International Dental Journal (2010) 60, 300-304

Dermatoglyphics – A marker for

malocclusion?
S Tikare1, G Rajesh2, KVV Prasad2, V Thippeswamy2 and SB Javali2
1
Coorg Instituite of Dental Sciences, K.K.Campus, Coorg District, Karnataka, India;
2
SDM College of Dental Sciences and Hospital, Sattur, Dharwad, Karnataka, India

Introduction: Dermatoglyphics is the study of dermal ridge configurations on palmar and

plantar surfaces of hands and feet. Dermal ridges and craniofacial structures are both
formed during 6-7th week of intra-uterine life. It is believed that hereditary and environ-
mental factors leading to malocclusion may also cause peculiarities in fingerprint patterns.
Objective: To study and assess the relationship between fingerprints and malocclusion
among a group of high school children aged 12-16 years in Dharwad, Karnataka, India.
Design: A total of 696 high school children aged 12-16 years were randomly selected.
Their fingerprints were recorded using duplicating ink and malocclusion status was clini-
cally assessed using Angle’s classification. Results: Chi-square analysis revealed sta-
tistical association between whorl patterns and classes 1 and 2 malocclusion (p<0.05).
However, no overall statistical association was observed between fingerprint patterns and
malocclusion (p>0.05). Conclusion: Dermatoglyphics might be an appropriate marker
for malocclusion and further studies are required to elucidate an association between
fingerprint patterns and malocclusion.

Key words: Fingerprint patterns, Angle’s classification, chi-square analysis

The term dermatoglyphics was coined by Cumins and
Midlo1 and is derived from two Greek words – derma
which means skin and glyphe which means carve. It
refers to the friction ridge formations which appear on
the palms of the hands and soles of the feet.. These der-
mal ridges over the palms and soles of an individual are
unique, universal, inimitable and classifiable. Currently,
all studies of the dermal ridge arrangements including
genetics, anthropology and Egyptology are classified
under the term dermatoglyphics2.
Finger, palm and sole impressions are said to be
products of both environment and heredity. It is an
established scientific fact that no two individuals, includ-
ing monozygotic twins, have the same fingerprints and
other details of dermal ridges. Thus, fingerprints are
unique to each person and they are not altered during
life time due to disease, age or any other reason.
Fingerprints are classified into three basic types
(Figure 1); whorls, loops and arches3. A whorl is distin-
guished by its concentric design, in which the majority
margin it is an ulnar loop, and if so to the radial margin
it is a radial loop. In an arch, the ridges pass from one
margin of the digit to the other with a distally bowed
sweep, which gives it its name.
The present day study of the hand has moved far
from the popular image of the sooth saying hand
readers, sages and theologians. Apart from their use
in identification of individuals by forensic experts, the
current state of medical dermatoglyphics is such that
association between fingerprint patterns and various
conditions such as diabetes mellitus, hypertension4,5,
psychosis6, breast cancer7, alcohol embryopathy8, epi-
lepsy9, congenital heart diseases10 and many others has
been established. Recently, recognition of irregular
fingerprints among patients with periodontitis11, dental
caries12 and certain types of congenital anomalies like
cleft lip and palate13,14 has drawn attention of investiga-
tors to the field of dental dermatoglyphics.
The development of dermal ridges starts from 12th-
13 week of gestation and by around 20th week, well
th

of ridges make circuits around the core; ridges of the
loop, instead of coursing in complete circuits, curve
around only one extremity of the pattern and flow to
the margin of digit. This extremity of the pattern thus
may be described as open. If the loop opens to the ulnar
© 2010 FDI/World Dental Press
0020-6539/10/04300-05
differentiated recognisable dermal ridges are formed15.
As genetic or chromosomal abnormalities might be re-
flected as alterations in dermal ridges, they can be used
as an easily accessible tool in the study of genetically
influenced diseases16. Dermatoglyphic investigation is
doi:10.1922/IDJ_2520Tikare05

Whorls Loops Arches
Figure 1. Classification of ridge patterns.
convenient, cost effective and requires no hospitalisa-
tion. It can help in predicting the phenotype of a pos-
sible future health condition.
Human tooth development also starts as early as the
6th week of embryonic life17. Since both dermal patterns
and craniofacial constitution are strongly but not exclu-
sively genetically governed structures, it may be hypoth-
esised that hereditary and genetic factors causing changes
in the lip, alveolus and palate may also cause peculiari-
ties in fingerprint patterns. Malocclusion is one of the
most commonly reported oral conditions and is widely
prevalent. Genetic factors are one of the most commonly
implicated putative aetiologic factors for this condition.
There are sparse reports of dermatoglyphic findings in
children with malocclusion, and only two studies have
been reported regarding the same in Indian popula-
tions, the results of which were equivocal18,19. Hence, the
present study was undertaken to further ascertain the
reliability of dermatoglyphics as a predictive diagnostic
tool for malocclusion in order to apply preventive and
interceptive orthodontics to the high risk groups. The ob-
jective of the present study was to assess the relationship
between fingerprint patterns and malocclusion among
high school children aged 12-16 years from the city of
Dharwad, Karnataka state in Southern India.
Materials and methods
The present study was conducted among 12-16-year-old
high school children (n=696) in Dharwad city. A list of
all high schools was obtained from the Block Educa-
tional Officer (BEO), Dharwad and three schools were
randomly selected. Permission to carry out the study
was obtained from high school authorities. Informed
consent was obtained from the concerned authorities
in the schools and ethical clearance was obtained from
the Ethical Review Committee of the institution. Only
children with fully erupted second molars were included
and those undergoing or who had undergone orthodon-
tic treatment were excluded.
Recording of fingerprint patterns of the study sub-
jects was achieved with a rolling impression technique
using black printer’s ink, as prescribed by the Kentucky
State Police, USA20. In addition, inputs were obtained
from Fingerprint Bureau, Police Commissioner’s Office,
Hubli-Dharwad city. To avoid duplication of finger-
301
prints, the fingers were numbered from 1-5 for left little
finger to the thumb, and from 6-10 for right thumb to
right little finger of the hand respectively. Duplicating
ink was applied with the use of cotton applicator to all
the distal phalanges of the fingers and the fingerprint
impressions were taken on a white proforma sheet with
blocks for each finger. The fingerprints were then veri-
fied and the whole procedure was repeated to ensure
proper recording of the fingerprints.
Clinical examination of the children was done by
another examiner and their occlusion was assessed by
Angle’s classification. The fingerprint records were later
sent to the fingerprint experts from Fingerprint Bureau,
Commissioners office, Hubli-Dharwad, Karnataka, In-
dia, for analysis. Once the data pertaining to fingerprints
was obtained from the fingerprint experts, it was entered
into a MS Excel spreadsheet (MS Office Excel 2007)
along with the data pertaining to occlusion status of
study subjects. Data were subjected to statistical analysis
using Intercooled Stata (Version 9.2).
Results
The frequency analysis of the fingerprint patterns in
various classes of malocclusion revealed that at each of
the frequency of whorl pattern in the three classes of
malocclusion were almost equally distributed. The ob-
servations were highly similar with respect to the ulnar
loop, radial loop and arch pattern (Table 1).
Comparison of the finger print pattern with different
classes of malocclusion was done using the Chi-square
test. Level of significance was set at 5%. There was a
statistically significant association in the whorl patterns
between class 1 and class 2 malocclusions. There was
no statistically significant association in the other fin-
ger print patterns and any class of malocclusion in the
present study (Table 2).
The overall analysis of finger print patterns and classes
of malocclusion showed that there was no statistically
significant association for the other fingerprint patterns
and any classes of malocclusion (p>0.05) (Table 3).
Discussion
The study of the pattern of dermal ridges has long fas-
cinated men through the ages and attempts have been
made to predict the future of individuals based on the
ridge patterns. Towards the end of the 19th century,
Galton put forth a rule called ‘proof of no change’,
which states that an individual’s dermatoglyphics remain
unchanged throughout his/her lifetime. On the basis
of these original studies, many researchers have investi-
gated dermatoglyphics in various fields such as forensic
medicine, genetics and anthropology21.
Although the use of various aspects of derma-
toglyphics including fingerprints is not clear in law, the
role of inheritance is well recognised. It is widely agreed
Tikare et al.: Dermatoglyphics – A marker for malocclusion?
302

Table 1 Percentage frequency of finger patterns in various classes of malocclusion among study subjects

  WHORLS ULNAR LOOPS RADIAL LOOPS ARCHES

Frequency C-1 C-2 C-3 C-1 C-2 C-3 C-1 C-2 C-3 C-1 C-2 C-3

0 14.51 19.58 14 5.96 7.69 6 84.29 83.22 86 83.5 81.82 82

1 9.15 15.38 16 5.77 6.99 8 12.92 14.69 14 6.96 7.69 10
2 13.12 9.79 8 7.36 6.99 10 2.78 1.4 0 4.77 2.1 4
3 11.93 4.9 10 10.93 4.9 8 0 0.7 0 1.59 2.1 2
4 9.34 9.79 4 7.75 12.59 14 0 0 0 1.39 4.2 0
5 8.55 6.99 10 10.74 8.39 6 0 0 0 0.4 0.7 0
6 6.36 9.79 10 11.93 10.49 4 0 0 0 0.4 0.7 0
7 9.34 4.2 6 13.12 9.09 14 0 0 0 0.99 0 2
8 6.56 6.99 8 13.92 13.99 12 0 0 0 0 0 0
9 5.37 5.59 8 7.55 10.49 14 0 0 0 0 0 0
10 5.77 6.99 6 4.97 8.39 4 0 0 0 0 0.7 0
Total 100 100 100 100 100 100 100 100 100 100 100 100

Table 2 Chi-square analysis of association between fingerprint patterns and malocclusion among study subjects
Fingerprint Pattern Class-1 & Class-2 Class-1 & Class-3 Class-2 & Class-3

Whorls 0.0492* 0.7227 0.8934

Ulnar Loops 0.1860 0.4949 0.8388
Radial Loops 0.1989 0.4848 0.7782
Arches 0.1548 0.9469 0.5623

* Statistically significant at 5% level of significance (p<0.05)

Table 3 Chi-square analysis of association between fingerprint patterns and malocclusion among study subjects
Malocclusion Whorls Ulnar loops Radial loops Arches

No at least 1 Total No Ulnar at least Total No at least Total No at least 1 Total

whorls whorl loops 1 Ulnar Radial 1 Radial arches arch
loop loops loop

Class 1 73 430 503 30 473 503 424 79 503 420 83 503

Class 2 28 115 143 11 132 143 119 24 143 117 26 143
Class 3 7 43 50 3 47 50 43 7 50 41 9 50

Total 108 588 696 44 652 696 586 110 696 578 118 696

p-value 0.321* 0.752* 0.892* 0.876*

* Not statistically significant at 5% level of significance (p>0.05)

that dermatoglyphic patterns are genetically governed.
Recognition of irregular fingerprints among patients
with certain types of congenital anomalies has drawn
attention to the field of medical dermatoglyphics21.
Dermatoglyphic patterns in patients with trisomy
2121, congenital heart diseases10, breast cancers7, au-
tism22, rheumatoid arthritis23, insulin dependent and
non-insulin dependent diabetes mellitus4 and skeletal
abnormalities24 has been probed. Investigators have also
explored the association of dermatoglyphics with CNS
disorders like autism22, psychosis6, epilepsy9, alcohol
embryopathy8 and central hypoventilation syndrome25,
Kabuki syndrome26 among other disorders.
International Dental Journal (2010) Vol. 60/No.4
While the development of the primary and second-
ary palate is completed by 7th and 12th week of intra-
uterine life respectively, volar pads related to ridge
patterns develop from 6-13th week of intra-uterine life.
Hence, the genetic message contained in the genome,
normal or abnormal, is deciphered during this crucial
period and could be reflected through dermatoglyph-
ics14. This might lead to a possible association between
dermatoglyphics and oro-facial disorders like cleft lip
and/or cleft palate and malocclusion.

The investigators have also reported that study sub-
jects with dental caries had lower frequency of loops
and higher growth of Sterptococcus mutans as compared
with the control group12.
Reddy et al.18 reported that dermatoglyphics can be a
predictor of malocclusion. A total of 96 study subjects
were included in the study who were divided into four
groups, with each group consisting of 24 individuals.
Results indicated that craniofacial Class 2, division II
pattern was associated with increased frequency of
arches and ulnar loops and decreased frequency of
whorls, whereas in Class 3, there was an increased
frequency of arches and radial loops with decreased
frequency of ulnar loops.
Trehan et al.19 also investigated the dermatoglyphic
patterns in 60 malocclusion patients. They observed
that Class 1 and Class 3 were associated with increased
frequency of whorls and both Class 1 and Class 2 divi-
sion I were associated with increased frequency of radial
loop and arches.
The results of the above mentioned studies are
in contrast with those observed in the present study.
Overall, no association was observed between der-
matoglyphic patterns and malocclusion among study
subjects. It was however noted that whorl patterns were
significantly associated with classes 1 and 3 malocclu-
sions. In studies which explore associations between
different variables, variations in sample size might lead
to results which are often contradictory. To avoid any
such errors, a healthy sample size of 696 study subjects
was included in the present study.
Help was sought from Fingerprint Bureau, Com-
missioners office, Hubli-Dharwad, Karnataka, India
for recording and interpretation of fingerprint patterns
from study subjects. Recording and interpretation of
fingerprint patterns can be prone to a lot of variations
and hence can be a source of error. To eliminate any
such pitfalls, assistance was sought from the Fingerprint
Bureau, which is a premier organisation in the country.
In the previous studies which have correlated derma-
toglyphics and malocclusion, there is no explicit men-
tion of the protocol employed for recording fingerprint
patterns of study subjects.
In other medical dermatoglyphic studies, no associa-
tion was observed between dermatoglyphics and blood
pressure27 and sleep apnoea syndrome28. Abnormalities
in the areas of palm and fingerprints are influenced by
a combination of hereditary and environmental factors.
The threshold theory as has been advanced by inde-
pendent studies conducted by Carter and Matsunaga
implies that only when the combined factors exceed
a certain level, can these abnormalities be expected
to appear. The aetiological factors responsible for the
manifestation of dermatoglyphic appearances and
malocclusion might not cross this threshold for these
conditions to manifest clinically14.
303
However, we acknowledge that further studies are
required to shed more light on the relationship between
dermatoglyphics and malocclusion. The present study
used Angle’s classification of malocclusion for clinical
assessment of study subjects. Use of a more sensitive
index such as the Dental Aesthetics Index (DAI) for
the same may optimise the correlation between the two
variables under investigation.
Furthermore, studies which include recording the
ridge patterns on the entire palm of the study subjects
and assessment of the Angle atd on the palmar surface
in addition to the distal phalange dermatoglyphic ridge
patterns might also be more informative. Moreover,
obtaining the total ridge count from the triradial point
to the centre of the ridge pattern on the distal phalange
of the fingers could also be useful.
Both dermatoglyphics and malocclusion have both
obvious polygenic and environmental influences and
both develop at similar time periods. Association ob-
served between whorl patterns and classes 1 and 2
malocclusions offer further avenues for research in this
particular field. Dermatoglyphics offers many distinct
advantages as a screening tool for malocclusion. It could
be used as an easily accessible, economical and non-inva-
sive marker for the aforementioned conditions. Findings
from such studies might offer important practical and/
or clinical implications for preventive and interceptive
orthodontics among paediatric patients. Further investi-
gations, particularly longitudinal studies may be required
to substantiate the findings presented herein.
Acknowledgements
We are grateful to Dr. Ashith Acharya, Forensic Odon-
tologist, SDM College of Dental Sciences & Hospital,
Sattur, Dharwad, for his inputs throughout the course
of the study and also for enhancing the quality of the
manuscript. We also thank the fingerprint experts,
Fingerprint Bureau, Commissioners’ office, Hubli-
Dharwad, Karnataka, India, for providing valuable
inputs in recording fingerprints and also for analysing
fingerprints.
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Correspondence to: Dr. S Tikare, Assistant Professor, Department
of Public Health Dentistry, Coorg Instituite of Dental Sciences,
K.K.Campus, Maggula Village, Virajpet – 571218, Coorg District,
Karnataka, India. Email: shreyas_tik@yahoo.co.in