A brush with the law – improving prisoners’ oral health

prisoner oral healthWe hear from the winner of Philips’ sponsored place on Victoria Wilson’s dental business course, Rachel Lawton about how she plans to improve prisoners’ oral health.

Rachel Lawton is a dentist who has worked for the prison services for more than 12 years, moving from part time to full time in 2012.

She currently works in a secure psychiatric unit, a medium secure psychiatric unit and six prisons at HMP Wymott and HMP Hindley.

Philips winner

When she was chosen as one of the winners of the Philips sponsored places on Victoria Wilson’s dental business course, Rachel was somewhat taken aback about why the proposed oral health promotion project she submitted in her application would possibly receive any attention.

Rachel’s working environment is far from glamorous; let alone the individuals she has to deal with.

Her patient-base is mainly criminals, gangsters, sex offenders of all ages and all spectrums of life. Many originate from areas of deprivation with poor education and chaotic lifestyles. Others have privileged upbringing as well as prestigious professions, but went astray at a point in their lives too.

Dental issues that practices typically address get compounded in prison with problems of alcohol, drugs, and eating disorders. There is a greater prevalence of physical and mental ill health.

Prisoners’ oral health

As Rachel explains: ‘There is undoubtedly a stigma with prisoners. I also feel that the profession tends to forget people like me because it is not a place you think of when you talk about dentistry and oral health promotion.

‘Nowadays it is all about practices that resemble boutique hotels or high tech start-ups with sleek streamlined processes and workflows. In our units, there is none of that.

‘We deal with a very heterogeneous group. In a setting that often exacerbates the difficulties we face for providing patient care and addressing health inequalities.

‘Whether they show you some gratitude or not, prisoners most certainly need our attention. This challenging environment is not an excuse to fail oral health inequalities. So I am here for the long haul.’

Rachel discussed her proposed oral health project with course director Victoria Wilson. She explained that her area of work appears neglected both in terms of research and oral health promotion.

She believes if we could do more work, it could improve prison dentistry in the long term.

Rachel hopes that she can explore forging links with other healthcare professionals to help bring her plans to fruition.

‘Bursting with ideas’

Victoria’s course provides an opportunity for Rachel to share ideas and brainstorm with her peers.

She knows how different prison dentistry is from mainstream dentistry. Institutionalised prisoners believe the dentist should do all the work for them.

Rachel wants to empower her patients to improve their own oral health, starting with understanding that it is their toothbrush, their oral health, their actions and lifestyles, and that they also need to take control of them.

In an environment where all control is rested from prisoners, this small step towards encouraging personal responsibility is a radical one (and actually not a million miles away from the preventive stance being adopted in mainstream dentistry).

Rachel says: ‘Before I started this course, it was difficult to process the idea in my mind. But with all these inspiring and motivational people who also join the course with me, and with Victoria’s guidance, I am now bursting with ideas and I am excited to see where I am heading for.

‘Thank you to Victoria and also to Philips for believing in me and supporting me. I hope I will not disappoint them! More to follow.’

We will subsequently report the second part of Rachel’s story, in which she describes the oral health project she is going to adopt in the prison system, at the conclusion of the course.

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