SACRAMENTO -- Sarina Borg had a tough choice to make. She could wait for months, maybe more than a year, to have her rotting teeth repaired by a dentist. Or she could get them pulled to be reunited with her baby daughter.
In California women's prisons, dozens if not hundreds of inmates like Borg are faced with the same wrenching decision: To gain access to a host of vocational-training and drug-rehabilitation programs for non-violent offenders -- including a course that teaches them parenting skills while living with their children in special housing -- - they must be cleared of any pre-existing health problems.
Just one badly damaged tooth will block them from entering a program.
"It's unconscionable," said Assemblywoman Sally Lieber, D-Mountain View, who has proposed legislation to shorten the waiting list for women wanting to get their teeth fixed by a prison dentist, a measure that passed its first committee hearing last week.
"We have women who are getting 16 and 18 out of 34 teeth pulled, and that really destroys their future job prospects," Lieber said. "We have to change the situation."
She introduced AB 2877 after learning that a court settlement agreement, which calls for vastly improved dental care in all state prisons over the next three years, had left the three women's institutions near the bottom of the implementation schedule.
Relatively few inmates qualify for the program that allows mothers to serve their sentences with their infants because of the strict dental-clearance and other reasons, such as a requirement that the prisoners retain legal custody of their children.
So when the opportunity to enroll was presented to Borg, 31, who is from Daly City, it didn't take long to make her decision: "I said hurry up and pull it," Borg recalled of her meeting with a prison dentist, "I want to be with my baby."
She ended up having four teeth removed to earn her the coveted transfer to a minimum-security, dormitory-like prison in Oakland, the East Bay Community Recovery Project. There, she could bond with her 3-month-old daughter, Kamaleia, and learn how to become a better mother, in a setting that costs less to taxpayers than a traditional prison. Borg is expected to serve the remainder of her two-year, eight-month sentence for robbery at the program.
Officials with the California Department of Corrections and Rehabilitation say the dental and health clearances are necessary because the specialized programs are based at smaller community prisons and don't have dentists or doctors on site. Thousands of men also must pass the same screening to get into specialized programs scattered across California.
"We don't want to send offenders out to these facilities and have major dental issues or medical conditions that would put them at risk," said Wendy Still, who oversees the state's three mother-infant community prisons, which house 71 women.
About 900 women are enrolled in all of the specialized programs, which cost the state as little as $90 a day per inmate, Still said, a taxpayer bargain compared with the $121 daily tab of a traditional prison bed.
But as helpful as the programs may be in preparing women for life after prison -- and as useful as they are at reducing California's notoriously high recidivism rate -- they also have a major downside on the personal lives of the inmates.
Mothers who undergo extractions to live with their children in the community prisons, and who learn job skills there, have difficulty finding work upon their release because employers would rather not hire someone whose mouth has more gaps than teeth.
"It's probably almost as big a deal as having a criminal record," said Allyson West, director of the California Reentry Program, which prepares inmates for their release from San Quentin. "They're going to be pigeonholed because of their appearance."
Inmates with missing teeth also suffer from low self-esteem.
"I'm still young and now I have no teeth down there, you know what I mean?" said Borg, who doesn't smile as often as she used to; she's missing three bottom teeth on the right side of her mouth. She also finds it hard to chew. "Being a woman, I just feel degraded, really bad."
Prison dental clinics don't typically offer dentures, implants or other cosmetic work.
Another inmate in the Oakland program, 31-year-old Michelle Filby, is self-conscious about a gap on the top row of her mouth, and other missing teeth, which she hopes to fix after her release, assuming she lands a good job.
Still, she has no regrets. "I'd rather lose a tooth than not have my baby, so to me it was worth it," Filby said. "But it would have been nice to maybe get a root canal or fillings."
Rachel Roth, an independent scholar and national expert on the health issues of women in prison, said the dental-clearance policy "just shows how desperate women are to get out of the big prisons and be with their children that they would allow themselves to be treated in such an inhumane way."
Prison statistics don't track how many women with severely damaged teeth, often caused by methamphetamine use and poor hygiene, have requested extractions to get into the programs.
About 9,000 teeth are pulled each year in California's three female institutions, according to prison system records. More than 12,000 women are housed in those prisons.
It's also difficult to determine how California's dental-clearance policy compares with the rest of the country, because not all states have similar women's housing programs; some institutions run nurseries within large prisons where health services are readily available.
Advocates for female inmates who are familiar with prison policies nationwide say California's dental-clearance requirement seems rare.
"That's extraordinary," said Tamar Kraft-Stolar, a director with the Correctional Association of New York, a non-profit agency with authority to inspect that state's prisons. "I've not heard of anything like that."