South African prison populations continue to grow because of the escalating crime and an overstretched judicial system. Objective: was to assess the oral health status and its impact on the quality of life in prison inmates in the Western Cape (Pollsmoor, Goodwood, Paarl and Worcester). Methods: A cross-sectional epidemiological survey involving a clinical oral examination and face-to-face interviews was used to collect information on DMFT, periodontal health, perceived needs and the impact of oral diseases on quality of life. Clinical examinations were carried out using WHO criteria. The impact on oral health quality of life was assessed using the OHIP-14. Results: Of the 340 study participants, 264 were male and 76 were female. The prevalence of oral disease was high. Nearly a third (59%) had shallow or deep periodontal pockets. The mean DMFT was 15.45 and the total DMFT increased with age. There was a substantial impact of oral health quality of life, with many citing problems with eating, drinking and pain. Self-reported dental needs indicated a perceived the need for dentures, scaling and fillings. Over two thirds of the sample (72%) reported that the dental services that they presently receive are poor. Conclusions: This study found a high prevalence of dental caries and periodontal disease among the correctional service populations. The oral health status of inmates was far below that of the general population with inmates having more untreated decay, more missing teeth and fewer filled teeth. There is an urgent need for the development of a basic oral health care package that should be offered to all inmates as eventually many of the will be returning to the community.