{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T16:02:05Z","timestamp":1791475325124,"version":"4.3.4"},"reference-count":33,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2019,2,1]],"date-time":"2019-02-01T00:00:00Z","timestamp":1548979200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100012095","name":"Scottish Government","doi-asserted-by":"publisher","award":["121.804485"],"award-info":[{"award-number":["121.804485"]}],"id":[{"id":"10.13039\/100012095","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Dentistry Journal"],"abstract":"<jats:p>Background: 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. Aim: Our aim was to conduct an oral health and psychosocial needs survey to identify the factors associated with accessing prison dental services in Scotland. Methods: A convenience sample of offenders from a male maximum security prison, a women\u2019s prison, and a young offenders\u2019 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. Results: 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 \u2018feeling irritable with people because of teeth, mouth, or dentures\u2019, 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\u2019s 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\u2019 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. Conclusions: 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\u2019 attendance.<\/jats:p>","DOI":"10.3390\/dj7010012","type":"journal-article","created":{"date-parts":[[2019,2,1]],"date-time":"2019-02-01T11:19:58Z","timestamp":1549019998000},"page":"12","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Factors Associated with Accessing Prison Dental Services in Scotland: A Cross-Sectional Study"],"prefix":"10.3390","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8733-1253","authenticated-orcid":false,"given":"Ruth","family":"Freeman","sequence":"first","affiliation":[{"name":"Dental Health Services Research Unit, University of Dundee, Dundee DD1 4HN, UK"},{"name":"Public Health, NHS Tayside, Dundee, DD2 1UB, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Derek","family":"Richards","sequence":"additional","affiliation":[{"name":"Centre for Evidence-based Dentistry, DHSRU, University of Dundee, Dundee DD1 4HN, UK"},{"name":"Dental Public Health South East Scotland, NHS Forth Valley, Stirling FK9 4SW, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2019,2,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1038\/sj.bdj.2014.548","article-title":"An overview of the prison population and the general health status of prisoners","volume":"217","author":"Heidari","year":"2014","journal-title":"Br. Dent. J."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"650","DOI":"10.4103\/2141-9248.139365","article-title":"Oral health status of a sample of prisoners in Enugu: A disadvantaged population","volume":"4","author":"Akaji","year":"2014","journal-title":"Ann. Med. Health Sci. Res."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1111\/j.1834-7819.2003.tb00006.x","article-title":"Oral health status of prison inmates\u2014New South Wales, Australia","volume":"48","author":"Osborn","year":"2003","journal-title":"Aust. Dent. J."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Guarnizo-Herre\u00f1o, C.C., Watt, R.G., Fuller, E., Steele, J.G., Shen, J., Morris, S., Wildman, J., and Tsakos, G. (2014). Socioeconomic position and subjective oral health: Findings for the adult population in England, Wales and Northern Ireland. BMC Public Health, 14.","DOI":"10.1186\/1471-2458-14-827"},{"key":"ref_5","unstructured":"Jones, C., McCann, M., and Nugent, Z. (2004, February 06). Scottish Prisons Dental Health Survey 2002, Available online: http:\/\/www.scotland.gov.uk\/Resource\/Doc\/47210\/0013527.pdf."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Heidari, E., Dickinson, C., Wilson, R., and Fiske, J. (2007). Oral health of remand prisoners in HMP Brixton, London. Br. Dent. J., 202.","DOI":"10.1038\/bdj.2007.32"},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Rodrigues, I.S., Silveira, I.T., Pinto, M.S., Xavier, A.F., de Oliveira, T.B., de Paiva, S.M., de Castro, R.D., and Cavalcanti, A.L. (2014). Locked mouths: Tooth loss in a women\u2019s prison in northeastern Brazil. Sci. World J., 2014.","DOI":"10.1155\/2014\/587469"},{"key":"ref_8","unstructured":"World Health Organization (2010, May 24). Europe Guide on Prison and Health. Available online: http:\/\/www.euro.who.int\/en\/health-topics\/health-determinants\/prisons-and health\/publications\/2014\/prisons-and-health."},{"key":"ref_9","unstructured":"Brutus, L., Mackie, P., Millard, A., Fraser, A., Conacher, A., Hardie, S., McDowall, L., and Meechan, H. (2013, January 15). Better Health, Better Lives for Prisoners: A Framework for Improving the Health of Scotland\u2019s Prisoners: Volume 1: The Framework. ScotPHN, Glasgow, 2012. Available online: http:\/\/www.scotphn.net\/pdf\/2012_06_08_Health_improvement_for_prisoners_vol_1_Final_(Web_version)1.pdf."},{"key":"ref_10","unstructured":"Everington, T. (2013, September 02). Healthier People Safer Communities: Working Together to Improve Outcomes for Offenders. Available online: https:\/\/www.scotphn.net\/wp-content\/uploads\/2015\/10\/Healthier-People-Safer-Communities-April-2013.pdf."},{"key":"ref_11","unstructured":"Freeman, R., Akbar, T., Buls, D., Edwards, M., Everington, T., Richards, D., Themessl-Huber, M., and Watt, C. (2012, September 25). The Oral Health and Psychosocial Needs of Scottish Prisoners and Young Offenders. Available online: http:\/\/dentistry.dundee.ac.uk\/sites\/dentistry.dundee.ac.uk\/files\/media\/SOHIPP-report.pdf."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"240","DOI":"10.1080\/19371918.2013.776415","article-title":"An exploration of women offenders\u2019 health literacy","volume":"29","author":"Donelle","year":"2014","journal-title":"Soc. Work Public Health"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1038\/sj.bdj.2014.646","article-title":"Multidisciplinary team working in an adult male prison establishment in the UK","volume":"217","author":"Heidari","year":"2014","journal-title":"Br. Dent. J."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1111\/j.1939-3938.2010.01079.x","article-title":"Oral health related quality of life among imprisoned Dutch forensic psychiatric patients","volume":"6","author":"Dijkstra","year":"2010","journal-title":"J. Forensic. Nurs."},{"key":"ref_15","first-page":"297","article-title":"Educated prisoners are less likely to return to prison","volume":"55","author":"Vacca","year":"2004","journal-title":"J. Correct. Educ."},{"key":"ref_16","first-page":"114","article-title":"Converting unmet need for care to effective demand","volume":"37","author":"Cohen","year":"1987","journal-title":"Int. Dent. J."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"306","DOI":"10.1111\/j.1600-0528.2012.00675.x","article-title":"What influences the use of dental services by adults in the UK?","volume":"40","author":"Marshman","year":"2012","journal-title":"Community Dent. Oral Epidemiol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"470","DOI":"10.1111\/cdoe.12097","article-title":"Does dental indifference influence the oral health-related quality of life of prisoners?","volume":"42","author":"Marshman","year":"2014","journal-title":"Community Dent. Oral Epidemiol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"E7","DOI":"10.1038\/sj.bdj.2011.682","article-title":"What motivates dentists to work in prisons? A qualitative exploration","volume":"211","author":"Smith","year":"2011","journal-title":"Br. Dent. J."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"783","DOI":"10.1037\/0021-9010.79.5.783","article-title":"Post hoc power analysis","volume":"79","author":"Gillett","year":"1994","journal-title":"J. Appl. Psychol."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Hill, K.B., Chadwick, B., Freeman, R., O\u2019Sullivan, I., and Murray, J.J. (2013). Adult Dental Health Survey 2009: Relationships between dental attendance patterns, oral health behaviour and the current barriers to dental care. Br. Dent. J., 214.","DOI":"10.1038\/sj.bdj.2012.1176"},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Humphris, G.M., Crawford, J.R., Hill, K., Gilbert, A., and Freeman, R. (2013). UK Population Norms for the Modified Dental Anxiety Scale with Percentile Calculator: Adult Dental Health Survey 2009 Results. BMC Oral Health, 13.","DOI":"10.1186\/1472-6831-13-29"},{"key":"ref_23","first-page":"40","article-title":"Psychometric properties of the modified dental anxiety scale: An independent replication","volume":"22","author":"Newton","year":"2005","journal-title":"Community Dent. Health"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1111\/j.1752-7325.2002.tb03415.x","article-title":"Developing short-form measures of oral health-related quality of life","volume":"62","author":"Locker","year":"2002","journal-title":"J. Public Health Dent."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1034\/j.1600-0528.2003.00051.x","article-title":"Validity of two oral health-related quality of life measures","volume":"31","author":"Robinson","year":"2003","journal-title":"Community Dent. Oral Epidemiol."},{"key":"ref_26","unstructured":"Scottish Government (2012, June 29). Prison Statistics and Population Projections Scotland: 2011-12, Available online: http:\/\/www.scotland.gov.uk\/Resource\/0039\/00396363.pdf."},{"key":"ref_27","unstructured":"NHS National Services Scotland (2018, October 29). National Dental Inspection Programme. Available online: http:\/\/www.isdscotland.org\/Health-Topics\/Dental-Care\/National-Dental-Inspection-Programme\/."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1111\/j.1600-0528.2007.00347.x","article-title":"The International Caries Detection and Assessment System (ICDAS): An Integrated System for Measuring Dental Caries","volume":"35","author":"Ismail","year":"2007","journal-title":"Community Dent. Oral Epidemiol."},{"key":"ref_29","unstructured":"ICDAS Foundation (2012, September 25). International Caries Detection and Assessment System. Available online: https:\/\/www.icdas.org\/."},{"key":"ref_30","unstructured":"International Caries Detection and Assessment System (ICDAS) Coordinating Committee (2012, September 25). Criteria Manual International Caries Detection and Assessment System. Available online: https:\/\/www.icdas.org\/uploads\/ICDAS%20Criteria%20Document%20corrected%202013.pdf."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1016\/j.disamonth.2014.04.005","article-title":"Dental care in corrections","volume":"60","author":"Costa","year":"2014","journal-title":"Dis. Mon."},{"key":"ref_32","unstructured":"Allen, J., Goldblatt, P., Daly, S., Jabbal, J., and Marmot, M. (2019, January 08). Reducing Health Inequalities through New Models of Care: A Resource for New Care Models. Available online: http:\/\/www.instituteofhealthequity.org\/resources-reports\/reducing-health-inequalities-through-new-models-of-care-a-resource-for-new-care-models."},{"key":"ref_33","unstructured":"NHS Health Scotland (2018, December 10). Mouth Matters Guide to Trainers: Better Oral Care for Offenders. Available online: http:\/\/www.knowledge.scot.nhs.uk\/media\/CLT\/ResourceUploads\/4086716\/a2b802de-6f65-4594-b749-01cfe0f5b9e4.pdf."}],"container-title":["Dentistry Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2304-6767\/7\/1\/12\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T12:30:30Z","timestamp":1760185830000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2304-6767\/7\/1\/12"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,2,1]]},"references-count":33,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2019,3]]}},"alternative-id":["dj7010012"],"URL":"https:\/\/doi.org\/10.3390\/dj7010012","relation":{},"ISSN":["2304-6767"],"issn-type":[{"value":"2304-6767","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,2,1]]}}}