Oral Care

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If a juvenile is already under the care of a community dentist, has seen the dentist recently and then is admitted to a detention center, does the youth still need a dental exam within 60 days?

Yes, an oral examination by a licensed dentist would still be required. The E-06 Oral Care standard for juvenile detention and confinement facilities states that an oral examination is performed by a dentist within 60 days of admission. An oral examination by a licensed dentist includes taking or reviewing the patient’s oral history, an extraoral head and neck examination, charting of teeth and examination of the hard and soft tissue of the oral cavity with a mouth mirror, explorer and adequate illumination.

However, if a juvenile who has received an oral examination in the correctional system within the past year is readmitted, a new exam is not required except as determined by the supervising dentist. The intent of this standard is that juvenile’s serious dental needs are met. Oral care is an important component of an individual’s overall health care. Poor oral health has been linked to numerous systemic diseases.
From CorrectCare Volume 31, Issue 1, Winter 2017

 
 

If an inmate wants to see the dentist for a cleaning or filling and is experiencing no pain, and thus does not want or need a nurse to evaluate the need, do the standards require the nurse to see the patient before letting the patient see the dentist?

There are a couple of standards that must be considered. Standard J-E-06 Oral Care requires that oral treatment, not limited to extractions, is provided according to a treatment plan based on a system of established priorities for care when, in the dentist’s judgment, the inmate’s health would otherwise be adversely affected. Standard J-E-07 Nonemergency Health Care Requests and Services requires that oral or written requests for health care are received daily by qualified health care professionals and triaged within 24 hours. Based on physician-approved protocols, qualified health care professionals schedule inmates, when indicated, for sick call or the next available clinician’s clinic. Not every sick call request requires a sick call appointment; however, when a request describes a clinical symptom, a face-to-face encounter between the inmate and the health care professional is required.

If the request you described does not include a clinical symptom, then a face-to-face visit would not be required by the Standards. I would advise working closely with the dentist at your facility to determine the appropriate response to requests for fillings or cleanings.

From CorrectCare Volume 28, Issue 1, Winter 2014

 
 

I work for a prison that accepts transfers from the state intake facility. Since the inmates are already in our system, we assume they do not need to have an oral exam within 30 days. At the intake facility, the oral screenings are done well within seven days.

It’s great that your oral screenings are done in a timely fashion, but standard P-E-06 Oral Care also requires an examination. If the health records document that an oral exam has been done within 30 days of the inmate’s admission to the intake facility/system, we would not expect your facility to repeat that exam. If an oral exam by a dentist is not being completed elsewhere (or there is no documentation that it was done), then your facility should be doing it within 30 days of inmates’ admission to your site.
— From CorrectCare Volume 26, Issue 2, Spring 2012

 
 

Our jail houses both state and county inmates. During a recent state inspection a question arose as to why we were not supplying dental floss to the state prisoners. The jail regulations say nothing about us having to provide dental floss. Someone said it was a potential weapon and could not be used. Someone else remembered that we once had samples of a special floss that was apparently OK to use in secure environments, but we cannot find the samples or the vendor. Does NCCHC require that inmates be given dental floss? What about the “potential weapon” aspect? Do you know of any vendors?

The NCCHC jail standards do not require that dental floss be provided to all inmates. The relevant standard is J-E-06 Oral Care. However, a facility’s responsible dentist may recommend use of dental floss as a good oral health practice. Also, as with any other prescribed health intervention, dental floss would be required under the standards if the responsible dentist or physician indicated a need for an inmate to use the floss for a specific health reason.

As to whether dental floss could or should be considered a potential weapon or contraband, this determination is to be made by the local correctional authorities. If this is the case and a dentist prescribes dental floss for an inmate, appropriate accommodations or alternatives would need to be made (J-A-03 Medical Autonomy).

Since you indicate that this issue came up during a state inspection, it is possible that your state regulations require correctional authorities to provide dental floss. Your state contact to the jail should be able to advise you.

If the state does require dental floss, the state prison system’s medical or dental director should be able to identify a vendor that sells a product appropriate for a correctional environment.
— From CorrectCare Volume 18, Issue 4, Fall 2004; updated February 2010