Oral Health Service Utilization Among Formerly Incarcerated Individuals: A Social Determinants of Health Scoping Review

Background: Oral health is a crucial component of overall health and well-being, yet it remains an under-researched area within incarcerated and reentry populations. Individuals who are incarcerated often enter correctional facilities with poor oral health due to long-standing disparities and limited access to preventive oral care. While some may receive dental services during incarceration, these services are typically designed to address urgent needs rather than offer comprehensive or continuous care. This discontinuity in care often leads to the deterioration of oral health after release, exacerbating chronic conditions, impacting self-esteem, and reducing overall quality of life. Given the heightened vulnerability of this population and the broader public health implications, there is a pressing need to understand the current state of oral health service utilization and interventions that support formerly incarcerated individuals. This scoping review aims to map the existing literature on oral health access, service use, and intervention models for formerly incarcerated individuals. Guided by the Social Determinants of Health (SDoH) framework, the review identified key structural, systemic, and individual-level barriers and facilitators influencing oral health outcomes during reentry.

Method: The review adapted the guidelines by Arksey and O’Malley (2005) alongside the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Adapting these two guidelines, we carried out a structured process that involved identifying research questions, selecting and reviewing relevant studies, charting key data, and synthesizing the findings. This approach provided a comprehensive overview of existing research on dental care and oral health service utilization among formerly incarcerated individuals. In all six databases were searched from 2000 to 2024.

Results: The systematic search yielded 449 studies, of which 16 met inclusion criteria and were reviewed. The majority were conducted in the United States (n=11), followed by Canada (n=4), and Iran (n=1). Cross-sectional designs were predominant (n=15), while only 1 was a true experiment. The most frequently reported oral health outcomes included self-reported oral health status (62.5%), periodontal disease (37.5%), dental caries (31.2%), and tooth loss (25%). Oral health care utilization patterns were analyzed in 8 studies (50%), often highlighting low engagement with post-release dental services. Across studies, the most commonly addressed SDoH were economic stability and healthcare access and quality. These domains were linked to financial insecurity, lack of insurance, and limited access to consistent, affordable dental care. The social and community context domain appeared in 9 studies, emphasizing barriers such as stigma, weak support networks, and navigation challenges. Other domains, such as education, living arrangements, and the built environment, were discussed in few studies.

Conclusion and Implications: Taken together, these findings underscore significant gaps in continuity of care and highlight structural barriers to oral healthcare for formerly incarcerated individuals, pointing to the need for more comprehensive and multi-level interventions. Addressing these barriers is critical to advancing oral health equity and supporting successful reentry outcomes.