Sir, The letter from Neville (BDJ 2015; 219: 146–147) has raised a number of issues in prison dentistry.1 However, these issues are not unique in the Republic of Ireland. For example, very few prisons have had oral health needs assessment carried out and this has led to commissioning based largely on guesswork. Recently, the Scottish Government has recommended that a survey of the oral health of prisoners in Scotland should be undertaken every five years to monitor improvements and inform service design.2

The nature of the prison environment makes the delivery of care as equally challenging as the oral health of the patients. The high turnover of prisoners in some institutions, particularly in remand or short-stay institutions, where short sentences or frequent transfers between facilities mean courses of treatment can go unfinished as prisoners are moved on. In 2012, the British Dental Association issued the individual booklets Oral healthcare in prisons and secure settings for England, Scotland and Wales where many of the ongoing issues in prison dentistry were highlighted.3

The National Association of Prison Dentistry website (http://www.napduk.org) has recently been expanded and is now a major resource for prison dental professionals. As well as providing information on upcoming events, it contains a member area with a comprehensive reference section including policy documents, academic articles and a members' forum.

Prisoners have ready access to legal services, and complaints can be frequent, time consuming and costly. There has been an increase in interest shown by specialist dental law firms who now actively advertise their services to patients in prison. Prisoners in HMP Wakefield successfully brought an action against the Wakefield District NHS Primary Care Trust in 2011 over dental services resulting in costs to the NHS of nearly £350,000.4