According to the Department of Health, the amount of untreated dental disease amongst the prison population is roughly four times greater than the level found in the general population coming from a similar background.
The prisoner profile is a familiar one across the UK; predominantly young men from deprived backgrounds with low literacy and educational ability, often with a history of drug-taking and alcohol abuse, poor nutrition and regular smoking.
As part of Mouth Cancer Action Month, organisers at the British Dental Health Foundation are making people aware of the risk factors. Given these are tobacco use, drinking alcohol to excess, poor diet, smokeless tobacco and the Human Papilloma Virus (HPV), transmitted via oral sex and coupled with their lack of awareness, the prison population are a particularly high risk group.
Dr Judith Husband, GDP at Bullingdon Prison in Oxfordshire, discussed some of the problems facing the inmates.
Dr Husband said: ‘Unfortunately, the demographic of inmates means their lifestyles have placed them in a high risk group. Awareness of the disease is exceptionally low and there’s no understanding of the lifestyle risks associated with mouth cancer. Around 80-85% of the prison population smokes, and we have a much higher number of people who have alcohol problems.
‘Research has proved these two risk factors combined increases the chances of developing mouth cancer by up to 30 times. Our challenge is to educate the inmates, make sure they know the risk factors, make sure they know the signs and symptoms and most importantly to make sure they come to the dental clinic if they are concerned about something.
‘We are trying to get the message across that it is important not just to visit the dentist when you are in pain. In the case of mouth cancer, catching it early could save your life. I’ve referred a number of suspicious lesions in guys who fit the traditional age demographic, but I have seen an increasing number of men who are between 25 and 30 present with suspicious lesions, too.
‘In the prison environment, it is crucial to communicate with the inmates. When they come for a full check-up I make a point of telling them I’ll be checking for mouth cancer. We have posters up in the clinic from previous Mouth Cancer Action Month campaigns which gets them talking.’
Although there have been some major improvements in the integration of preventive care, Dr Husband still believes more can be done to help the prison population.
‘People aren’t dwelling on oral health issues as much as they were 12 years ago. We have seen a higher number of inmates get into the “action” stage and come for a check-up. But it isn’t all good news. Waiting times for the clinic are longer than ever, resources are stretched and part-time initiatives that made a difference are being shelved.
‘That makes campaigns such as Mouth Cancer Action Month as important as ever. We must continue to raise awareness of the disease to as many people as possible, particularly those at risk.’