The ‘tooth doc’ from Barlinnie
They’re some of Scotland’s most hardened criminals, bearing the scars of a lifetime of violence. But when Kieran Fallon, the ‘tooth doc’ at Glasgow’s Barlinnie prison, reaches for his drill, his inmate patients are as scared as little schoolboys.
“A lot of them haven’t been to the dentist for years and are terrified,” he said. “These guys, heavily scarred from fights, would stand up to someone facing them with a sword or a blade, but they run a mile from the dentist. Often, the first question I am asked is: ‘Is it going to hurt?’”
Dr Fallon has treated some extremely violent and dangerous men who are either on remand awaiting trial or serving up to four years of their sentence, some before being transferred to another prison.
However, he has never been assaulted or threatened.
“The top gangsters are usually extremely well-behaved and personable. They know how to behave in polite company and, if you didn’t know who they were, you wouldn’t think for a minute that they were gangsters or violent people. But they are – they are intelligent because they’ve worked out how to get others to work for them, but they’ve usually got to the top of the tree by being vicious and ruthlessly violent.”
However, not all his patients are hardened career criminals, he’s also dealt with some less than accomplished offenders.
He said: “I’d only been in my post at Barlinnie for about a week, when a patient came in to see me about an extraction. He grew quieter and more nervous during the examination but he promised to come back for the extraction.
“Afterwards a prison officer asked me if I recognised him, which I didn’t. It turned out that the young man was inside because he’d tried to steal my car outside my practice in Royston. I’d come running outside and scared him off and later identified him in a mug shot.
“He never did come back for his extraction!”
After two decades of treating some of the worst cases of dental decay in the country, Dr Fallon still finds his work satisfying.
“The average age of prisoners is mid-20s and some of these young men are reasonably good looking and they are often concerned with their appearance.
But when they open their mouths it’s not attractive. Being able to smile properly raises their self-esteem and boosts their confidence to escape the cycle of drugs, crime and jail.”
Dr Fallon has been the dentist for Barlinnie – known as ‘Bar-L’ – for 20 years, so he is accustomed to dealing with severe dental decay.
“A lot of it is basic dentistry – extractions, caries and fitting dentures. In some of the worst cases the teeth are completely worn down to gum level and all that remains are dark roots. When it’s a complete disaster area, I have to extract all the teeth and provide them with dentures. They’re usually fairly straightforward extractions because the gum condition is poor so teeth and the roots don’t have a lot of bone support.”
Drugs are a constant problem in Barlinnie and large numbers of prisoners come to the jail with significant drug habits. Bar-L, which has 1,600 inmates, is the largest single supplier of methadone in Europe. Dr Fallon says these factors contribute to the severe dental decay he sees in a great many cases inside the Barlinnie Health Care Centre, where the dental surgery is located.
“Many of the inmates are substance abusers who lead chaotic lives. They often don’t brush their teeth and their diet is not nutritious. People on drugs are focused on getting their next hit so they don’t have a lot of money to spend on food. When they do eat they tend to crave sweet things such as fizzy soft drinks and chocolate bars.
“On the outside, they either won’t make the effort to go to a dentist, or some dentists won’t treat them because they don’t make attractive clients and keep missing appointments.
“One of the body’s natural defences against tooth decay is a good flow of saliva, which acts as buffer against the acidity from sweet things. Heroin and methadone have a side-effect of drying the mouth and that encourages tooth decay.”
Barlinnie is Scotland’s largest prison, but Dr Fallon, who has spent most of his career working within deprived communities, is neither fazed nor fearful. In fact, he finds it all extremely rewarding.
“I enjoy the challenge of this type of dentistry. I’m dealing with some really quite badly looked after mouths and trying to bring them around to a reasonable level.”
Also, many of the inmates have a very negative view towards dentists. “Their contact with the dentist has been symptomatic and they only go when they experience pain. The association is always negative,” said Dr Fallon, who owns the Royston Dental Practice in Glasgow, as well as providing dental treatment at the prison alongside colleague Dr Pat Toland.
Because of their lifestyles, attitudes and social problems, by the time many prisoners ask to see Dr Fallon, they have advanced dental decay.
“When they take narcotic drugs they won’t be aware of the pain. But if they are not on a methadone programme or enter the detoxification programme at Barlinnie, they start to experience pain.
“They are only allowed mild painkillers such as paracetamol so when the pain kicks in they ask their hall nurse if they can see the dentist.” He said most prisoners are brought to the surgery in a small group and are supervised by an officer in the waiting room, but when they come into the surgery they have privacy.
“There is a segregation unit for violent prisoners and they are brought over in handcuffs with two officers who stay during the treatment.
“But they are uncufffed and I’ve never had a problem.”