“Inside Out” by Keri Blakinger is a partnership between NBC News and The Marshall Project, a nonprofit newsroom covering the US criminal justice system. The column draws on Blakinger’s unique perspective as an investigative and formerly incarcerated journalist.
At the end of 2016, Nicholas Bailey had no more teeth. A Michigan prison dentist removed them all because they were decaying.
“I am in pain,” he wrote in a series of complaints to prison staff begging for dentures. “I can’t eat because I don’t have any teeth.”
But instead of giving him dentures, the medical staff gave him soft food and told him he should wait, even though he said his gums were swollen and bleeding. Indeed, under Michigan Department of Corrections policy, inmates can only get dental treatment during their first two years in prison if treatment is considered urgent – and being toothless doesn’t count.
Even among prison systems that limit dental care, Michigan’s policy is an outlier – and one of many problems outlined in a multi-year dental trial. In court records and interviews, dozens of prisoners complained that their decayed teeth were left to rot and ache. Some said they had been pressured into having otherwise repairable teeth pulled out, by practitioners who asked them to choose between living in pain and losing a tooth.
“Most people in society have had a toothache at some point, and they know how serious it can be,” said Daniel Manville, the Detroit-based lawyer who sues the state prison system. and its medical providers for dental care. practices. “But in a system where you have to wait two years for dental treatment, that’s barbaric.”
Michigan Department of Corrections spokesman Chris Gautz said the agency’s dental care did not violate the Constitution’s prohibition on cruel and unusual punishment and was “much better than what the majority of prisoners were receiving. before entering prison ”. He declined to comment on the individual allegations in the pending litigation.
While Michigan’s two-year wait is unusual, the reluctance to deal with dental issues is not. Florida prisons will not make crowns or bridges, and Texas consistently refuses to supply dentures, offering a mashed mess dining regimen instead. Under the federal system, inmates can only get dentures if their sentence is at least three years. In Nebraska – as in Michigan – the state had a policy prohibiting new prisoners from routine dental treatment, although authorities removed the rule after the Nebraska ACLU filed a complaint. (The lawsuit was later dismissed, and Nebraska officials said the policy change was unrelated.)
When I was arrested a little over ten years ago for drug trafficking in upstate New York, I was taken aback by the lack of dental care behind bars. County jail wouldn’t do anything about cavities, so the only choices for a bad tooth were to have it pulled out or live in pain until you’re released or sent to state jail.
A few months later, while still in the county jail, I cracked a molar tooth and a large piece of my tooth came loose in my mouth. But when the guards put handcuffs and shackles on me and took me to a doctor, he said he didn’t want to pull out a tooth that could be saved.
So the guards took me back to jail, where I made unnecessary requests to the nurse, writing long essays on tiny shapes and sketching out little cemeteries filled with teeth. I couldn’t believe they were planning on doing nothing, and somehow hoped my creativity would grab their attention.
It wasn’t, but something else: my family. I was fortunate to have parents who supported me by calling the jail and offering to pay for dental care themselves at $ 161. Many prisons would not have allowed this, but the prison I was in agreed, and the guards took me to have a tooth fixed.
Not everyone was so lucky. Many of the women I met when I was sent to jail had spent months in the county jail without prosthetics or dental treatment.
In Michigan, the legal battle for Manville began after prisoner Robert Johannes lost a filling. When the prison dentist tried to replace her, the whole tooth broke. Over the following years, dentists continued to pull his teeth out until he could no longer chew – but, according to the lawsuit, the prison still refused to give him dentures.
After five years of almost toothlessness, Johannes filed a lawsuit in 2014. The complaint accused the prison system and medical providers of willful disregard, alleging that dental staff removed some teeth unnecessarily and ignored others that needed treatment. Instead of asking for money, the lawsuit simply demanded better dental care.
But that’s not what happened.
Months before Johannes sued, Michigan prisons had created a new policy to reduce the waiting list of 8,000 people for dental care – not by treating prisoners more, but by rendering many of them ineligible. to treatment.
From now on, new detainees could no longer receive treatment considered to be “routine”. It meant no cleaning, but according to Manville and his clients, it also meant no fillings or dentures. If a cavity hurt too much, the dentist told inmates they could wait at least two years for a filling – or just accept an extraction immediately.
Gautz, the prison spokesperson, said the change was not an attempt to cut costs, but rather a plan to ensure that inmates serving long sentences can access routine care. The state spends about $ 300 million a year on health care for about 31,000 prisoners, he said.
As more and more prisoners filed similar complaints, Manville added them to the case. There was the man who said medical staff told him to wait two years for his broken tooth to be repaired, the man who was unable to get a replacement prosthesis after saying prison staff had broken the ones he already had, and the woman who had had 20 teeth pulled in two years and still could not have dentures even though her gums were bleeding when she ate.
In response to the lawsuit, the prison service said the dentists at the prison were dealing with urgent issues and pointed out that overall they were doing more fillings than extractions. But, state attorneys wrote, “Being without a few, many, many, or all of your teeth is not, in and of itself, an urgent dental condition.
The case has now lasted so long that many of the first prisoners involved have been released, including Johannes.
The case will likely not go to trial until next year. But for Bailey, some of the problems are now a thing of the past: after three years of requests, in 2019, authorities finally gave him what he wanted.
“I’m glad I have dentures,” he wrote in a recent email from prison. “I look more human with my teeth.”
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