Unlike almost any other specialty area, correctional nurses get involved with inmate dental issues. Whether during intake assessment or as a sick call request, we must initiate treatment and referral for a variety of oral conditions. It is important to determine which are emergencies requiring an immediate dental evaluation and which can await a standard dental visit.
Inmate Dental Issues
Meth Mouth and other Drug Issues
Generally speaking any substance abuse is not good for mouth health. Drug abusers are not focused on dental care and often don’t even notice tooth pain until they are in jail and withdrawing. Mouth infections or abscesses can go on without notice while they have access to the drugs.
Meth mouth is a particularly unattractive mouth condition brought on by the common circumstances of methamphetamine use. The drug decreases the production of saliva, a natural tooth enamel protector. Meth users crave sugary drinks and foods and the drug induces clenching and grinding of the teeth which leads to cracking and wear.
Heavy drinking and smoking, common behaviors for the inmate population, are significant contributors to oral cancers. Chewing tobacco and snuff increase the risk of oral cancer by 80% according to a World Health Organization report. These products are popular with inmates in some parts of the country. Surprisingly, oral cancer is the sixth most common cancer in white males and the fourth most common in black males. Be alert for growths in the mouth when performing intake assessments and screenings. Common areas are under the tongue and the upper lip.
Poor nutrition, substance abuse, and negligent dental hygiene leads to oral infections. Left unattended, a simple oral condition can turn into a systemic emergency. Oral infections can encompass the entire face and extend to sinuses or lead to airway obstruction.
When is Emergency Treatment Needed?
Emergency treatment is needed for a dental condition any time the patient is having difficulty breathing or swallowing. If the mouth cannot be opened or there is facial space involvement, immediate treatment is necessary. A ‘toxic’ appearance with a high fever would also be an indicator. In any of these situations immediate intervention should be sought.
Have you experienced dental emergencies in your practice? Share your story in the comments section below.
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