OF THE 42 AMERICAN MEDICAL ASSOCIATION STANDARDS FOR INMATE MEDICAL AND DENTAL SERVICES 22 REFER IN VARYING DEGREES TO DENTAL CARE AND TREATMENT. THE STANDARDS REQUIRE PHYSICIAN APPROVAL OF DENTAL SERVICES, QUARTERLY AND ANNUAL STATISTICAL REPORTS, RECEIVING SCREENING, HYGIENE, EXAMINATION AND TREATMENT, AND LICENSING OF DENTISTS IN THE STATE IN WHICH THEY PRACTICE. A DENTAL EXAMINATION IS REQUIRED FOR EACH INMATE ON OR BEFORE THE 90TH DAY OF INCARCERATION. EMERGENCY DENTAL CARE IS ALSO REQUIRED ON A 24-HOUR BASIS. IN MICHIGAN JAILS, THIS MEANS HAVING MEDICATION ON HAND IN THE JAIL IN THE EVENT AN INMATE HAS A TOOTHACHE AND BEING PREPARED TO SEND AN INMATE TO A HOSPITAL EMERGENCY ROOM IF NECESSARY. A TOOTH EXTRACTION MAY RESULT IN A DRY SOCKET WITHIN 1 TO 7 DAYS. JAIL STAFFS ARE TRAINED TO HANDLE THIS CIRCUMSTANCE BY FOLLOWING THE WRITTEN STANDING ORDERS OF THE PHYSICIAN OR DENTIST. MICHIGAN JAIL RECORDS SHOW THAT ONLY 5 PERCENT OF THE INMATES STAY BEYOND 90 DAYS. IN ORDER TO MEET THE STANDARD REQUIRING DENTAL EXAMINATIONS WITHIN A 90-DAY PERIOD, INMATES SCHEDULED TO BE IN JAIL FOR THAT LONG A PERIOD ARE FLAGGED TO RECEIVE DENTAL EXAMINATIONS ON THE 80TH TO THE 85TH DAY OF INCARCERATION. ROUTINE, CURSORY ORAL EXAMINATIONS SHOULD BE MADE SOON AFTER THE INMATE IS BOOKED, HOWEVER. IT IS IMPORTANT FOR INMATES TO KNOW HOW TO GET EMERGENCY DENTAL CARE, AND WRITTEN AND ORAL INSTRUCTIONS SHOULD BE GIVEN ON HOW TO BRUSH TEETH AND CARE FOR GUMS. SINCE MOST DENTISTS PREFER TO USE THEIR OWN EQUIPMENT IN THEIR OFFICES, A VARIETY OF CONTRACTUAL ARRANGEMENTS CAN BE MADE TO PROVIDE INMATES THIS CARE. WAYS MUST BE FOUND TO CHANGE THE RELUCTANCE OF MANY COUNTY BOARDS TO PROVIDE APPROPRIATE DENTAL SERVICES FOR JAIL INMATES.