More toothless Texas inmates to get dentures, not just pureed food

The Texas prison system is changing its denture policy — creating a dedicated denture clinic and hiring a prosthodontic specialist — in an effort to ensure that more inmates get teeth.

The move to amp up dental care comes after a Houston Chronicle investigation found that toothless and nearly toothless inmates in Texas prisons were routinely being denied dentures and instead offered pureed food.

“We want to see more dentures prescribed,’ said Dr. Lanette Linthicum, medical director for the Texas Department of Criminal Justice.

Aside from the new policy proposal and clinic creation, the prison system plans to review denture-related grievances from the past year and re-evaluate those prisoners who filed complaints, hold training for unit dentists to clarify when dentures are necessary, and put together a review board to look at who needs dentures and who doesn’t.

The changes — some of which are already underway — drew laudits from advocates, though some said the issue still speaks to the need for independent oversight of the prison system.

“It’s amazing,” said Doug Smith of the Texas Criminal Justice Coalition. “But it shouldn’t take this. I think TDCJ should want independent oversight as much as the community.”

State Sen. John Whitmire, D-Houston, said he is glad the state responded “correctly” but expressed disappointment that refusal to give dentures had ever been a problem in the first place.

“The state has a responsibility for the safety and welfare of the citizens we incarcerate,” he said. “I just expect them to provide proper care before I read about it in the Chronicle.”

In 2016, prison medical providers approved giving out 71 dentures to a population of more than 149,000 inmates, many of whom are elderly, have a history of drug use or came from impoverished backgrounds with sub-par dental care.

A year-long Chronicle investigation included correspondence from more than two dozen prisoners who told of their failed efforts to get teeth, their difficulties chewing, and their reluctance to switch to a diet of pureed cafeteria food — the alternative offered in most instances for those without teeth.

Some said they’d had all their teeth removed with the false promise of dentures to come. Others lost them over time, or came in with dentures that broke, only to learn that the prison system wouldn’t agree to replace them. Some filed grievances and request forms, but were repeatedly denied — sometimes by staffers citing policies no longer in place, other times by dentists claiming they couldn’t get teeth unless they became underweight.

The long-standing policy at the time only allowed for dentures in situations of “medical necessity” — and chewing didn’t count. One medical director framed the blended diet as a “better solution than the mastication and chewing process.” It was, he said, a “misunderstanding” that teeth were necessary, an assertion some correctional dental specialists disagreed with.

“Prison shouldn’t be just about bare physical survival,” Fred Cohen, a retired law professor who authored a book on Correctional Managed Health Care and the Law, said last month. “That’s the outer fringes of how a civilized society would operate.”

Although the prison system routinely revisits its policy, prison spokesman Jeremy Desel said over the summer that there were no changes expected at the time.

“The current dental prosthetic policy was last reviewed in April of last year,” he said then, “and there are no plans for it to be reviewed again in the future.”

But on Wednesday, that all changed. The system’s three medical directors and three dental directors met to discuss possible changes, and came away with a series of plans.

“We looked at our current policy on dental prosthetics and we made some changes,” Linthicum said. “I think the most significant change is that we went into more detail about what is a medical necessity.”

The new policy isn’t finished yet, but when asked whether the new language would expand the definition of medical necessity to be more expansive, Linthicum said, “That’s sincerely our hope.”

Though the prison system can implement the policy as soon as it’s done, the new language won’t be formally adopted until December, when the Correctional Managed Health Care Committee holds its next quarterly meeting.

Before then, though, there are other changes the prisons can make without additional approval. They’re already working on figuring out a site for a unit-based denture clinic, where prisoners could be fitted for prosthetics if unit dentists determine they qualify.

The department already has in place a similar system for some other medical needs, including glasses and prosthetic limbs.

To man the new clinic, the prison system will bring in a dentist who specializes in dentures, Linthicum said.

Officials will also put together two review boards — one for the facilities that receive healthcare from the University of Texas Medical Branch and another for the facilities that receive it from Texas Tech University Health Sciences Center. The boards will be made up of dentists who will evaluate the cases of prisoners in need of dentures.

One of the boards’ first tasks will be to evaluate all of the past year’s “Step 2” grievances — those inmate complaints that have escalated beyond an initial round of review — to figure out which ones might be good candidates for dentures.

That’s simply not true

Many people have bad teeth and or can’t afford good dental care which is expensive

Used to be most people lost thei teeth and got dentures

I’ve probanly spent 30,000 past 20 years on caps and veneers etc

My wife has never had a cavity

I brush more than she does....

Her teeth have plaque more which paradoxically protects them from caries

Life is hard on teeth

It’s a question of enamel and inflammation

It can be drugs like meth but my grandmothers didn’t do meth thst I’m aware of and both had chompers

Good dentistry is very expensive, and worth it, but paying more does not mean your get it. Some people on TV, especially news personalities, have extensive dental work that must have cost a fortune. Their teeth are supernaturally white, straight, and uniform, like a row of piano keys. That always looks fake to me, and sometimes I wonder if I’m not looking at a set of dentures. Good dental restoration should look natural, not obvious.

I’m sure. But the point isn’t whether people need dentures, it’s whether or not people need to be paying for yet other people’s dentures, especially under the threat of force by the government (IRS). And while certainly some people naturally lose their teeth, I’m quite positive that most prisoners most of the time lose their teeth, especially prematurely, to drugs. And finally, if prisoners are losing their teeth in old age, then the whole argument about providing them dentures so they can get a job when they get out falls apart. That’s the problem with conservatives, we want smaller government and lower taxes, right up until YOU have to pay for YOUR grandma’s dentures. Then, you want all the welfare the gov’mint can give you.

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