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 Table of Contents  
ORIGINAL ARTICLE
Year : 2017  |  Volume : 7  |  Issue : 2  |  Page : 116-119

Dental caries experience and use of dental services among inmates of a district jail, Tumkur city


Department of Public Health Dentistry, Sri Siddhartha Dental College, Tumkur, Karnataka, India

Date of Web Publication28-Dec-2017

Correspondence Address:
Dr. Mythri Halappa
Department of Public Health Dentistry, Sri Siddhartha Dental College, Tumkur, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijmd.ijmd_41_17

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  Abstract 


Introduction: The present survey was carried out to assess the dental caries status among the jail inmates, which would be helpful in planning suitable oral health-care services in a prison setting.
Methodology: A cross-sectional survey was conducted in district jail. Demographic details along with caries status using DMFT index were assessed.
Results: Two hundred and three inmates were included in the study, and 79.8% had decayed or missing or filled tooth and 20.2% were free from dental caries.
Conclusion: A high proportion of prison inmates were affected by dental caries indicating the need for initiating oral health promotion activities among prison inmates.

Keywords: Dental caries; dental service utilization; health promotion; jail inmates


How to cite this article:
Halappa M, Surya B, Aswathi N M. Dental caries experience and use of dental services among inmates of a district jail, Tumkur city. Indian J Multidiscip Dent 2017;7:116-9

How to cite this URL:
Halappa M, Surya B, Aswathi N M. Dental caries experience and use of dental services among inmates of a district jail, Tumkur city. Indian J Multidiscip Dent [serial online] 2017 [cited 2019 Jul 21];7:116-9. Available from: http://www.ijmdent.com/text.asp?2017/7/2/116/221767




  Introduction Top


Access is one of the main barriers of health-care delivery system. To overcome this, primary health-care approach was addressed. However, each population group needs a different approach for health care. One of the strategies in public health is to identify unique population groups, study their health problems, and explore the methods needed for their health care.[1] Prisoners make one such unique group of population as they are different from other people in the context of their freedom of movement. The jail inmates are a unique and challenging one with many health problems, including poor oral health.[2] They are a psychologically, socially, morally, and economically affected group which makes them to neglect their general as well as oral health. The inmates in jail have a different lifestyle; routine dental care and daily oral hygiene are not in their regular component of lifestyle.[1],[2]

As inmates are more likely to have disadvantaged backgrounds or come from localities with increased levels of social exclusion, with a high proportion of them being unemployed prior to sentencing. As a consequence, oral health requirements of prisoners at admission may be particularly high with a significant amount of unmet treatment needs. Added to this, the facilities available are not up to satisfactory level, and therefore, the oral health status of them is affected to a marked extent.[3]

Now, there is a growing recognition that there is a direct link between oral health and lifestyle-related diseases such as heart disease and arthritis. This lack of attention in maintaining oral hygiene is reflected in the overall health status.[3],[4] Hence, an assessment of their oral health is required as there is a need toward the oral health promotion of these inmates.

Objective

The objective of this study is to know the prevalence of dental caries among inmates of a district jail, Tumkur city.


  Methodology Top


A cross-sectional study was conducted in March 2016. Prior permission was obtained from superintendent of police for both male and women cell, Tumkur jail, for conducting the oral examination and participants who were willing to participate were only included in the study.

A day and time was confirmed to their convenience, and on the day of study, type III examination was done using natural light, mouth mirror, and a probe. Demographic details such as age and gender were noted, and it was mentioned to maintain the anonymity. To measure dental caries prevalence, 1997 WHO modification of decayed, missing, and filled tooth (DMFT) index was used. As photos were not allowed inside the jail for ethical reasons, photographs of examination of inmates could not be obtained. A descriptive statistics were used to calculate the results.


  Results Top


Two hundred and three inmates were included in the study, and out of which, 58.63% were male and 41.37% were female [Graph 1]. The minimum individual age was 21 years while the maximum was 62 years [Graph 2].



More than 72% were illiterate or studied till primary school, 16% till high school, and 12% completed graduation.

On examination, it was found that 79.8% had decayed or missing or filled tooth and 20.2% were free from dental caries [Table 1]. Eighty-one percent of dental caries were observed in the molars ( first molar being more prevalent) compared to other teeth (19%). Maxillary teeth were observed to be more affected (67.4%) compared to mandibular teeth (33.6%).
Table 1: Percentage of inmates and number of caries affected teeth

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[Table 2] showed that majority of the inmates (84.2%) had decay component compared to missing (18.2%) and filled (6.9%), and the pattern was similar in both the genders. When the total number of tooth affected is considered, decayed tooth was more compared to missing and filled in both the genders [Graph 3].
Table 2: Status of decayed, missing, and filled teeth in prisoners

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When age-wise distribution according to DMFT in the genders was considered, among males, DMFT score was more in 26–30 years, and in females, it was in 31–35 years' age group [Table 3]. As the distribution of people was not homogeneous, statistical significance was not found. The number of average DMFT was more among females compared to males [Table 4].
Table 3: Distribution of decayed, missing, and filled teeth among different age groups of the prison inmates

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Table 4: Average decayed, missing, and filled teeth among male and female inmates

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  Discussion Top


The inmates will have unique and challenging health problems including poor oral health.[5] The current study was the first attempt to assess the dental caries status of inmates in district jail, Tumkur city, India.

Majority of the inmates were illiterate 203 (22.5%) and were unemployed or farmers. These findings were in contrast with prison inmates of Central Prison Bangalore by Uma and Hiremath 2011,[6] where majority of prison inmates, i.e., 764 (58.4%) had achieved more than secondary education. However, the education status of the prisoners in the present study was similar to remand prisoners in London,[7] institutionalized older people in Northeast Brazil,[8] and prisoners in Jaipur.[4]

A large proportion of 42.9% of the inmates used finger and toothpaste/powder and 34.7% used toothbrush and toothpaste/toothpowder for cleaning their teeth in this study. This shows that they are least concerned about their oral health. This was similar to the findings by Luciene Ribeiro Gaiao et al.[8] where only 53% of study population use toothbrush as a cleaning aid.

This finding was in contrast to the studies by Nobile et al.,[9] Anup et al.,[4] and Osborn et al.[10] where it was observed that more than 86% of the participants brushed their teeth using toothbrush and toothpaste.

Nearly 46.2% of inmates in our study had visited the dentist out of which 45.9% had received care. Study findings were in accordance with the studies conducted by Nobile et al.,[9] Osborn et al.,[10] and Bansal et al.[11] The reason for the visit in our study may be because of frequent treatment camps being organized in the hospital within the jail premises.

The prevalence of oral mucosal lesions has variation among the inmates. The overall prevalence of oral mucosal lesions among the inmates of our study was 12%. This result was similar to the study conducted by Uma and Hiremath [6] in Karnataka and in contrast to Anup et al.[4] in Jaipur, India.

The prevalence due to untreated dental decay is greater in prison population.[12] The high prevalence may be attributed to the low utilization of preventive and therapeutic dental services and inadequate dental personnel for the prison inmates.

About 79.8% of the participants had dental caries prevalence which was similar to Dhanker et al.,[1] K Singh et al.,[13] and Anup et al.,[4] but the mean DMFT score of inmates in our study was low in comparison to other studies.[14],[15] The decayed component was more compared to other components in the present study which was similar to Cavalcanti et al.[2]

The mean missing teeth and filled teeth observed in our study participants is lower than a study conducted in Brixton [7] and Italy.[9] Such discrepancies may be due to lack of awareness among the inmates pertaining to dental treatment.

The mean DMFT of the present study was low when compared to other studies conducted in Mathura,[2] Jaipur,[4] Brazil,[8] and Chennai [14] and was similar to study conducted in Jodhpur.[15] The mean filled teeth in the present study was low which was similar to study conducted in Jodhpur.[15] The low proportion of filled teeth among prisoners could be attributed to the difficulty in accessing dental services, their negative attitude toward dental health, and limited resources available at prison settings. Age-wise mean DMFT of inmates showed more in males at the age group of 25–30 and in females at the age of 30–35 years.

Overall, our findings were that a large proportion of the inmates were affected by dental caries, and it seemed unlikely that prisoners with dental problems will receive preventive care indicating the importance of providing dental prevention services in the prison settings. Hence, oral health programs targeted at correction and prevention of dental disease should be incorporated in prison settings to promote the oral health, and health education programs should also be organized to create awareness on the importance of good oral health.


  Conclusion Top


Our study suggested that a high proportion of prison inmates were affected by dental caries and many prisoners never used dental services because of its nonavailability. Restorative treatment being the main reason for the use of dental services, “decayed” and “missing” components contributed to the high mean DMFT index which necessitates the need for initiating oral health promotion activities among prison inmates.

Acknowledgment

I would like to acknowledge L Ralte, Aveek Ghosh, Nirakar T, and Shobitadarini for helping during the study and Dr. Bharateesh JV, Head of the Department, for supporting the study.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Dhanker K, Ingle NA, Kaur N, Gupta R. Oral health status and treatment needs of inmates in District jail of Mathura City – A cross sectional study. J Oral Health Comm Dent 2013;7:24-32.  Back to cited text no. 1
    
2.
Cavalcanti AL, Rodrigues IS, de Melo Silveira IT, de Oliveira TB, de Almeida Pinto MS, Xavier AF, et al. Dental caries experience and use of dental services among Brazilian Prisoners. Int J Environ Res Public Health 2014;11:12118-28.  Back to cited text no. 2
    
3.
Heng CK, Morse DE. Dental caries experience of female inmates. J Public Health Dent 2002;62:57-61.  Back to cited text no. 3
    
4.
Anup N, Gautam B, Preeti V, Swasti T, Siddharth A, Himanshu K. Oral health status and treatment needs of inmates in district jail of Jaipur City – A cross sectional study. J Nurs Health Sci 2014:3;22-31.  Back to cited text no. 4
    
5.
Dayakar MM, Shivprasad D, Pai PG. Assessment of periodontal health status among prison inmates: A cross-sectional survey. J Indian Soc Periodontol 2014;18:74-7.  Back to cited text no. 5
[PUBMED]  [Full text]  
6.
Uma SR, Hiremath SS. Oral health care for inmates of central prison, Bangalore an institutionalized approach. J Indian Assoc Public Health Dent 2011;17:297-304.  Back to cited text no. 6
    
7.
Heidari E, Dickinson C, Wilson R, Fiske J. Verifiable CPD paper: Oral health of remand prisoners in HMP Brixton, London. Br Dent J 2007;202:E1-6.  Back to cited text no. 7
    
8.
Ribeiro Gaião L, Leitão de Almeida ME, Bezerra Filho JG, Leggat P, Heukelbach J. Poor dental status and oral hygiene practices in institutionalized older people in Northeast Brazil. Int J Dent 2009;2009:846081.  Back to cited text no. 8
    
9.
Nobile CG, Fortunato L, Pavia M, Angelillo IF. Oral health status of male prisoners in Italy. Int Dent J 2007;57:27-35.  Back to cited text no. 9
    
10.
Osborn M, Butler T, Barnard PD. Oral health status of prison inmates – New South Wales, Australia. Aust Dent J 2003;48:34-8.  Back to cited text no. 10
    
11.
Bansal V, Sogi GM, Veeresha KL. Assessment of oral health status and treatment needs of elders associated with elders' homes of Ambala division, Haryana, India. Indian J Dent Res 2010;21:244-7.  Back to cited text no. 11
[PUBMED]  [Full text]  
12.
Amit B, Tony J. Dental health in prisons. In: Lars M, editor. Health Inprison: A WHO Guide to the Essentials Inprison Health. 1st ed. Copenhagen: WHO Regional Office for Europe; 2007. p. 148.  Back to cited text no. 12
    
13.
Singh K, Gill AS, Cheema HS, Anandani C, Pani P, Dhillion P. Dental caries status and treatment needs in a prison setting at Ferozepur city. J Pioneer Med Sci 2015;5:15-8.  Back to cited text no. 13
    
14.
George B, John J, Saravanan S, Arumugham IM, Johny MK. Dental caries status of inmates in central prison, Chennai, Tamil Nadu, India. J Nat Sci Biol Med 2015;6:S110-2.  Back to cited text no. 14
    
15.
Hans R, Thomas S, Dagli J, Solanki J, Arora G, Prevalence of dental caries among prisoners of central jail. Jodhpur city, Rajasthan, India. World J Dent 2014;5:92-7.  Back to cited text no. 15
    



 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4]



 

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