Improving Oral Health in Prisons (PriOH): Protocol for a Randomized Controlled Trial

Abstract

Background: People living in prisons often experience poor oral health, which could be attributed to their limited access to (dental) care, financial constraints, and a general lack of awareness and prioritization toward their oral hygiene. A pilot study involving motivational interviewing (MI) has shown promising results for improving the oral health outcomes of people living in prisons. Objective: The protocol for this study aims to assess the efficacy of integrated MI and oral hygiene packages in improving oral health among people living in prisons, compared to controls without added MI. Methods: This oral health in prisons study is a multicenter, randomized, double-blinded controlled trial that recruited inmates from 4 prisons in Rogaland County. The trial aimed to recruit 320 participants before randomly allocating them to either a control or intervention group. The intervention group received MI, consisting of a 30-minute session encouraging inmates to discuss their current and desired oral health behaviors and attitudes, highlighting discrepancies to motivate change. Assessments were conducted at 4 and 12 weeks after initiation. The primary outcome measurement is the mucosal-plaque scores to assess oral health behaviors, attitudes, and oral hygiene. Secondary outcome measurements are oral hygiene routines, sugary food and drink intake, oral health perception, and oral health-related questions. Results: Data collection started in November 2021 and ended in June 2023. A total of 327 participants were recruited, of which 126 received the intervention. Conclusions: Integrating MI in oral health programs at prisons can significantly improve the oral health of incarcerated individuals. Should the results from this study demonstrate efficacy, it could be valuable insight for policy makers, oral health practitioners, and correctional services in addressing the needs of a traditionally underserved group before being scaled up to enhance dental care practices in prisons.