Oral health and background characteristics in a prison population: the PriOH study
DOI:
https://doi.org/10.2340/aos.v85.45307Keywords:
Incarceration, social determinants of health, dental anxiety, DMF index, preventive dentistryAbstract
Objectives: The Nordic welfare state aims for social security and equality. However, incarcerated people often face vulnerable situations impacting oral health. This study describes oral health and background characteristics of incarcerated people in Norway and explored differences between Nordic and non-Nordic origins.
Material and methods: This cross-sectional study included 326 participants from four prisons in Norway. Dental personnel conducted visual oral examinations and collected questionnaire data on sociodemographic, socioeconomic and health-related background, self-reported oral health and dental anxiety.
Results: The population mainly consisted of young (mean 36.9 ± 11.8) men (95.4%). Almost half had low education (46.4%), reported financial difficulties (37.8%), lacked labor market attachment (45%), and over half (54.8%) experienced physical pain. Dental services were irregularly used (56.2%), and dental anxiety was prominent (39%). Almost half reported poor oral health (46.5%) and clinical measures (mean decayed, missing and filled teeth [DMFT] 11.4 ± 7.4) revealed decayed teeth in four of 10 individuals (39.8%). Group differences showed that non-Nordic individuals had stronger labor market attachment, fewer health challenges, and less caries experience than Nordic individuals.
Conclusion: Diverse socioeconomic backgrounds, untreated caries, poor self-reported oral health, dental anxiety, and irregular dental attendance were common. The group disparities challenge the equity goals of the Nordic Welfare state.
Downloads
References
Hakeberg M, Wide Boman U. Self-reported oral and general health in relation to socioeconomic position. BMC Public Health. 2017;18(1):63. https://doi.org/10.1186/s12889-017-4609-9 DOI: https://doi.org/10.1186/s12889-017-4609-9
Sabbah W, Tsakos G, Chandola T, Sheiham A, Watt RG. Social Gradients in oral and general health. J Dent Res. 2007;86(10):992–6. https://doi.org/10.1177/154405910708601014 DOI: https://doi.org/10.1177/154405910708601014
World Health Organization. Closing the gap in a generation: health equity through action on the social determinants of health: final report of the commission on social determinants of health. Geneva: World Health Organization; 2008. Report No.: ISBN 978-92-4-156370-3.
Solar O, Irwin A. A conceptual framework for action on the social determinants of health. Geneva: World Health Organization; 2010. Report No.: ISBN 978-92-4-150085-2.
World Health Organization. Operational framework for monitoring social determinants of health equity. Geneva: World Health Organization; 2024. Report No.: ISBN 978-92-4-008832-0.
Pedersen AW, Kuhnle S. The Nordic welfare state model. In: Knutsen OP, editor. The Nordic models in political science: challenged, but still viable? Bergen: Fagbokforlaget; 2017. p. 1–20.
Norwegian act relating to dental health services. Lov om tannhelsetjenesten [Act on the dental health service], LOV-1983-06-03-54 (1983). Last updated: LOV-2024-06-25-54 from 01/7-24. [cited 2025 Jan 10]. Available from https://lovdata.no/dokument/NL/lov/1983-06-03-54?q=tannhelse
Goldblatt P, Castedo A, Allen J, Lionello L, Bell R, Marmot IM, et al. Rapid review of inequalities in health and wellbeing in Norway since 2014 – full report. London: Institute of Health Equity, University College of London; 2023 [cited 2025 Apr 06]. Available from https://www.instituteofhealthequity.org/resources-reports/rapid-review-of-inequalities-in-health-and-wellbeing-in-norway-since-2014/read-the-full-report.pdf
Peres MA, Macpherson LMD, Weyant RJ, Daly B, Venturelli R, Mathur MR, et al. Oral diseases: a global public health challenge. Lancet. 2019;394(10194):249–60. https://doi.org/10.1016/s0140-6736(19)31146-8 DOI: https://doi.org/10.1016/S0140-6736(19)31146-8
Amaya A, Medina I, Mazzilli S, D’Arcy J, Cocco N, Van Hout M-C, et al. Oral health services in prison settings: a global scoping review of availability, accessibility, and model of delivery. J Community Psychol. 2023;52(8):1108–37. https://doi.org/10.1002/jcop.23081 DOI: https://doi.org/10.1002/jcop.23081
Enggist S, Møller L, Galea G, Udesen C, editors. Prisons and health. Copenhagen: WHO Regional Office for Europe; 2014. [cited 2025 Oct 14]. Available from: https://www.unodc.org/documents/hiv-aids/publications/Prisons_and_other_closed_settings/2014_WHO_UNODC_Prisons_and_Health_eng.pdf.pdf
Tran NT, Baggio S, Dawson A, O’Moore É, Williams B, Bedell P, et al. Words matter: a call for humanizing and respectful language to describe people who experience incarceration. BMC Int Health Hum Rights. 2018;18(1):41. https://doi.org/10.1186/s12914-018-0180-4 DOI: https://doi.org/10.1186/s12914-018-0180-4
Evensen KB, Bull VH. Oral health in prison: an integrative review. Int J Prison Health. 2022;19(2):251-269. https://doi.org/10.1108/IJPH-08-2021-0081 DOI: https://doi.org/10.1108/IJPH-08-2021-0081
Hurlen B, Jacobsen N, Hurlen P. Hepatitis B serum markers and oral health in a group of Norwegian male prisoners. Acta Odontol Scand. 1984;42(1):53–8. https://doi.org/10.3109/00016358409041132 DOI: https://doi.org/10.3109/00016358409041132
Korkosz R, Trzcionka A, Hildebrandt T, Kiełbratowski M, Kuśka-Kiełbratowska A, Rahnama M, et al. Oral findings in male prisoners: a systematic review. J Clin Med. 2024;13(6):1736. https://doi.org/10.3390/jcm13061736 DOI: https://doi.org/10.3390/jcm13061736
Bryne E, Bergum KH, Gjedrem WG. Improving Oral Health in Prisons (PriOH): protocol for a randomized controlled trial. JMIR Res Protoc. 2024;13:e60817. https://doi.org/10.2196/60817 DOI: https://doi.org/10.2196/60817
World Health Organization. Oral health surveys: basic methods - 5th edition. Geneva: World Health Organization; 2013. Report No.: ISBN: 978-92-4-154864-9
Humphris GM, Freeman R, Campbell J, Tuutti H, D’Souza V. Further evidence for the reliability and validity of the Modified Dental Anxiety Scale. Int Dent J. 2000;50(6):367–70. https://doi.org/10.1111/j.1875-595X.2000.tb00570.x DOI: https://doi.org/10.1111/j.1875-595X.2000.tb00570.x
Humphris GM, Morrison T, Lindsay SJ. The Modified Dental Anxiety Scale: validation and United Kingdom norms. Community Dent Health. 1995;12(3):143–50.
Vainionpää R, Pesonen P, Laitala M-L, Pohjola V, Anttonen V. Dental fear and dental health and attendance among Finnish Male Prisoners. J Oral Maxillofac Res. 2019;10(4):e4. https://doi.org/10.5037/jomr.2019.10404 DOI: https://doi.org/10.5037/jomr.2019.10404
Nermo H, Willumsen T, Rognmo K, Thimm JC, Wang CEA, Johnsen J-AK. Dental anxiety and potentially traumatic events: a cross-sectional study based on the Tromsø Study-Tromsø 7. BMC Oral Health. 2021;21(1):600. https://doi.org/10.1186/s12903-021-01968-4 DOI: https://doi.org/10.1186/s12903-021-01968-4
Svensson I. Reading and writing disabilities among inmates in correctional settings. A Swedish perspective. Learn Individ Differ. 2011;21(1):19–29. https://doi.org/10.1016/j.lindif.2010.08.002 DOI: https://doi.org/10.1016/j.lindif.2010.08.002
Lyshol H, Grotvedt L, Fagerhaug TN, Feuerherm AJ, Jakhelln G, Sen A. A study of socio-economic inequalities in self-reported oral and general health in South-East Norway. Sci Rep. 2022;12(1):13721. https://doi.org/10.1038/s41598-022-18055-5 DOI: https://doi.org/10.1038/s41598-022-18055-5
Tsakos G, Watt RG, Guarnizo‐Herreño CC. Reflections on oral health inequalities: theories, pathways and next steps for research priorities. Community Dent Oral Epidemiol. 2023;51(1):17–27. https://doi.org/10.1111/cdoe.12830 DOI: https://doi.org/10.1111/cdoe.12830
Soares M, Gonçalves M, Rompante P, Salazar F, Monteiro L, Pacheco J-J, et al. Assessment of oral health status in a prison population in Northern Portugal. J Clin Exp Dent. 2023;15(11):e912–9. https://doi.org/10.4317/jced.60551 DOI: https://doi.org/10.4317/jced.60551
Vainionpää R, Peltokangas A, Leinonen J, Pesonen P, Laitala M-L, Anttonen V. Oral health and oral health-related habits of Finnish prisoners. BDJ Open. 2017;3(1):1–5. https://doi.org/10.1038/bdjopen.2017.6 DOI: https://doi.org/10.1038/bdjopen.2017.6
Kondratyev SA, Turkina AY, Franco A, Budinas TV, Ovsienko AG. Prevalence of oral diseases and the assessment of the simplified oral hygiene, decayed-missing-filling and community periodontal indices among inmates of the Russian Federation. Bioscience. 2019;35(2):666–73. https://doi.org/10.14393/BJ-v35n2a20198-43408 DOI: https://doi.org/10.14393/BJ-v35n2a20198-43408
Priwe C, Carlsson P. Oral health status of male swedish citizens at admission to prison. J Correct Health Care. 2018;24(4):382–94. https://doi.org/10.1177/1078345818792243 DOI: https://doi.org/10.1177/1078345818792243
Freeman R, Richards D. Factors associated with accessing prison dental services in Scotland: a cross-sectional study. Dent J (Basel). 2019;7(1):12. https://doi.org/10.3390/dj7010012 DOI: https://doi.org/10.3390/dj7010012
Berisha N, Sejdini M, Begzati A, Zajmi L, Krasniqi L, Rimondini L. Oral health of lipjan convicts: Kosovo Prison House. Int J Dent. 2018;2018:1–7. https://doi.org/10.1155/2018/6529658 DOI: https://doi.org/10.1155/2018/6529658
Dahl KE, Wang NJ, Skau I, Ohrn K. Oral health-related quality of life and associated factors in Norwegian adults. Acta Odontol Scand. 2011;69(4):208–14. https://doi.org/10.3109/00016357.2010.549502 DOI: https://doi.org/10.3109/00016357.2010.549502
Hadler-Olsen E, Jönsson B. Oral health and use of dental services in different stages of adulthood in Norway: a cross sectional study. BMC Oral Health. 2021;21(1):257. https://doi.org/10.1186/s12903-021-01626-9 DOI: https://doi.org/10.1186/s12903-021-01626-9
Haysom L, Indig D, Byun R, Moore E, van den Dolder P. Oral health and risk factors for dental disease of Australian young people in custody. J Paediatr Child Health. 2015;51(5):545–51. https://doi.org/10.1111/jpc.12761 DOI: https://doi.org/10.1111/jpc.12761
Janssen PA, Korchinski M, Desmarais SL, Albert AYK, Condello LL, Buchanan M, et al. Factors that support successful transition to the community among women leaving prison in British Columbia: a prospective cohort study using participatory action research. CMAJ Open. 2017;5(3):E717–23. https://doi.org/10.9778/cmajo.20160165 DOI: https://doi.org/10.9778/cmajo.20160165
Stein L, Bondø T, Endresen EH, Berggren T. Oral health services in Norwegian prisons. A survey among dentist and prison staff. Nor Tannlaegeforen Tid. 2022;2022(132):616–23. DOI: https://doi.org/10.56373/2022-8-3
Heidari E, Dickinson C, J F. An investigation into the oral health status of male prisoners in the UK. J Disabil Oral Health. 2008;9(1):3–12.
Relvas M, Rocha L, Rompante P, Salazar F, Monteiro L, Vinhas AS, et al. Oral lesions and disorders and their prevalence arising from the use of illicit drugs in a prison population. Acta Odontol Scand. 2025;84:37–46. https://doi.org/10.2340/aos.v84.42721 DOI: https://doi.org/10.2340/aos.v84.42721
Arora G, Humphris G, Lahti S, Richards D, Freeman R. Depression, drugs and dental anxiety in prisons: a mediation model explaining dental decay experience. Community Dent Oral Epidemiol. 2020;48(3):248–55. https://doi.org/10.1111/cdoe.12522 DOI: https://doi.org/10.1111/cdoe.12522
Indregard A-MR, Ihlebæk CM, Eriksen HR. Modern health worries, subjective health complaints, health care utilization, and sick leave in the Norwegian working population. Int J Behav Med. 2013;20(3):371–7. https://doi.org/10.1007/s12529-012-9246-1 DOI: https://doi.org/10.1007/s12529-012-9246-1
Eriksen HR, Svendsrod R, Ursin G, Ursin H. Prevalence of subjective health complaints in the Nordic European countries in 1993. Eur J Public Health. 1998;8(4):294–8. https://doi.org/10.1093/eurpub/8.4.294 DOI: https://doi.org/10.1093/eurpub/8.4.294
Ihlebæk C, Eriksen HR, Ursin H. Prevalence of subjective health complaints (SHC) in Norway. Scand J Public Health. 2002;30(1):20–9. https://doi.org/10.1177/14034948020300010701 DOI: https://doi.org/10.1177/14034948020300010701
Bergum KH, Bull VH, Stein LM, Evensen KB. Prisoners’ perceived oral and general health and their experience with accessing, understanding and assessing health information: a qualitative study. Eur J Oral Sci. 2024;132(2):e12972. https://doi.org/10.1111/eos.12972 DOI: https://doi.org/10.1111/eos.12972
Becker T, Levin L, Shochat T, Einy S. How much does the DMFT index underestimate the need for restorative care? J Dent Educ. 2007;71(5):677–81. https://doi.org/10.1002/j.0022-0337.2007.71.5.tb04324.x DOI: https://doi.org/10.1002/j.0022-0337.2007.71.5.tb04324.x
Additional Files
Published
Issue
Section
License
Copyright (c) 2026 Kathrine Høyvik Bergum, Emilie Bryne, Linda Maria Stein
This work is licensed under a Creative Commons Attribution 4.0 International License.
Acta Odontologica Scandinavica publishes high quality original research papers as well as critical reviews relevant on diseases of the oral cavity, their treatment, epidemiology and associated biomaterials and their development.
