Dental care in prison and after release runs on two different systems, and the handover between them is where most people lose their teeth. Inside, Justice Health NSW provides the care. Outside, eligibility for public dental depends on a Medicare card and a concession card, which often have to be re-established. This article sets out what exists in each setting, what to do first, and what to bring. It is written for the person going through it and for the family member trying to help.
Key takeaways
- Justice Health NSW provides health care to over 30,000 patients a year and states that oral health in secure settings meets the same standard as community public services.
- The NSW Audit Office found that between January and April 2021, only 17 per cent of custodial patients recommended for dental care within 1 week were seen in that timeframe, with an average wait of 31 days.
- The Australian Institute of Health and Welfare reports that about 1 in 5 prison dischargees had a dental condition diagnosed for the first time in prison, more than for any other health condition.
- After release, NSW public dental requires a Medicare card plus a Health Care Card, Pensioner Concession Card or Commonwealth Seniors Health Card, then a call to the Oral Health Call Centre on 1800 679 336.
- Justice Health NSW runs a Connections program that helps with a release plan, identity documents and getting a Medicare card sorted.
- A dental team treats the tooth, not the history; nobody has to explain where they have been in order to be treated for pain.
Who provides dental care in NSW prisons
In New South Wales, health care in custody is delivered by the Justice Health and Forensic Mental Health Network, usually shortened to Justice Health NSW. It provides care to more than 30,000 patients each year across over 100 community, inpatient and custodial settings, and its stated position is that oral health care in secure settings meets the same standard as public health services in the community. Head office can be reached on 02 9700 3000.
In practice, dental care happens through the prison health clinic on scheduled days, with waiting lists managed centrally rather than at each centre. Patients are triaged by clinical urgency against recommended maximum waiting times, the same principle used across the public system.
Why the need is so much higher
The gap starts before anyone is admitted. AIHW National Prisoner Health Data Collection figures show that about 1 in 7 prison entrants had seen a dentist in the community in the year before entry, and about 1 in 6 reported needing to see one but not doing so. Around 71 per cent of entrants were current smokers. Older NSW research, drawn from a stratified random sample of 789 people across 27 correctional centres, found more missing and decayed teeth and fewer filled teeth than in the non-prison population.
Dentists working in the system cite the familiar drivers: smoking, drug dependence, a high-sugar diet and interrupted access to routine care. None of that is a character judgement. It is what happens to teeth when prevention stops and risk factors stack up.
How long people wait inside
The best Australian numbers come from the NSW Audit Office report on access to health services in custody. Between January and April 2021, only 17 per cent of patients recommended for dental care within 1 week were seen in that timeframe, and the average wait was 31 days. Twenty-five per cent of custodial patients waited longer than the recommended maximum time, against 18 per cent of people in the community public dental system.
That was a substantial improvement on where it had been. In 2019, only 3 per cent of dental patients were seen within target timeframes, with an average wait of 93 days. The Audit Office also noted a data problem worth knowing about: the dental database is not linked to the main appointment system, so it is not possible to tell whether a minor dental problem escalated into an infection needing antibiotics.
Work has been done on it. The Agency for Clinical Innovation project A Brush with Justice began with 2,053 patients on the oral health waiting list and a person with constant toothache waiting up to 56 days. At Hunter Correctional Centre a mobile dental unit cut the number of urgent and semi-urgent patients waiting by 84.9 per cent. Those are early results from one site, not a statewide outcome.
What treatment is available inside
Justice Health provides dental care and oral health education aimed at freedom from oral pain and disease. NSW research records examinations, fillings and extractions among the treatments provided, so the common claim that prison dentistry is extraction-only is not supported by the data. Of people who had seen a dentist in the previous year in that study, 62 per cent had an examination, 38 per cent had fillings and 28 per cent had extractions.
What is genuinely limited is time and continuity. Long or multi-visit treatment is harder to complete, and dentures have historically sat on a separate waiting list. Teledentistry is used at selected centres, with virtual care across prison health rising from about 3 per cent in 2018 and 2019 to about 5 per cent by 2021.
Getting dental care in NSW: in custody and after release
The table below is the practical version. Waits are indicative and depend on triage.
| What you need | Where to go | What to bring or have ready | Typical wait |
|---|---|---|---|
| Dental care while in custody | The prison health clinic, referred to Justice Health dental | Nothing beyond being in custody | Triaged by urgency; the audited average was 31 days |
| Help with ID and a Medicare card before release | Justice Health NSW Connections program, through the health clinic | Any identity documents you already hold | Start well before your release date |
| Public dental after release | NSW Oral Health Call Centre, 1800 679 336, Monday to Friday 8am to 4pm | Medicare card and a Health Care Card, Pensioner Concession Card or Commonwealth Seniors Health Card | Emergency and relief of pain prioritised; routine care wait-listed |
| A replacement Medicare card | Services Australia, Medicare enquiries on 132 011 | Identity documents, or a Connections referral | Often days rather than weeks once ID is sorted |
| Advice out of hours | healthdirect, 1800 022 222, 24 hours | Nothing | Immediate phone advice |
| Facial swelling, trouble swallowing or breathing | Nearest hospital emergency department, or call 000 | Nothing, go now | Immediate |
| Practical support after release | Community Restorative Centre NSW, 02 9288 8700 | Nothing | Varies by service |
| Private dental care | Any general practice, including Lumi Dental in Melrose Park | Your medicine list and any known allergies | Usually days, and same day for genuine emergencies |
The day of release: what actually changes
Release changes eligibility, not need. Inside, care is provided because you are there. Outside, NSW public dental services are available to adults who are NSW residents, are Medicare-eligible, and hold or are a dependent on a Health Care Card, Pensioner Concession Card or Commonwealth Seniors Health Card. A State Seniors Card on its own does not qualify.
That is why identity documents matter so much on day one. Without a Medicare card and a concession card, eligibility cannot be established, and the dental problem waits while the paperwork catches up. Justice Health NSW established the Connections program in 2007 for exactly this, providing a transition coordinator, a release plan and help obtaining identity documents and a Medicare card, along with links to Centrelink and community health.
The three steps to public dental after release
Step one: Medicare
Get a Medicare card or replace a lost one through Services Australia on 132 011. If a Connections coordinator has started this before release, follow it up in the first week rather than waiting for post.
Step two: a concession card
Apply to Centrelink for a Health Care Card or the relevant concession card. A Crisis Payment for release from prison is available through Centrelink and is worth asking about at the same appointment.
Step three: call the Oral Health Call Centre
Phone 1800 679 336 between 8am and 4pm on a weekday. You will be asked about your dental need and general health, then prioritised. Say clearly if you are in pain, not sleeping, or unable to eat, because relief of pain and emergency care are prioritised over routine treatment.
What a dental practice will and will not ask
A dental team treats the tooth, not the history. Nobody has to explain where they have been in order to be treated for pain. What a practice does need is clinical: your medical history, the medicines you take, allergies, whether you smoke, and when the problem started. Those questions exist because they change what can safely be given, particularly local anaesthetic, antibiotics and pain relief.
You will be asked for a name, a date of birth and a contact number, because a clinical record has to belong to someone. If you have no fixed address, say so and give a phone number or a support service contact instead. If you have been away from dental care for years and the idea of the chair is the hardest part, that is common and it is manageable. Our guide to dental anxiety covers what to ask for, including going slowly and stopping on a signal.
If you are in pain before any of that is sorted
Pain does not wait for paperwork. Call healthdirect on 1800 022 222 at any hour for free registered nurse advice. Go to the nearest emergency department, or call 000, if there is facial or neck swelling, difficulty swallowing, difficulty breathing, or a jaw you cannot open, because those are signs of spreading infection. Our emergency dentist guide sets out what to do first for a knocked-out tooth, bleeding or severe toothache, and Lumi Dental has an emergency dentist page with contact details.
If a tooth is beyond saving, knowing what the appointment involves takes some of the fear out of it. Our article on what to expect from a tooth extraction walks through it step by step.
Paying for care when public dental is not an option
Some people are not eligible for public dental, and some cannot wait for it. Private treatment can usually be staged, with the urgent problem handled first and the rest planned over months. Ask for a written quote, ask which items are urgent, and ask whether treatment can be split across visits. Our guide to payment plans and affording treatment covers the options honestly, including what to watch for.
How this differs from our guide for people without housing
Lumi Dental has a companion article on dental care when you are homeless, and the two overlap without being the same. That one is about finding care with no fixed address, no storage for a toothbrush and no reliable phone. This one is about a transition with a known date, where the fix is largely administrative: Medicare, then a concession card, then a phone call. If both apply, start with the housing article, because accommodation and a contact number make everything else possible.
Common questions
Do people in prison get dental care in Australia?
Yes. In NSW, Justice Health NSW employs dentists who deliver care in prison health clinics, with the stated aim of matching community public dental standards. Patients are triaged by clinical urgency, and waiting times have historically been long.
How long do you wait for a dentist in prison in NSW?
The NSW Audit Office found that between January and April 2021, 17 per cent of patients recommended for dental care within 1 week were seen in that time, with an average wait of 31 days. That was an improvement on 2019, when the average wait was 93 days. Urgent problems are prioritised.
How do you get dental care after leaving prison in NSW?
Call the NSW Oral Health Call Centre on 1800 679 336, Monday to Friday between 8am and 4pm, once you have a Medicare card and a qualifying concession card. You will be asked about your dental need and general health and prioritised by urgency. Relief of pain and emergency care come first.
What if you do not have a Medicare card when you are released?
The Justice Health NSW Connections program assists with release planning, including obtaining identity documents and a Medicare card and linking people to Centrelink. Services Australia can also be contacted on 132 011. Until that is sorted, healthdirect on 1800 022 222 and hospital emergency departments remain available.
Why is oral health worse in prison populations?
Interrupted access to routine care is the main driver. AIHW data show only about 1 in 7 prison entrants had seen a dentist in the previous year, around 71 per cent were current smokers, and about 1 in 5 dischargees had a dental condition diagnosed for the first time in prison. Diet and drug dependence add to the risk.
If you or someone you support needs a tooth looked at without a long explanation attached, the team at Lumi Dental in Melrose Park can help. See what a first visit includes on our current deals page, ask for a written quote, or book online. Our general dentistry page explains that first appointment.
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.
