One of the first things I discovered when I started in corrections was the importance of teeth. Frankly, I did not think much about these handy items while in nursing school and, working in critical care and orthopaedics before going behind bars, I didn’t have much opportunity to consider them. In addition, my patient population was generally middle-class and affluent, in comparison to my correctional patient population. Needless to say, I had a fiery baptism into the crazy world of dental issues.
Why are dental conditions a concern for correctional nurses? First of all, nurses end up being the first person an inmate sees about a dental concern. This is usually at a receiving screening or through the nursing sick call process. So, nurses must be able to determine the nature of the issue and make a decision about urgency of treatment. A dental episode might be remedied with instruction on self-treatment, may need assignment to the next available dental appointment, may need urgent evaluation by a dentist, or may need emergency treatment in the acute care setting. It requires significant clinical judgment abilities to appropriately manage dental issues.
Another reason dental conditions are a concern for correctional nurses is because there are so many of them in our patient population. Our patients are less likely to have received dental care in the past and many have a lifestyle that does not include high levels of dental hygiene. Therefore dental decay and periodontal disease are seen frequently. Our patients come from violent backgrounds that can result in tooth trauma. They also indulge in high levels of alcohol, tobacco, and drug use. All these substances have a negative effect on dental health. Methamphetamine use, in particular, can cause severe dental erosion and decay. Self-medicating with alcohol and drugs can mask tooth pain. Once incarcerated and withdrawn from these substance, inmates feel increasing mouth pain that leads to dental requests for evaluation and treatment.
Finally, systemic chronic conditions and infections affect dental health. Nurses who understand the relationship of dental conditions to systemic disease can often activate medical evaluation when a dental manifestation is observed. For example, canker sores or herpes can appear on the mouth of an immunosuppressed individual and periodontal infection can exacerbate blood glucose levels in diabetics.
What have you discovered about dental conditions as a correctional nurse? Share your experiences in the comments section of this post.
Read more about dental issues for correctional nurses in Chapter 7: Dental Conditions from Essentials of Correctional Nursing. Order your copy directly from the publisher. http://www.springerpub.com/product/9780826109514#.UDqoiNZlQf4
Photo Credit: © vladimirfloyd – Fotolia.com