HOUSTON (AP) — Inmates without teeth in Texas are routinely denied dentures because state prison policy says chewing isn't a medical necessity because they can eat blended food.

Texas prisons' medical providers approved 71 dentures to a state inmate population of more than 149,000 in 2016, the Houston Chronicle reported. It's a sharp decline from 15 years ago, when more than 1,000 dental prosthetics were approved.

California, the next-largest prison population, has given nearly six times as many dentures as Texas in the past decade, despite the Lone Star State having nearly 19,000 more inmates than the Golden State. California's prison system provided more than 4,800 dental prosthetics in 2016, according to the state's Department of Corrections and Rehabilitation data.

Many Texas inmates are in need because they're elderly, have a history of drug use or came from impoverished backgrounds with subpar dental care.

But state policy has strict guidelines saying that inmates can't get dentures unless they're underweight or suffering from other medical complications. The policy recommends that inmates with fewer than seven teeth undergo reviews for dentures, but there usually needs to be additional health issues to merit serious consideration for the few dental prosthetics doled out each year.

"Ultimately, it is a medical decision," said Texas Department of Criminal Justice spokesman Jeremy Desel.

Death row inmate Paul Devoe soaks crackers in coffee to eat them with his three remaining teeth. Devoe and other inmates have complained about bleeding gums, sore mouths, choking and being unable to eat. Many have reported that their teeth were pulled with the promise of receiving dentures, only to find out that wasn't the case.

The Texas prison system doesn't have any plans to change its denture policy.

"The current dental prosthetic policy was last reviewed in April of last year, and there are no plans for it to be reviewed again in the future," Desel said earlier this year.

Fred Cohen, a retired law professor who authored a book on Correctional Managed Health Care and the Law, said that a class-action lawsuit is the only way inmates will be able to see reform.

Sen. John Whitmire said, "Unfortunately, too many people don't care."

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