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Dental care matters to everyone

Dentist Chair

I’m a member of staff in the Start360 AD:EPT service and this is the story of John and his teeth!

John has been a long term substance user since the age of 14; his use of substances varied from alcohol, amphetamines and cannabis to eventually being introduced to heroin.  John smoked heroin to begin with but after a while he started to use intravenously.  His lifestyle became unmanageable and he started to commit crime to fund his considerable habit; this ranged from stealing and burglary to driving unlicensed and uninsured cars to get his heroin.

Years of opiate use and personal neglect created a number of health and social problems for John.  He was placed on Opiate Substitute Therapy by the Community Addiction Team and was relatively stable in his recovery with occasional lapses.  John then came to prison and started working with Start360’s AD:EPT service on the psychosocial aspects of his substance use.  He identified confidence, low self-esteem, shame and embarrassment as major triggers for relapse. He stated he felt like a lesser person to other who he classed as ‘normal’ people, not only for being a criminal and a drug user but also because he had let his personal care decline so much he had periodontal disease and his teeth had decayed to a considerable extent (opiates, amphetamines and alcohol reduce the saliva production that protects against dental decay and periodontal diseases). John covered his mouth with his hand when talking and was socially impaired by not only his physical appearance but his emotional distress around this.

Through the work with AD:EPT, trust started to build and John disclosed the impact his decayed teeth were having on his mental health.  This trust was strengthened further when the AD:EPT worker overheard an incident of teasing on the landing with John about this.  The worker supported John in challenging this appropriately. He was feeling hopeless about his future and felt his teeth, lack of confidence and self-esteem, combined with his criminal record, would further decrease his rehabilitation opportunities. We decided to be proactive and approached Prison Health Care for help, explaining the situation and asking for help with a solution.

John had several consultations with the Prison Health Care Dentist in custody and it was agreed he would have new dentures fitted in custody.  This was a huge relief for John and, although anxious regarding the amount of dental work required, he was keen to get it started.

John now has a complete new set of dentures fitted.  The first day I saw him with these he could not contain his beautiful new smile.  He talked without covering his mouth with his hand and all his body language improved.  He is walking tall and looking younger, and so much happier. He is also more confident and positive regarding his future and he now believes in the possibilities he has ahead of him.  He is motivated for release, feels empowered in his recovery and is ready to start living his life.

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