Dental torture – ‘tangible negligence by government officials’

The Human Rights Data Project defines torture as:

“The purposeful inflicting of extreme pain, whether mental or physical, by government officials or by private individuals at the instigation of government officials. This includes the use of physical and other force by police and prison guards that is cruel, inhuman, or degrading, and deaths in custody due to tangible negligence by government officials.” 

This post, ‘80% of countries use torture – New Zealand is one of them, explains that democracies tend to use ‘clean’ torture techniques that leave no physical signs of abuse. It also explains that psychological torture techniques produce similar levels of post-traumatic stress disorder as physical torture.  This link describes the psychological impact of the Corrections Department’s Medicines Policy which actively discourages prison doctors from prescribing opiate painkillers and other medications to prisoners – leaving them in severe pain and often forcing them into withdrawal.

Minimum dental services policy

Corrections also discourages dentists from providing proper dental care to prisoners.  In 2012, the Ombudsman issued a 157 page report titled: Investigation of the Department of Corrections in relation to the Provision, Access and Availability of Prisoner Health Services. It was highly critical of the Department pointing out that nearly half of the country’s 8,500 prisoners reported problems with their teeth. It said:

“Prisoners have high dental health needs, possibly caused by increased levels of neglect of oral care, high rates of substance abuse, smoking and underlying poor nutrition. Prisoners vary in their ability and motivation to take care of their own oral health, often entering prison with a previously chaotic lifestyle. “

Management at Corrections don’t care. They have what the Ombudsman calls a ‘minimum dental services policy’ which is similar to their ‘discouraged medication policy’.  The ‘minimal services’ are supposedly justified by Section 81 of the Corrections Regulations 2005 which states:

“Any examination or treatment must be primarily concerned with the relief of pain,  the maintenance of a reasonable standard of dental care relative to the dental and oral health of the prisoner concerned before the prisoner was admitted to the prison, or both.” 

The Department interprets this regulation to mean that if inmates had poor dental care prior to coming to prison, it will continue to provide poor dental care.  For most prisoners, all the Department offers is low level pain relief.  Prisoners with tooth decay or toothache inform the prison nurse who (may or may not) put them on a waiting list. For prisoners on the list, no matter how bad the pain, all the nurses will provide is panadol.  That’s because the ‘discouraged medication policy’ inhibits doctors from prescribing strong pain killers.

Extraction is the standard procedure

Dental tortureWhen a prisoner finally gets to see the dentist, all the dentist is allowed to do is extract the offending tooth.  Amalgam fillings are not permitted for offenders who came into prison with bad teeth.  In The Effects of Imprisonment on Inmates and their Families Health and Wellbeing, Dr Michael Roguski says:

“This restrictive eligibility criterion was said to result in tooth extraction as the standard form of prison dental treatment. In a number of cases, participants indicated that teeth are extracted regardless of whether tooth restoration, such as a filling, is the more appropriate or the easier course of action.”

Sometimes even extraction is not available.  This painful policy is more likely to be applied to short term prisoners. Those who are going to be released within 12 months usually get no dental treatment at all. One inmate described his ordeal to the Ombudsman like this:

“I put in a chit to see a nurse about my tooth which was decayed. She declined to put me on the dentist’s list. Some months later, I saw the nurse again because it was sore at night. She told me to take Panadol. My tooth finally abscessed and, when I saw the nurse, I was told that because I was getting out soon, I could see a dentist then.”

The reality is that 80% of the 20,000 people who end up in prison each year are released within 12 months.  Panadol is ‘dished out like lollies’ but opiate pain killers are not allowed. If prisoners are in severe pain, they may be lucky enough to have the tooth extracted, but that’s all. No attempt is made to provide fillings or save the tooth before it needs to be extracted.

Long waiting lists

The rules are slightly different for the 20% of inmates who are in prison for more than 12 months. But even for this group of prisoners, getting to see a dentist in prison is still extremely difficult.  The Department has difficulty even finding dentists who are willing to work in prison. In 2012 the Ombudsman reported that no dentists were available in Christchurch and a Wellington dentist had to be flown down to provide dental care at all three Canterbury prisons.

Arohata women’s prison has never had a dentist.  Once a fortnight, female prisoners at Arohata are transported to the health centre at Rimutaka prison to see the dentist. On dental days, the Rimutaka Health Centre is closed (to males needing medical attention), because female prisoners are not allowed to mix with male prisoners.

At other prisons there are long waiting lists. As a result, some prisoners resort to pulling out their own teeth. One prisoner described his experience to Dr Roguski like this:

Last year I filled in a form in July. I didn’t get seen till just before Christmas. But by then I’d already pulled it out myself. They’d given me Panadol and cloves, but that was no good. It was too painful. I couldn’t eat I was in so much pain. I was losing weight. I’ve pulled three out myself so far. (Timaiti, Māori man, 40–50 years)

The Ombudsman concluded:

“Very few prisoners we spoke to commented favourably in respect to dental services. At the prisons we visited, prisoners regularly complained about delays in dental treatment. Not only did they complain about suffering pain during such delay, but referred to additional dental problems such as infection and abscess by reason of the delay.”

“The length of waitlists for prisoners requiring dental treatment indicates a failure to meet the Department’s Performance Standard B.06 (Dental Care) that states: “the dentist’s practice hours are adequate to meet the prescribed minimum dental services for each prisoner”. It would appear that the dental service is not being resourced at a level which reflects the high levels of dental need which exist in New Zealand prisons.”

What the Ombudsman should have said is that the Department spends $1 billion a year on containment and security but is incredibly reluctant to spend money on ensuring that prisoners have adequate dental care. This reluctance causes intense suffering for thousands of prisoners on a daily basis. It constitutes cruel, inhumane and degrading treatment and is a breach of the Department’s duty of care.

The reality is that withholding treatment from patients in severe pain is a form of psychological torture.  Since there is an official regulation justifying this policy, this is institutionalised torture – due to tangible negligence by government officials.

Democracies like to use ‘clean’ torture techniques – leaving no visible signs of the suffering they cause. But if we look more closely, there are signs. Most of these victims leave prison with substantially fewer teeth than they started with.  But who’s counting?  Not the Corrections Department, that’s for sure.

8 thoughts on “Dental torture – ‘tangible negligence by government officials’

  1. When Anne Tolley said: “We have to make sure they get good health services in prison, but they are entitled to no better health services than anyone outside prison” she was taking a logically contradictory stance. No one outside of the prison system has a limitation placed on the quality of their healthcare based on this sort of ideological postion rather than material constraints. It is simply self-righteous Tory sadism that belongs in the 19th Century and the inevitable result of this sort of attitude is the appalling treatment you describe above.

    The prison system is potentially a very efficient way of providing healthcare which would save the public health system a great deal of money. The current system seems to be the result of the politics of hatred and condemnation meted out by the most privileged in our society.

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  2. I worked in a NZ prison for 5 years (not fr Corrections) and confirm what this article says. I found the injustice in prison intolerable. There are some very good prison officers who act humanely and treat prisoners as the citizens that they are. However the further up the Corrections heirachy you go the more out of touch with reality they are and the more it is about their own careers and positions. The NZ Dept of Corrections is a the most controlling, incompetent and self serving government dept.

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  3. If they want dental and medical to the highest quality, then pay for it at the same rate alike every other law biding person. Stop the winging Brooking, prison should not be full of free hand outs that I as a tax payer am expected to pay for. Prisons are nothing but a free ride for lazy pricks wanting to hide from responsibility.

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      1. At the expense of what Rodger? Perhaps you could take more money away from the pensions, education, hospitals, policing and give it to prisoners who expect a free ride. Remember prisoners pay no power, no clothing costs, no rent, no food costs, no medical, no dental, no cost to see the doctor, or physio and jump ques for specialist appointments. If $95,000 is the cost to look after one prisoner and if you want to reduce the cost, tell me what we should take off prisoners to pay for the cost, blankets sounds like a good start, wait, what about tents we could put them all in tents, now that would save money.

        Roger Brooking writes: How about at the expense of $13 million dollars wasted on cell phone blocking technology that doesn’t work. How about the $6 million Judith Collins wasted on new uniforms for prison officers. That would pay for lot of dental treatment.

        By the way, how come you don’t have the courage to put your name to your comments?

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      2. I do my name is BAZ Hooker. Cell phone blocking does work, but as tecos introduce new technology which upgrades are required.
        If a prisoner prior to being sentenced has a long term history of dental care , ie scrape and scale, every 6 months, continuous check up every 6 months, etc they are able to have the same care on the inside. However not every prisoners has looked after the teeth or every visited a dentist, most have abused them through continuous drug use (meth mouth) so why give them treatment that they have chosen not to use while free. Prison should not be a free ride.

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      3. This is from the Human Rights Commission report published 2011

        • Dental Care – Prisoners (who are detained for more than one year) are entitled to the same level of dental care that they accessed in the community. This means that previous disadvantage is continued into the prisons. For many prisoners, this means that dental pain is generally relieved by extractions rather than other remedies (National Health Committee, 2010). The Ombudsmen’s Office (2005:58) noted that dental treatment was subject to delays and was ‘inadequate’

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  4. I have 28 teeth twice drilled due to a cruel dentist out of military system, totally not needed just to put me in screaming pain I heard him.say as I was still numb to his assistant as he was done drilling. I have to educate those that think teeth are seperate from your health. I now have diabetes, gained weight, have chect pain and mini strocks, dental done poorly or aggressively kills people. If we are humane does it matter if someone is in prision. Dental needs to be done very well for all aotherwise we are not human. It’s no different then getting diabetes or heart care is is necessary. Those that make free ride comments either do not care for others or simply lack medical knowledge

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