A survey of primary and specialised health care provision to prisons in England and Wales

Planning for future provision of dental services in prison: an international proposal of two systems

This article describes a proposal for the future organisation of the delivery of dental and oral health services for prisoners. This vision is based on an analysis of the existing prison dental programmes in England and the United States (Federal Bureau of Prisons, [FBOP]), together with discussions from two key individuals from both countries who championed changes to prison dental services and have published in the field of prison dental services. Both countries have similar visions. Some of the suggested work has already been addressed in the past (for example, introduction of state of the art dental facilities in the UK prison setting), some are in process (for example, electronic patients' records) and some may be addressed in the near future (for example, prisoners' involvement with the services provided for them). Some of the expressed visions for the future in this article are driven by evidence-based literature and dental workforce policy.

The health of prisoners

More than 10 million people are incarcerated worldwide; this number has increased by about a million in the past decade. Mental disorders and infectious diseases are more common in prisoners than in the general population. High rates of suicide within prison and increased mortality from all causes on release have been documented in many countries. The contribution of prisons to illness is unknown, although shortcomings in treatment and aftercare provision contribute to adverse outcomes. Research has highlighted that women, prisoners aged 55 years and older, and juveniles present with higher rates of many disorders than do other prisoners. The contribution of initiatives to improve the health of prisoners by reducing the burden of infectious and chronic diseases, suicide, other causes of premature mortality and violence, and counteracting the cycle of reoffending should be further examined.