Dental Health Status of Incarcerated Individuals in Silesia: A Five-Year Retrospective Case-Control Study

Background: Incarcerated individuals often experience poor oral health due to limited access to care and socioeconomic disadvantages. Objective: This study assessed the dental health status of incarcerated individuals in Silesia over a five-year period using the Decayed, Missing, and Filled Teeth (DMFT) index and compared their outcomes to a matched control group from the general population. Methods: We conducted a retrospective observational case-control study at the University Centre for Dentistry in Bytom, reviewing records of 136 incarcerated patients (mean age 36.8 ± 7.9 years; 9.4% women) and a matched control group between 2019 and 2024. Results: Incarcerated individuals had a higher mean DMFT score (14.4 ± 5.7) compared to controls (11.5 ± 6.5; mean difference = 2.95, 95% CI: 1.53 to 4.37; Cohen's d = 0.49), with more decayed (4.9 ± 3.2 vs. 3.4 ± 2.4) and missing teeth (4.3 ± 3.2 vs. 3.5 ± 2.6). Most incarcerated patients (65.5%) required oral surgical treatment, most commonly for retained roots (25.9%) and impacted teeth (24.5%). No significant DMFT differences were observed based on age or sex, although disparities were most pronounced in older female prisoners (mean DMFT 17.8 vs. 9.8 in controls aged 40+). Conclusions: Incarcerated individuals in Silesia demonstrated a significantly higher burden of untreated dental disease and greater tooth loss compared to non-incarcerated controls over the five-year period. The predominance of advanced dental conditions requiring surgical intervention highlights missed opportunities for early and preventive care in this vulnerable population.