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OBJECTIVE To test a theoretical mediation model and investigate whether drug use and/or dental anxiety act as mediating factors between depression and dental decay experience among prisoners. METHOD A cross-sectional survey was conducted on a convenience sample of 300 prisoners across three prison establishments in Scotland. Depression and dental anxiety were measured using the Centre for Epidemiological Studies Depression Scale and the Modified Dental Anxiety Scale, respectively. Drug use was assessed using three yes (scoring 1)/ no (s