Partly due to two major economic recessions since the turn of the century, the number of Americans without dental insurance who visit the dentist regularly has steadily decreased. The overwhelming majority of inmates are included in that group of individuals without dental insurance. Additionally, inmates tend to lack the dental IQ to understand the essential need for preventative dental care. Typical exposure to dentistry may have revolved around symptomatic relief of a decayed tooth, rather than restorative and preventative dental care. Thus, inmates tend to present with patterns of decay that far exceed that of the population at large. Illicit drug use has historically been associated with dental caries in part due to neglect of oral hygiene. However, the emergence of methamphetamine abuse has elevated this concern to another level. “Meth Mouth” is the term commonly used to describe methamphetamine abusers who present with rampant circumferential smooth surface carious lesions. The mechanism of action of such decay patterns is believed to be due to decreased salivary flow and the ravenous consumption of sugary soft drinks on behalf of the addict as well as generalized neglect of dental hygiene. Affected teeth present nearly insurmountable restorative challenges and the abuser may exhibit cardiovascular conditions that further complicate the delivery of dental care. Socioeconomic challenges have arguably never been a greater barrier to dental services. While most states provide coverage for dental care for impoverished children, reimbursement mechanisms preclude the widespread availability of such care. Furthermore, given the tremendous financial challenges facing state legislators, the safety net for coverage of adult dental services is rapidly dwindling or in many cases disappearing. To complicate matters, a large percentage of inmates emanate from unstable housing settings or have no actual homestead. Dental care is typically not a primary priority until an emergent condition develops. As stipulated previously, inmates present with a far greater incidence of hypertension, asthma, Hepatitis C, and HIV than the population at large. General dentists may not be