison dental care is largely limited to emergencies, often prioritizing extractions over restorative treatment and operating with long waitlists that delay care. While a toothbrush is provided upon entry, additional supplies must be purchased, which can be difficult with limited funds, and copays may further add to the financial burden.³  These challenges, combined with logistical, financial, and administrative barriers, restrict access to dental professionals and resources, leading to unmet needs, untreated disease, and impacts on overall health and self-esteem.

Improving oral health care access in carceral settings requires solutions that address their unique barriers. The dental workforce in the Federal Bureau of Prisons is insufficient, leading to delayed care and limited prevention; expanding staffing and targeted training can help ensure timely, comprehensive services. Partnerships with dental schools and nonprofit organizations offer a practical path forward, leveraging students and faculty to deliver care tailored to incarcerated individuals, while groups like the Cade Moore Foundation’s Every Mouth Matters connect volunteer dentists and support sustainable programs. These collaborations can also reduce transportation barriers by facilitating care at dental schools and enriching interdisciplinary training.^{4, 5} Teledentistry is another promising approach, enabling remote consultations, triage, and follow-up.⁶ Oral health education can be integrated into existing prison health programs, including chronic disease management, substance use treatment, mental health services, and preventive screenings, supporting a more comprehensive approach to care.

Policy change is essential. Federal and state agencies, public health departments, and educational institutions should prioritize routine and preventive dental services in correctional facilities, including screenings, cleanings, fluoride treatments, and patient education. Advocacy targeting policymakers, education boards, and professional organizations can help advance and implement these standards.

Focusing on early detection and intervention can reduce oral disease and reinforce oral health as a critical component of overall well-being. Providing dental care during incarceration has lasting benefits after release, including improved oral health, self-confidence, employability, and community integration. The World Health Organization recognizes oral health as integral to overall health, underscoring the need for comprehensive care in all settings. Addressing unmet dental needs during incarceration can reduce barriers to successful reintegration and advance health equity.⁷

Action Steps to Support Carceral Communities and Foster an Inclusive Dental Workforce:

• Improve data collection by broadening and standardizing prison health records and metrics to better understand oral health status of this population and enable additional research.
• Integrate dental care into primary care through collaboration with correctional administrators.
• Expand the dental workforce in correctional facilities through targeted recruitment, training, and investment to address current staffing shortages and care delays in the Federal Bureau of Prisons.
• Advocate for policy reforms to mandate standard preventive dental care across all four medical care levels in correctional health services, focusing on Bureau of Prisons regulations and policy statements.
• Build partnerships among dental schools, community organizations, and correctional facilities to deliver clinical care, connect volunteer dentists with incarcerated individuals, and establish sustainable prison dental programs, e.g., The Cade Moore Foundation's Every Mouth Matters program.
• Learn more: Working as a prison dentist⁸ | Behind Bars – The Overlooked Crisis of Oral Health in Prisons – Solidarity Dental Foundation⁹

Authored by: Tina Brandon Abbatangelo, DDS, and the EDI Committee

References:

1. Prison Policy Initiative (2026)
2. Mehta V, Bhadania M, Noor T, Meto A, Mathur A. Exploring the oral health status in incarcerated populations: a narrative review. Ghana Dent J. 2025;22(2):95–102.
3. CareQuest Institute for Oral Health. Oral Health in Incarcerated Persons. Boston, MA: August 2024. Copyright © 2024 CareQuest Institute for Oral Health, Inc.®
4. Wickramasinghe D, Gray R, Plugge E. Dental education and prison health: a scoping review. J Dent Educ. 2022;86(10):1292–1303.
5. The Cade Moore Foundation. Every Mouth Matters: Prison Dental Care.
6. da Costa CB, Peralta FDS, Ferreira de Mello ALS. How has teledentistry been applied in public dental health services? An integrative review. Telemed J E Health. 2020;26(7):945-954.
7. World Health Organization. Oral health. Geneva: WHO.
8. Amaya, A., Medina, I., Rezaei, F., Soleimani, P., Bosworth, R., Stöver, H., & Moazen, B. (2025). Understanding the complexities of oral healthcare delivery in correctional settings: a qualitative exploration of barriers, facilitators, and opportunities. BMC Public Health, 25(1), 3039.
9. Solidarity Dental Foundation. (n.d.). Behind Bars – The Overlooked Crisis of Oral Health in Prisons. Retrieved March 19, 2026, from https://www.solidaritydental.org/summerblogs/blog-six