The decay in prison dental care

Many Americans forget that, in fact, Guam is a territory of the United States. Indeed even the federal government seems to forget that, as was the fact that while the people of Guam serve in the American military they are often excluded from services for veterans, was highlighted.  That’s why it’s unsurprising that developments in their Department of Corrections aren’t flying high on the media radar. But perhaps we should shift our gaze their way for a moment, to look at an oft-overlooked issue in prison health care: dental care.

When we’re talking about dental care in prison, we’re not talking about aesthetics—like tooth whitening or invisiline braces—we’re talking about a serious health care issue. It is the same reason that public health advocates outside the prison setting advocate for including dental care in all health coverage (be it public or private). Regular dental care also acts as an important screening method for several types of cancers. Periodontal and gum disease are directly linked to heart health—heart disease being one of the primary sources of morbidity and mortality in this country. As researchers have indicated, you don’t have general health without oral health.

Due to concerns regarding DOC compliance, the territory recently handed over medical care for the island’s prisoners to Guam Memorial Hospital and in doing so, were able to clean up a backlog of issues in the San Agustin institution, many of which were related to dental issues. A public health doctor was brought in to assess best practices for the facility, train staff on oral assessments, subsequently the DOC plans to bring a dentist and two oral hygienists on staff. 

Under DOC regulations, there are dental care standards which must be adhered to, but are frequently ignored by institutions seeking to cut corners, and there is a virtual catalogue of dental-related litigation outlining the ramifications of such practices. Just one example of the many issues is the prison practice of utilizing “extraction only” policies, whereby rather than repairing diseased death or gums, they simply pull out the teeth. However while this may seem like a cost-effective policy, it fails to recognize that when teeth are pulled, there are other problems that occur. Dentures may be required, and proper-fitting ones are costly. And without a proper fit, serious gum infections may result. Extraction may also fail to remedy underlying issues which, if left untreated, can lead to bone loss, abscess, and infections like sepsis.

So as Guam looks to be taking dental health in prison seriously, we need to ask why other jurisdictions are not. And once again, rather than decrying the fact that prisoners might have access to dental care that the general public does not, better to ask why you don’t.