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Dentist Matthew Eaton and dental assistant Jenna Flom work to extract a tooth for Cass County Jail inmate Joe Miller Wednesday at Family HealthCare, Fargo. 

FARGO — The gums are often swollen and red. The teeth are cracked and decayed. Sometimes, they’re blackened or missing.

Nursing supervisor Heidi McLean has seen a lot of mouth misery in her 19 years of working with inmates at the Cass County Jail.

The worst is damage done by the use of drugs, including methamphetamine and heroin.

“The teeth just rot down to become almost little nubs,” she said.

McLean, a Fargo Cass Public Health employee contracted to work at the jail, supervises the nursing staff there and coordinates medical and dental care for inmates at Family HealthCare in Fargo.

She said most inmates are underinsured or uninsured, so they haven’t had access to routine dental care.

Some suffer from mental illness, or make lifestyle choices that cause their mouth to deteriorate.

“They’re not thinking about their teeth and their dental hygiene,” McLean said.

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Pain usually leads them to the dentist. With 10 to 15 inmates on the waiting list, however, it can take a month or two, maybe more, to be seen.

The inmate is transported by a sheriff’s deputy to the appointment, wearing the usual bright orange jail garb. The inmate's hands and feet remain cuffed the entire time.

Matthew Eaton, dental director at Family HealthCare, said the inmate patients are generally very respectful.

“They’re excited to have someone address their tooth pain because sometimes, it’s pain that they’ve been dealing with for a while,” he said.

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