Inside a NSW prison, dental care comes through the prison health service. On the day of release, that stops, and getting a tooth seen again depends on paperwork: a Medicare card, a concession card and a phone call. Many people leave with a dental problem that was waiting for treatment, and the weeks after release are when it is most likely to be put off.
This guide is for people in custody or recently released, and for family members and workers helping them. It covers how care works on each side of the gate and what to sort out first.
Justice Health NSW provides care while you are in custody
Health care in NSW correctional and youth justice centres is delivered by the Justice Health and Forensic Mental Health Network, known as Justice Health NSW. The NSW policy on eligibility for public dental services names people in custody in publicly operated centres as eligible, with access through Justice Health or by referral to a local health district.
Dental care is arranged through the health clinic in each centre. Patients are triaged by urgency, so someone with swelling or severe pain should be seen before someone needing a routine filling. If you are in pain, tell the clinic staff clearly how bad it is, whether it keeps you awake, and whether there is any swelling.
Waits inside have been long
The NSW Audit Office examined access to health services in custody in 2021. Between January and April 2021, only 17 per cent of patients who were recommended dental care within seven days received it in that time, and the average wait for that group was 31 days. In a sample month that year, 25 per cent of patients in custody waited longer than the recommended maximum, compared with 18 per cent of people using community public dental services.
Those figures were an improvement. In 2019, only 3 per cent of dental patients in custody were seen within target times, and the average wait was 93 days. The Audit Office also found that the dental database was not linked to the main appointment system, so the records could not show whether a dental problem had escalated, for example to an infection needing antibiotics.
More than extractions are available
A common belief is that prison dentistry only pulls teeth. Research does not support that. A NSW survey of 789 people across 27 correctional centres (Osborn and colleagues, Australian Dental Journal, 2003) found that among those who had seen a dentist in the previous year, 62 per cent had an examination at their last visit, 38 per cent had fillings and 28 per cent had extractions. The same study found high levels of decayed and missing teeth, and concluded that past dental care for this group had been poor.
What is harder in custody is continuity. Treatment that takes several visits, such as root canal treatment or dentures, can be interrupted by transfers, court dates or release. If you are partway through treatment when you leave, ask the clinic for a summary of what was done and what is still needed. It helps the next dentist pick up where things stopped.
After release, eligibility depends on two cards
Outside custody, NSW public dental care is available to adults who live in NSW, are eligible for Medicare, and hold or are listed as a dependant on an eligible concession card, such as a Health Care Card or Pensioner Concession Card. You show your Medicare card and concession card at the clinic, and staff may ask for a second form of identification such as a driver licence or NSW Photo Card.
Without those cards, eligibility cannot be confirmed, and a dental problem can sit untreated while documents are replaced. That is why the order of the first few steps matters.
Medicare first
If your Medicare card has expired or been lost, contact Services Australia to replace it. If release planning has already started the process, follow it up in the first week rather than waiting for mail to arrive.
Then a concession card
Apply through Centrelink for a Health Care Card or the concession card that matches your payment. Ask at the same time about any payments available to people recently released from custody.
Then call public dental
NSW public dental services are booked by phone on 1800 679 336. You will be asked about pain, swelling and your general health, and given a priority. Say clearly if you are in pain, cannot sleep or cannot eat. Under the NSW access policy, a dental emergency such as facial swelling from a tooth has a recommended maximum wait of 1 day, and pain that disturbs sleep 7 days. Routine care can take much longer.
Pain before the paperwork is done
A toothache will not wait for a Medicare card. For free advice from a registered nurse at any hour, call healthdirect on 1800 022 222. Go to the nearest hospital emergency department, or call 000, if there is swelling of the face or neck, trouble swallowing or breathing, or a jaw that will not open. These can be signs of a spreading infection.
Our emergency dentist guide covers first steps for common problems, and our emergency dentist page has Lumi's contact details. If a tooth needs to come out, our article on what to expect from a tooth extraction explains the appointment.
What a dental practice will ask you
You do not need to explain where you have been to get treatment. A dental team needs your name, date of birth and a way to contact you, plus clinical information: your medical history, current medicines, allergies, any smoking and when the problem started. Those details affect which anaesthetic, antibiotic or painkiller can be used safely. If you do not have a fixed address, say so, and give a phone number or the contact details of a support worker.
After years away from the dentist, many people find the hardest part is sitting in the chair again. That is common. You can ask for things to be explained first, to go slowly and to stop with a hand signal. Our guide to dental anxiety has more on this.
Paying for private care
Some people do not qualify for public dental care, and some cannot wait for it. In private practice, treatment can often be staged: the urgent problem first, then the rest over time. Ask for a written estimate, ask which parts are urgent, and ask whether the work can be spread across visits. Our article on payment plans and affording treatment sets out the options.
If housing is also a problem, our companion guide to dental care when you are homeless covers finding care without a fixed address. Start with accommodation if you can, because a place to stay and a working phone make every other step easier. Link2home (1800 152 152) is the NSW homelessness information line.
Questions people ask
Do people in NSW prisons get dental care?
Yes. Justice Health NSW provides dental care in custody, triaged by urgency. Waiting times have been long, although the NSW Audit Office found they had improved between 2019 and 2021.
What if I do not have a Medicare card when I get out?
Replace it through Services Australia as soon as you can. Until then, healthdirect on 1800 022 222 and hospital emergency departments remain available for urgent problems.
Will a dentist treat me if I have a record?
Yes. Your history in custody is not part of a dental assessment. The questions you are asked are about your health, because they affect what treatment is safe.
Getting a tooth looked at
If you, or someone you support, needs a dental problem checked without a long explanation, our team at Lumi Dental in Melrose Park can help. After your examination you will usually receive a written treatment plan, often by email. See our current deals, read about a first visit on our general dentistry page, or book online.
Sources
- Audit Office of New South Wales. Access to health services in custody (2021). audit.nsw.gov.au
- Osborn M, Butler T, Barnard PD. Oral health status of prison inmates: New South Wales, Australia. Aust Dent J. 2003. PubMed
- NSW Health. PD2026_023 Eligibility for Public Dental Services. health.nsw.gov.au
- NSW Health. PD2024_034 Oral Health Access. health.nsw.gov.au
- Justice Health NSW. Support for released patients. nsw.gov.au
This article is general information only and is not a substitute for personal dental, medical or legal advice. Services, phone numbers and eligibility rules change, so confirm details with the provider. Please see a dental or medical professional about your own situation, and call 000 if breathing or swallowing is affected.
