Por:
Arianna Alexandra Amaya Rodríguez
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Fecha:
2023
Abstract:
Changes in demographics and epidemiology have made non-communicable diseases (NCDs) a global and highly relevant problem. Globally, oral diseases cause serious health and economic burdens, leading to a substantial reduction in quality of life for those affected. Oral diseases and other NCDs share modifiable risk factors, including tobacco use, harmful use of alcohol and unhealthy diets, as well as the same socioeconomic determinants. The oral cavity provides valuable insights into overall health, as systemic diseases such as diabetes, HIV/AIDS, and autoimmune disorders often presents oral manifestations. However, in prison settings, where access to healthcare is limited and challenging as a human right, individuals experience exacerbated oral health outcomes and complications.
Oral health status serves as a mirror of overall health, highlighting the interconnectedness between oral health and general well-being. The involvement of health authorities in prison settings plays a significant role in promoting and maintaining optimal oral health, which in turn has a profound impact on the physical and mental health of PLP. The World Health Organization's Oral Health Report of 2022 emphasizes the importance of addressing oral health inequalities as a crucial step in achieving fairness and implementing preventive interventions. Therefore, coherent and comprehensive regulation and legislation in oral health are needed to achieve social justice, ethical public health policies and professional practice. This study used a combination of methods with a focus on qualitative research. The first phase involved following the guidelines set out in “Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA)” to conduct a comprehensive and systematic scoping review addressing the primary and secondary objectives of the study. The third objective was covered by semi structured interviews involving purposive sampling, identified by three target groups: dentist personnel working in prisons; prison health experts; harm reduction policymakers, to gain insight from global prison health experts on potential areas of improvement for oral health in prison. In the first phase of this study, scientific articles published between January and August 2022 were gathered and reviewed. Subsequently, in 2023, a series of interviews were conducted involving fifteen participants. Ethical approval for the study was obtained from the Ethics Committee of the Ruprecht Karls Faculty of Medicine in Heidelberg (S 288/2023). The data collection instrument was carefully designed to accommodate the specific profiles of the participants, all owing for necessary adjustments to ensure the relevance and effectiveness of the study. Online in depth semi structured interviews were conducted via Zoom with relevant health prison experts. The combination of inductive and deductive approaches was used to design the study, collect and analyze data, and answer the research questions. The major findings of this study shed light on the persistent neglection of oral health into the health systems across different settings. Challenges and limitations in addressing oral health in prison, remains with a focus on the provision of emergency treatments and dental mutilations as services provided instead of conservatives approaches. Comprehensive and specialized dental care is necessary to avoid burdens on the health system, mostly from preventable oral disorders. Oral care and basic dental hygiene are still on the list of necessities in prison settings, as well as lack of resources, committed staff, and infrastructure to support the delivery of comprehensive dental services in prisons. In order to increase access to quality dental care, address oral health disparities, and promote the overall well-being of PLP, policy reforms, capacity building, and collaboration are necessary.
