Abstract
BACKGROUND: People living in prison face exceptionally high prevalence rates of tooth decay, periodontal disease, and poor oral health-related quality of life. Despite its importance, various aspects of oral healthcare in prison settings remain understudied. The present study investigates the barriers and facilitators associated with providing and utilizing oral health services in prison settings, drawing on insights from prison health experts, managerial and custodial staff, healthcare providers, and individuals with lived experience of imprisonment. METHODS: From March to June 2023, a total of fifteen participants participated in semi-structured in-depth interviews. Interviews were conducted until data saturation to identify barriers and facilitators of oral health services in prisons. Potential areas for improvement were also explored. Thematic analysis was used to analyze the data. Themes and sub-themes were derived from the dataset and converted into preliminary codes which aligned with research objectives. RESULTS: The first topic, barriers, included two themes: organizational barriers related to the provision of services, and individual barriers related to the utilization of services. The second topic, facilitating factors, included six themes: funding, community partnership, substance use treatment, communicating with policy makers, transportation, and education. CONCLUSION: Ensuring the oral health of incarcerated individuals is a fundamental aspect of their right to health and a crucial factor in their successful reintegration into society. Formerly incarcerated people are often hard to reach in the community, making the period of confinement a unique opportunity to deliver quality oral healthcare. Given that most incarcerated individuals will eventually return to their communities, providing comprehensive healthcare, including oral health interventions, represents a valuable public health investment.