Editor’s note: While this blog follows Gideon Walletsky’s time in prison, it’s important to remember that many of his experiences are shared by thousands of inmates across the United States. From time to time, Gideon’s stories will serve as a starting point in examining larger issues in America’s prison system. This installment of Revealed takes a look at prison dental care.
For many people, a trip to the dentist is an open invitation for strangers to pry into their mouths with all sorts of medieval-looking implements. It’s a torture session at worst, an uncomfortable inconvenience at best. But for inmates with serious dental issues, the hope of healing overshadows the discomfort of going to the dentist.
A painful procedure
Gideon is currently trying to schedule an appointment for some not-so-routine dental work. Most of the teeth in the bottom of his mouth are missing; a few front teeth, an impacted wisdom tooth, and two back teeth (one on each side) are all that remain. During the appointment, the dentist will pull out the wisdom tooth and the two molars so Gideon can be fitted for dentures. To extract the wisdom tooth, the dentist will have to cut into Gideon’s gums and remove part of his jawbone.
Although Gideon hopes to be unconscious during the procedure, he’s fully aware that he probably will be given only local anesthesia. In addition, there’s a good chance he will turn down painkillers after the dental visit because of the side effects. In his prison, inmates typically are given a choice after medical procedures: take codeine or go without pain relief. Gideon is allergic to codeine, and the side effects are often worse than the pain. “Codeine makes me nutty,” he explained. “It makes [my] skin crawl, eyeballs itch.”
Gideon, only in his mid-40s, dreads the idea of living with dentures, but they’re necessary because his back teeth are in “pretty bad” shape. During visits with his family, he avoids getting chewy foods like beef jerky from the prison vending machines. “I haven’t been able to chew in a while,” he said.
Like most things in prison, dental care comes slowly. It takes Gideon about a month to see the dentist after putting in a request. He will have to wait about six months for his dentures after he is fitted for them, meaning he will be “chewing like a beaver” with his bottom front teeth in the meantime.
‘They guinea pig on us’
Gideon’s procedure won’t be performed at the prison or in a local dental office. Instead, to save money, the prison will transport him to a nearby “student clinic” for future dentists. Undergraduate dental students work under the supervision of licensed dentists to provide services.
The dental clinic is part of a medical college that allows future doctors and dentists to gain experience during their education. Gideon says that because many of the doctors and dentists are still in training, the care at the hospital is sometimes suspect. “They guinea pig on us,” he complained.
Inmates are put in handcuffs and leg shackles when they leave the prison for medical appointments, and two guards accompany each inmate. When possible, guards sneak inmates in and out of medical facilities through side doors. (Gideon will be taken in a back door when he visits the dentist.) If there is no side door, guards are forced to take inmates through the front door, where the public can see them. “I just do my shuffle,” Gideon quipped, referring to his gait while wearing leg shackles.
Dental issues common among prisoners
Dental issues are extremely common in prisoners, and many inmates’ dental problems predate their time in the penal system. A large number of inmates grew up in poor families and didn’t have access to quality dental care before going to prison. Others lack knowledge of proper dental hygiene. In addition, many prisoners come from backgrounds that encourage drug and tobacco use and heavy drinking, which contribute to dental issues. Gideon believes many of his dental issues are the result of his family’s history of bad teeth.
It’s worth noting that although Gideon has had his share of problems over the years, the care provided by his prison seems to be better than the care many inmates receive. He says inmates in his facility sometimes are given fillings instead of having teeth extracted at the first sign of trouble, a common approach in American prisons. Indeed, the chart below shows that prison dental care differs vastly from the care provided on the outside:
While you can’t say the dental care Gideon receives is the best, there are numerous stories of inmates being provided inadequate care or being denied care altogether:
- In several lawsuits, inmates alleged they were denied access to basic items like toothpaste and toothbrushes, resulting in lost teeth. In one case, a toothless inmate was denied a soft diet in retaliation for filing a legal claim, resulting in bleeding gums. In several other cases, inmates waited months for treatment of tooth decay, eventually resulting in pus coming from their eyes.
- A Michigan inmate filed a lawsuit claiming prisoners in that state often wait up to two years for partials or dentures.