A systematic review of oral health research in prisons

Objective: To provide a systematic overview and analysis of the scope, nature and outcomes of oral health research in prisons. Methods: A structured literature review using Medline, Embase, Cochrane Library, Healthy Informatics and Psychinfo. This was followed by extensive hand search. Results: 120 articles were included in the review. They comprised 3 interventions; 59 cross-sectional studies, including surveys, secondary data analyses and audits; 2 reviews; and 42 descriptive articles or commentaries. Most authors struggled with conducting research in the prison environment but some were able to utilise the penitentiary context to conduct (ethical) research otherwise not possible. Most articles focused on prisoners' oral health status, their experiences of oral health care and promotion, often with respect to their socio-demographic backgrounds. A number of articles investigated aspects of dental care provision in the prison context and few explored different research approaches within prisons. High oral health care needs and considerable under-treatment were reported across the globe, ethnicities, ages, sexes and types of prisoners. The relevance of oral health to prisoners and the wider society was examined and innovative as well as routine approaches to providing oral health care in prisons were presented. Conclusion: A wealth of evidence on oral health and oral health care in prisons is available. Oral health needs among prisoners are high and often unmet. Almost all existing research on oral health in prison consists of descriptions, commentaries and cross-sectional studies. Only a handful of oral health interventions in prisons have been reported in the literature. If ever high quality empirical research is needed, it is on oral health care provision in the prison environment.