Freeman Ruth, Richards Derek
Dental Health Services Research Unit, University of Dundee, Dundee, DD1 4HN, UK.
Public Health, NHS Tayside, Dundee, DD2 1UB, UK.
Dent J (Basel). 2019 Feb 1;7(1):12. doi: 10.3390/dj7010012.
Prisoners have poorer dental health than non-prison populations. It is known that the prison environment can promote health and thus, policies, including access to dental care, are in place to promote health during imprisonment. Our aim was to conduct an oral health and psychosocial needs survey to identify the factors associated with accessing prison dental services in Scotland. A convenience sample of offenders from a male maximum security prison, a women's prison, and a young offenders' institution was gathered. A questionnaire examined the demography, prison experience, dental anxiety, oral health-related quality of life, and reported attendance of dental services. A dental examination was conducted using the International Caries Detection and Assessment System to diagnose obvious decay. A hierarchical logistic regression analysis was performed. 342 prisoners participated. When missing data were excluded, the final sample was 259. The regression analysis showed the following: Model 1 characterized the offenders by demography and prison experience, explaining 19% of the variance. Model 2 showed that an offender was 36% more likely to attend dental services for every unit change in the 5-point ranking scale of 'feeling irritable with people because of teeth, mouth, or dentures', explaining an additional 7% of the variance. Model 3 explained 35% of the variance, (i.e., an additional 9%) and was adopted as the final model to characterize offenders who access dental services when in prison. An offender who reported accessing prison dental services was 3.28 times more likely to be male. For each increase in the year of an offender's age, the offender was 5% more likely to access prison dental services. An 11% greater chance of accessing prison dental services for every experience of remand was also found. An offender was 32% more likely to access prison dental services for each increased level of irritability, and there was a 2 times higher likelihood of emergency dental services' attendance. There was a 19% lower chance of accessing prison dental services for each additional tooth affected by decay and a 13% greater chance of accessing prison dental services for each unit increase in missing teeth. In conclusion, this investigation identified factors associated with access to prison dental services in Scotland. The role of accessibility factors, such as the oral health impact of irritability, appeared to increase perceptions of dental need and promote dental services' attendance.
囚犯的口腔健康状况比非囚犯人群更差。众所周知，监狱环境会影响健康，因此，包括提供牙科护理在内的各项政策已到位，以在监禁期间促进健康。我们的目的是开展一项口腔健康和心理社会需求调查，以确定与苏格兰囚犯获得监狱牙科服务相关的因素。我们从一所男性高度设防监狱、一所女子监狱和一所青少年犯教养所中选取了一个便利样本。一份问卷调查了人口统计学信息、监狱经历、牙科焦虑、与口腔健康相关的生活质量以及报告的牙科服务就诊情况。使用国际龋病检测和评估系统进行牙科检查，以诊断明显的龋齿。进行了分层逻辑回归分析。342名囚犯参与了调查。排除缺失数据后，最终样本为259人。回归分析结果如下：模型1根据人口统计学信息和监狱经历对罪犯进行特征描述，解释了19%的方差。模型2表明，在“因牙齿、口腔或假牙而对人感到烦躁”的5分制量表中，每变化一个单位，罪犯接受牙科服务的可能性就增加36%，这又解释了7%的方差。模型3解释了35%的方差（即额外的9%），并被用作最终模型来描述在监狱中获得牙科服务的罪犯特征。报告获得监狱牙科服务的罪犯中男性的可能性是女性的3.28倍。罪犯年龄每增加一岁，其获得监狱牙科服务的可能性就增加5%。还发现，每次被还押候审，获得监狱牙科服务的可能性就增加11%。罪犯易怒程度每增加一级，其获得监狱牙科服务的可能性就增加32%，而就诊急诊牙科服务的可能性则高出2倍。每多一颗牙齿出现龋齿，获得监狱牙科服务的可能性就降低19%，每缺失一颗牙齿，获得监狱牙科服务的可能性就增加13%。总之，这项调查确定了与苏格兰囚犯获得监狱牙科服务相关的因素。诸如易怒对口腔健康的影响等可及性因素的作用似乎增加了对牙科需求的认知并促进了牙科服务的就诊。
