Mr. T. has been asking since May to be taken to the hospital to have six dead teeth removed. However, to this day, nothing. his dental health deteriorates day by day, as does his mental health. I don’t know what to do anymore. The testimony of Mr. T., incarcerated at the Bapaume detention center, is far from isolated. Many detainees report their wait, suffering, and dejection in the face of difficulties accessing dental care in prison. This situation, confirmed by healthcare professionals, is even more alarming as detainees are particularly affected by dental health problems.
Triggered by the OIP, several regional health agencies (ARS) and sanitary units in penitentiary environments (USMP) confirm a particularly dire access to care. In a context of overcrowding, waiting times lengthen and the number of accessible dental consultations decreases.
The annual report of the USMP of the pre-trial detention center of Périgueux emphasizes a significant number of medical appointments being postponed or canceled throughout the past year. In 2024, 64% of scheduled appointments had to be canceled. On the other hand, the USMP of the Strasbourg pre-trial detention center reports a six-month waiting time for a dental consultation, outside of emergencies. For newcomers, the Martinique ARS mentions a three to four month wait before a first dental assessment is carried out, even though each detainee should normally undergo a medical examination promptly.
Context: The lack of access to dental care in prisons is a widespread issue affecting the health and well-being of inmates.
Fact Check: The article highlights the challenges faced by detainees in accessing dental care, leading to long waiting times and cancellations of appointments.
Human and Material Resources Degraded
The long waiting times, cancellations, and rescheduling of consultations are primarily due to the lack of medical personnel in USMPs. In many penitentiary establishments, positions for dentists and dental assistants are scarce, or even non-existent. For instance, the Moulins-Yzeure penitentiary center has had a vacant dentist position for two years. The Auvergne-Rhône-Alpes ARS speaks of an almost chronic understaffing issue across all USMP facilities regarding dentists.
This understaffing issue is attributed by ARS to the difficulty in recruiting practitioners due to specific unattractiveness in the prison environment and the location of some penitentiary centers in medical deserts. Several nurse positions are also vacant, limiting the medical care available to detainees. In some cases, tensions between medical teams and penitentiary facility management worsen this situation. The understaffing is further exacerbated by prison overcrowding, as the number of healthcare workers remains based on theoretical prisoner numbers rather than actual figures.
Extract rather than treat
In response to this situation, many ARS and USMPs resort to short-term solutions that are insufficient in addressing the needs of the inmate population. Student dentists, private dentists, or temporary professionals are called upon to fill the vacant positions. Prevention days on oral hygiene are also organized.
In the absence of adequate medical intervention, detainees regularly receive painkillers, some with high addiction risks. Mr. B., incarcerated at the Moulins-Yzeure penitentiary center and deprived of care since January 2025, explains that he is not receiving medical care “aside from mouthwashes and Tramadol,” despite his catastrophic oral health condition.
Context: The lack of adequate dental care in prisons results in inmates often having their teeth extracted rather than receiving proper treatment.
Fact Check: Due to the shortage of dental professionals, inmates resort to receiving painkillers instead of long-term dental care.
Self-Harm as a Last Resort
In the face of pain and the impossibility of receiving timely care, self-harm incidents are common. For example, Mr. T. had to intervene two or three times to drain an abscess with a needle, remove a piece of tooth with nail clippers, or open his gum with a razor blade. These improvised interventions in distress, with non-compliant materials and in a non-sterile environment, pose significant dangers and risk infection.
The structural problem of access to dental care in carceral environments significantly impacts the health of the affected inmates. They face intense daily suffering, hindering even basic tasks such as communication or eating. Mr. B. struggles to speak and pronounce certain sounds while wishing for alternative bread due to pain in his gums.
Context: Inadequate access to dental care in prisons leads to inmates resorting to self-harm, risking infection and further health complications.
Fact Check: The poor access to dental care in prisons results in inmates resorting to self-mutilation due to untreated dental issues, leading to significant health risks.
The article was published in the International Prison Observatory’s magazine, “DEDANS DEHORS” No. 128 – Preparation for prison release: the great renunciation.
