FORENSIC DENTISTRY 2.

Revolutionary War

Definition
Forensic Odontology
• is the application of dentistry in legal proceedings deriving
from any evidence that pertains to teeth
• Is the proper handling, examination, and evaluation of
dental evidence, which will be then presented in the
interest of justice
• 1775 – Paul Revere was the first forensic dentist in the
United States because he identified fallen revolutionary
soldiers.
• Paul Revere made a silver bridge for one man. The man
was killed in the Revolutionary War.
• Body was in mass grave and identified by his silver dental
work.
3. 1849

• Mass Deaths at Vienna Opera House Fire

Two main functions of forensic odontologist • Dental evidence is first admitted into court system in US

1. Identify human remains The Most Famous Bitemark Case of the 20th Century
2. Analyze bite marks
Ted Bundy is suspected of having abducted and murdered over 30
women over a 10- year period.

FORENSIC IS DERIVED FROM THE LATIN WORD ‘FORUM’ WHICH
MEANS COURT OF LAW
FORENSIC DENTISTRY PLAYS A MAJOR ROLE IN IDENTIFICATION IN
MAN MADE OR NATURAL DISASTER – EVENTS THAT RESULT IN
MULTIPLE FATALITIES THAT MAY NOT BE IDENTIFIABLE THROUGH
CONVENTIONAL METHODS SUCH AS FINGER PRINTS
An intraoral photograph of Ted Bundy. The lower front teeth proved
to be useful at trial to link him to a bitemark found on a murdered
college student.
Courtroom exhibit showing the injury pattern is actually two
bitemarks nearly superimposed in the same area.

The identification of missing and unidentified people has legal and

Medico-Legal Investigation
humanitarian significance
Forensic odontology studies the following:
Major Fields of Forensic Odontology
1. Identifying unknown human remains through dental records, and
1. Civil – Non-Criminal
assisting at location of mass disaster
a. Identification of an individual remains, where
death is not due to any suspicious circumstances 2. Eliciting the ethnicity and assisting in building up a picture of
b. Mass disasters – identification of victims of hotel lifestyle and diet of skeletal remains at archeological sites
fires, aircraft, and other transport accidents
c. Malpractice or Fraud 3. Determining the sex of an unidentified individual
d. Age estimation
4. Age estimation of both the living and deceased
e. Identification of a living person due to loss of
memory 5. Recognition and analysis of bite marks found on victims of attack
2. Criminal and other substances such as food stuff
a. Identification of persons from their dentition or
teeth (victims and suspects) 6. Presenting evidence in court as an expert witness
i. Living person
ii. Dead person
b. Dealing with bite marks identification (self-
inflicted or inflected by another)
i. Foodstuff
ii. On the assailant
iii. The victim

History of Forensic Odontology

1. 66 AD

• First body identified using teeth

• Lollia Paulina
• The First Record of Forensic Dental Identification
• (Agrippina – married Emperor Claudius - mother of Nero)
Developing a Career as a Forensic Dentist 3. Matching of data obtained from the body with the record of the
missing person.
Forensic Odontologists
Sequential Type of Examination
• Must have DDS degree
• Should have specialized training in the field through I. Dental
lectures
1. Radiographs

1.1 dental

1.2 lateral head

1.3 anterior- posterior

1.4 disarticulated jaws

2. Study models

3. Photographs

Il. Clothing

Forensic Odontologist analyzing animal teeth for comparison. 2.1 Type

Theory of Human Identification 2.2 Color

All human identification is based on the fact that each human is 2.3 Size (belt size, shoe size, etc.)
considered to be unique. Ill. External Body
Two basic types of identification:

1. Confirmation

• In confirmation identification, the deceased is thought to

be a particular person.
o Ex. Person is killed and burned in a rented car.
The deceased is thought to be the person who
3.1 Birth marks
rented the car. The consultant compares
antemortem records of the renter with 3.2 Scars
postmortem records of the deceased.
3.3 Tattoos
2. Unknown
3.4 Evidence of old burns or fractures
• In unknown identification, the deceased is found in a
situation in which no clues at the scene lead to any 3.5 Circumcision present
particular person e.g., a skeleton found in in a field.
3.6 Unusual physical characteristics
Process of Identification
E.g. Missing digits, large ears or nose
The process of identification are performed by a team in the
IV. Internal body
following manner:
4.1 Missing organs
1. Examination and recording of all details of an unknown body and
living persons. E.g. Appendix, gall bladder, etc.

Methods used are: 4.2 Old fractures

1.1 Clinical examination - includes visual examination, x-rays, models 4.3 Foreign bodies
and photographs.

1.2 Microscopic examination - teeth and body

One can not be expected to be an expert in every area. Do not
1.3 Chemical examination - stains (blood, food chemicals, etc.) hesitate to call upon your colleagues in related fields.

2. Collection of information of a sinister character from missing

person
Dental Identification • Premolars
• Canine
Teeth
• Incisors
• Hardest part of body attached to jaws. It serves to help
digest food, act as a defense mechanism, etc.
• Teeth are made of a crown with enamel surrounding a Teeth differ in:
pulp.
• Size
1. Every human body ages in a similar manner, the teeth also follow • Shape
a semi-standardized pattern. These quantitative measurements help • Root type
establish relative age of person.
Standard Teeth Development for Age Estimation
2. Each human has an individual set of teeth which can be traced
back to established dental records to find missing viduals.

3. Teeth is made of enamel (hardest tissue of the body) so it can

withstand trauma (decomposition, heat degradation, water
immersion, and desiccation) better than other tissues in body.

4. Teeth are a source of DNA: dental pulp or a crushed tooth can

provide nuclear or mitochondrial DNA that to help identify a person.

Teeth Through The Years

Childhood
Analyzing Teeth

The Universal System

1. Teeth are given a specific number. (Primary teeth are given

specific capital letter)

2. Any dental work done on surface is noted.

3. Sheets kept on dental file forever. When person is missing,

files are transferred to the missing person's office.

Dental Notation

The three most common systems are:

Primary teeth sprout from milk buds and are temporary. Once they
1. The ISO System (WHO)
fall out, permanent teeth as seen on the other side appear.
- aka ISO 3950 (FDI)

- it is used worldwide
Adulthood
- can be easily adapted to computerized charting

2. Universal Numbering System

- widely used in the USA

- aka "American System"

3. Palmer notation method

- used in United Kingdom

Permanent adult teeth come in when primary teeth fall out; they are
permanent because they establish roots inside the gums. Third ISO System by the World Health Organization
molar come in around the mid teenage years.
- uses a two-digit numbering system in which the first number
Teeth Basic represents a tooth's quadrant and the second number represents
the number of the tooth from the midline of the face.
Approximately 32 teeth in adult mouth

Four types of teeth:

• Molars
Universal Numbering System

For permanent teeth Personal Identification

- the numbers 1 - 32 are used Dental Identification from teeth and Facial

For primary teeth 1. Identification is the establishment of a

- the uppercase letters A through T are used person individuality

The tooth designated "1" is the maxillary right third molar and the 2. Required for legal and humanitarian reasons
count continue along the upper teeth to the left side. Then the count
3. Help in settlement of property, facilitate remarriage of a surviving
begins at the mandibular left third molar, designated number 17,
spouse and Structure allow cremation or burial of the body ,
and continues along the bottom teeth to the right side.
according to relevant religious and cultural customs

• Physical features are prone to change over time,

fingerprints are exceptions but like other soft tissue,
undergo postmortem change.
• Being the strongest structure present in the body, dental
hard tissues are resistant to postmortem decomposition.
• Moreover most material used by dentist for restoring
teeth are also resistant to postmortem destruction.
• Therefore the use of dental evidence is the method of
choice in establishing the identity of badly burnt,
traumatized, decomposed and skelentonised remains

Postmortem examination (autopsy)

• is the examination of a body after death. The aim of a post-

mortem is to determine the cause of death.
• Postmortems are carried out by pathologists (doctors who
Palmer Notation Method specialize in understanding the nature and causes of
disease).
- was originally termed the "Zsigmondy system" after the
Hungarian dentist Adolf Zsigmondy who developed the idea in
1861, using a Zsigmondy cross to record quadrants of tooth
positions.

For Permanent teeth - numbered 1 to 8

For Primary dentition - depicted with a quadrant grid using Roman

numerals I, II, III, IV, V to number the teeth from the midline distally.

Palmer changed this to A, B, C, D, E.

POSTMORTEM IDENTIFICATION III. Skeletonized Remains

Classifications of Recovered Human Remains ✓ Photographs

✓ Radiographs
1. Viewable ✓ Dental Charting
2. Traumatized ✓ Jaw Articulation and Occlusal Analysis
3. Burned ✓ Preservation of Remains
4. Drowned
5. Decomposed SUGGESTED BASIC EQUIPMENT AND SUPPLIES
6. Skeletonized
1. Robe or Gown, Gloves, Eye Protector
Viewable Victim
2. Toothbrush, Mouth Mirror, Explorer
• Usually one that has recently died a nonviolent death
3. Peroxide, Bleach
• Little physical change between the appearance while alive and
the appearance upon being discovered dead. 4. Hair Spray or spray varnish, cyanoacrylate
• Victims may be viewed by family or friends and have open
casket funerals a. To stabilize fragile tissues
• Requires special handling to avoid disfiguring or mutilating the
5. X-ray film, Camera, flash, video camera
orofacial structures
6. Pens, pencils, postmortem dental chat
Traumatized Victim
BASIC DATA TO RECORD
• Fairly recent but violent, death
• Victim usually has suffered some amount of physical trauma 1. Case Number
• Removal of the maxilla and mandible is done to present the best
possible view 2. Date and Time

Burned Victim 3. Jurisdiction and/or Authority in charge

• Similar to traumatized victim a. Authorization to process remains

• Condition vary from slightly reddened skin to badly burned with 4. Contacting agent for jurisdiction
charred or incinerated remains
• The fragility of the remains requires special handling 5. Location

Drowned Victim 6. Suspected ID

• Can range from viewable to decomposed 7. Body type - including estimated age, sex, race, type of remains
• Cold water victim - appears severely bloated but basically well
8. Description of dental remains
preserved
• Warm to hot water - badly bloated and decomposed

Decomposed and Skeletonized Victims

• The remains will present with most, if not all, soft tissues gone
• Care must be taken with dental structures

POSTMORTEM EXAMINATION AND EVALUATION

Outline of Procedures a forensic Dentist may Employ:

I. Visually Identifiable Body

✓ Photographs
✓ Radiographs
✓ Dental Charting
✓ Dental Impression
✓ Preservation Of Oral Structures

II. Decomposed/Incinerated/Traumatized Body POSTMORTEM DENTAL CHARTING

✓ Photographs Postmortem record should include:

✓ Radiographs
✓ Dental Charting 1. All existing dentition/missing dentition and restoration
✓ Stabilization and/or Preservation of Remains a. Types of restorative materials and surfaces restored
b. Evaluation of periodontal status, calculus and stain
 c. Tipped, rotated, impacted/partially erupted • reflect all soft tissue, including muscle and oral mucosa to
d. Determination of postmortem loss of teeth expose bone.
2. Fixed, removable ad implant prosthetics
3. Identifying marks on any removable prosthetics LABELING AND PRESERVATION OF DENTAL EVIDENCE
4. Occlusal relationship
1. Teeth and resected of fragmented jaw can be preserved in
5. Unique intra- and interarch characteristics, including tori
either 10% formalin or embalming fluid.
6. Unique individual tooth characteristics
2. Labels must not be smeared, removed or faded over time.
7. Radiographic interpretation from postmortem radiographs
3. Must include the case number and date and examiner.
including:
4. Soft tissues should not be stored in formalin or embalming fluid
a. RCT
because it will cause desiccation and distortion of the tissues as
b. Unique presentation of normal structures
well as dissolving pigmentation or blood by products.
i. Root morphology - dilacerated roots
✓ Some pathologists simply freeze the soft tissue specimens.
ii. Pulpal anatomy – pulp stones
✓ They used a solution that will not distort the tissue.
iii. trabeculae, exostosis
✓ 2 parts 5% acetic acid, 4 parts formaldehyde and 4 parts
iv. Sinus morphology
water.
8. Photographic and videotape review
✓ Place tissue in solution, then remove and wrap in towel of
9. Dental impression (if indicated)
solution and store in a labeled ‘Zip-locked’ freezer bag and
a. Use an ADA approved silicone impression material
freeze.
b. Pour dental stone (not plaster)
c. Pour two sets of impression BURNED AND INCINERATED REMAINS
d. Label each set with date, your name, case number and
victim name Four categories or degrees (5 in forensic dentistry)
e. Label to maintain the chain of evidence
1. First degree burns
f. Keep the impression materials in their trays and with the
• Burns are superficial with no blistering
models for future use
• Burned area is swollen, red, painful
COMPARISON OF ANTEMORTEM AND POSTMORTEM DATA 2. Second degree burns
• Some or most of the epidermis is destroyed
DEGREE OF CERTAINTY • There is blister and scarring sometimes results
3. Third degree burns
1. Positive Identification
• Both the epidermis and dermis are destroyed and tissue
• It is when the antemortem and postmortem data match
undergoes massive necrosis.
with sufficiently detail to establish that they are from the
• Pain is often absent due to destruction of nerve endings.
same individual
• Scar formation
• There is no irreconcilable discrepancy.
• This type of burn is always fatal.
2. It is when the antemortem and the postmortem data have
matching features but because of the quality of either the 4. Fourth degree burns
postmortem remains or the antemortem evidence, it is not • Charring occurs with the total destruction of skin and
possible to positively establish dental identification. underlying tissues.
3. Insufficient evidence 5. Fifth degree burns
• There is no enough information to compare • These are cremated remains.
4. Exclusion • This is a logical extension of categories for forensic victim
• It is when the antemortem and the postmortem data are identifications
clearly not a match • Example: Pile of cremated remains was found near Panther
Meadows
RESECTION AND DISSECTION
Age Determination
• To provide full access to dental structures, techniques in
resection and dissection may be necessary • Determining Age from teeth:
• A proper written authority is obtained beginning dissection or o The estimation of age from dental development
resection. o Estimation is the only conclusion in the identification of
age. This is to avoid overconfidence and misdirection of
TECHNIQUES FOR EXPOSING THE DENTAL STRUCTURES FOR an investigation or judicial proceedings.
EXAMINATION AND RECORDING DENTAL EVIDENCE • Three categories in the analysis of dental evidence
1. Changes that occurs to the developing deciduous and
1. Extraoral Incisions (facial dissection) permanent dentition before eruption
• Extend bilateral incisions from the oral commissures to the 2. Gross morphological changes caused by wear and dental
body of ramus parallel with the plane of occlusion. pathology that occur after eruption
2. Inframandibular incision 3. Histological changes which can be related to the age of
• Incise the skin inferior and medial to the mandible in a tooth
direction from the ear across the midline to the opposite • Molar development as an estimator of chronologic age
ear.
3. Jaw resection
 • Third molar development as depicted in radiograph is
sometimes used to assess chronologic age from middle teens
and early 20’s

Factors which may be used for age estimation in children

1. Anomalies of tooth eruption

a. Early eruption of teeth
b. Early loss of deciduous teeth
c. Early eruption of permanent teeth
d. Late eruption of permanent teeth
2. Developmental defects
a. Dentinogenesis imperfecta and Amelogenesis imperfecta
3. Histological structures
• Neonatal line
4. Presence of high incidence of caries

Factors in age estimation in adult

• Morphologic, histologic, and chemical changes in teeth and jaws

1. Abrasion
2. Formation of secondary dentin
3. Addition of cementum
4. Retraction of gingiva
5. Resorption of root
6. Sclerosis of dentin or transparency of dentin
7. Changes in mandibular angle
8. Changes physically and chemically teeth

Methods of age estimation

1. Gustafson method (1947)

• The evaluation of ground sections of teeth is the foundation for

Gustafson’s method for age estimation from teeth 2. Maples aging method
• In the ground section, six age-related parameters are assessed
and their changes are contrasted using an age versus regression • This is an improvement of the Gustafson’s method
curve of age.
• Criteria for Age Estimation (A S P C R T) Bitemark evidence
1. Abrasion 1. Human bitemarks: Examination, recovery, and analysis
✓ wear and tear over the occlusal surface
• The process of bitemark identification is complex and
2. Secondary dentin formation
requires a high degree of expertise and experience
✓ deposition of dentin within the pulp cavity
• The examination and analysis of bitemark evidence found at
3. Periodontal destruction (gingival retraction)
a crime scene is one of the most stimulating and challenging
✓ gingival margins become retracted
areas of forensic odontology.
4. Cementum apposition
• If properly preserved and protected, bitemarks can provide
✓ Apposition of cementum at and around the roots of
an important link between the victim and assailant.
teeth
5. Resorption of cementum and root dentin Recognition of Bitemarks
✓ Root resorption due to aging (ageing nasa ppt)
6. Transparency at or near the apex • Human bitemarks vary in:
✓ Transparency of the dentin at the root level 1. Location
• Each criterion is allotted by point values of 0,1,2, and 3. 2. Appearance
o The sum of the several criteria reflects the age of the 3. severity
tooth. • Appearance of bites:
• High degree of skill and experience of the investigator is very 1. Oval circular contusions
much needed. 2. Bruises
3. Abrasions
4. Indentations
5. Lacerations
6. Avulsions
• Most bites exhibit markings from several of the six upper and or
six lower front teeth
 • Animal bites result in severe laceration of the skin surface or • Obtain consent and explain the examination protocol to the
complete removal of sections of skin and tissue suspect.

Targets of human bites ll. Physical Examination

1. Nipple and other areas of the breast • It is important to ask the suspect if he had any denial
2. Abdomen treatment at the time of the presumed date of bitemark.
3. Thighs
4. Back and shoulder III. Photographs
5. Nose
• A series of photographs of the suspect and the dentition
6. Ears
which records the shapes, contours and positions of the
7. Fingers
teeth and jaws from a variety of viewpoints is ideal.
Target of animal bite • Photograph the full face and profile of the suspect.

1. Feet Three dental die stone models should be fabricated.

2. Legs
• 1st model - kept as an untouched record of the suspect.
3. Hands and arms
• 2nd model — used during bitemark analysis
Recovery of bitemark evidence from the victim • 3rd model - will be used as backup

1. General consideration

• It is recommended that the odontologist keep detailed VI. Saliva Swab

accounts of the procedures used to collect and preserve the
• The odontologist should obtain a sample of saliva from the
evidence.
suspect.
2. Salivary trace evidence • The saliva and DNA biological evidence from the suspect can
be compared to the results from the swab taken from the
• Serologists estimate that 80% - 85% of the human population bite on the victim.
secrete agglutinins in their body fluids (saliva, seminal fluid,
tears and perspiration) which can be used to determine the
person’s ABH blood group classification.
CANVAS: M1 Introduction to Forensic Odontology
3. Photographs
Forensic science
• The injury site should be extensively photographed using color
• the application of the methods of the natural and physical
and black and white print film
sciences to matters of criminal and civil law.
• Photography is the least expensive part if the recovery
• Almost any science can be forensic science because almost any
protocol and the most significant and useful evidence.
science can contribute to solving a crime or evaluating civil
4. Surface moulding harm.

• An accurate mold of the skin surface can be obtained using
dental impression materials.
• Low medium viscosity vinyl polysiloxane (VPS) impression
materials have been found to be very accurate and possess
good long-term stability.
• A light body impression material is expressed into the injury
site with a syringe and is allowed to completely cover the
injury.
5. Tissue removal
• In the case of deceased victim, the skin may be removed and
preserved
• It is important to maintain the skin in its original anatomical
shape and avoid any distortion of bitemark pattern
Recovery of Bitemark Evidence from the Suspect
I. General Consideration
• In examining any patient, the odontologist should follow
recommended infection control and asepsis practices.
Areas of Forensic Science are:
1. Forensic Anthropology
• deals with skeletal biology, which includes bone and bone
system structures and their relationships to characteristics
such as gender, age, race, socioeconomic status, and so
forth.
2. Criminalistics
• defined as the application of scientific methods to the
recognition, collection, identification, and comparison of
physical evidence generated by criminal or illegal civil
activity.
• It also involves the reconstruction of such events by
evaluation of the physical evidence and the crime scene.
3. Forensic Engineering
• uses the concepts of mechanical, chemical, civil,
and electrical engineering as tools in the reconstruction of
crimes and accidents and the determination of their cause.
 • It involves traffic accident reconstruction wherein forensic
engineers use evidence such as skid marks; damage to cars
and their positions after the accident; road and
environmental conditions; injuries to drivers, passengers,
and pedestrians; and witness accounts.
4. Jurisprudence
• most members of which are lawyers who have a strong
interest in the legal aspects of the status of scientific
evidence in the courts.
• They study and comment on the admissibility of scientific
evidence, especially new types of evidence.
5. Forensic Pathology
• in charge of determining the cause and manner of death.
• Other states employ the expertise of medical examiner who
is a physician or coroner, an officer who employs forensic
pathologists to carry out the necessary duties.
6. Forensic Entomology
• deals mainly with the dead victim by determining the
postmortem interval by examining which insect populations
inhabit the body.
7. Forensic Psychiatry (and to some extent Psychology)
• have long been involved in determining whether persons
are mentally competent to stand trial and to aid in their own
defense.
8. Questioned-Document Analysis
• It is an apprenticeship field, requiring years of practice and
works with an experienced examiner.
• The most familiar area of questioned-document
examination is handwriting analysis to determine if a
particular person was the author of a document.
9. Toxicology
• is the analysis and identification of poisons and drugs in the
body causing death or injury, the most common kinds of
cases examined involve drunk or drugged driving.
10. Forensic Odontology
• or Forensic Dentistry as it is also known, encompasses a sub-
specialty of dentistry that deals specifically with the
relationship between dentistry and the law.
• Experts in this field are known as forensic odontologist or
forensic dentist, whose job consists mostly of analysis and in
some cases, fieldwork.
• Forensic dentistry is one of the most interesting yet poorly
understood of all the areas of the profession of dentistry.
M1 L 1 History
Forensic Odontology
• is the application of dentistry in legal proceedings deriving from
any evidence that pertains to teeth.
• is the proper, handling, examination and evaluation of dental
evidence, which will then be presented in the interest of justice.
Forensic is derived from the latin word FORUM which means court of
law
Major Fields of Forensic Odontology
1. Civil – Non-Criminal (𝑀2 A𝐼 2 )
• Mass disasters – identification of victims of hotel fires, aircraft
and other transport accidents.
• Malpractice or fraud
• Age estimation
• Identification of an individual remains, where death is not due
to any suspicious circumstances.
• Identification of a living person due to loss of memory
2. Criminal (ID)
• Identification of persons from their dentition or teeth (victims
and suspects), (cases of abuse)
o Living and Dead person
• Dealing with bite marks identification
o Foodstuff
o On the assailant
o The victim
HISTORY
1. 66 AD
• The First Record of Forensic Dental Identification
• First body identified using teeth
• Lollia Paulina – due to tooth decay, she had her teeth
replaced with gold teeth.
• This gold teeth became the evidence of Agrippina who is
married to Emperor Claudius, mother of Nero
2. 1175
• Revolutionary War
• Paul Revere was the first forensic dentist in the United
States because he identified fallen revolutionary soldier (Dr.
Joseph Warren) thru his dental work (silver bridge)
3. 1849
• Mass deaths at Vienna Opera House Fire
• Dental evidence is first admitted into court system in US
4. 1850
• John White Webster Case
• First convict based on dental evidence
• Murder in Medical School: The Parkman – Webster Case
• John White Webster murdered George Parkman
5. 1898
• L’ART DENTAIRE EN MEDECINE LEGALE
o The first book written on Forensic Odontology
o written by Dr. Oscar Amoedo.
• Dr. Oscar is also known as the “father of Forensic”
THE MOST FAMOUS BITEMARK CASE OF THE 20TH CENTURY
• Ted Bundy is suspected of having abducted and murdered over
30 women over a 10-year period since 1974.
• An intraoral photograph of Ted Bundy.
• The lower front teeth proved to be useful at trial to link him to a
bitemark found on a murdered
HOW TO BECOME A FORENSIC ODONTOLOGIST?
1. Must be a licensed dentist or physician.
2. Get work experience. Take on an internship role in the type of
forensics you would like to pursue. Or get a graduate degree in
forensic science.
3. Seek a professional certification through the various prestigious
forensic organizations and associations
4. Perfect your resume and cover letters. Apply for jobs in the field
in which you have decided to specialize.
5. Practice interviewing for a job as if you were speaking as an
expert witness in court. They are looking for someone who has
a meticulous appreciation for the facts of a case.
6. Continue to supplement your career with continuing education
courses after you get a job. Make sure you are on the cutting
edge of the field in order to be eligible for promotions or better
opportunities.
Organization of Forensic Odontology
1. American Board of Forensic Odontology (ABFO)
• The American Board of Forensic Odontology was organized in
1976 under the auspices of the National Institute of Justice.
• Created bite mark methodology guidelines and standard
terminologies describing bite marks, and guidelines to collect and
preserve evidences.
2. Bureau Of Legal Dentistry (BOLD)
• is a forensic odontology laboratory at the University of British
Columbia.
• It is the first and only laboratory in North America that is
dedicated to full-time forensic dentistry research, casework and
graduate teaching.
• It is the place where laboratory discoveries and modern forensic
methods are applied to dental evidence to assist in the resolution
of legal issues.
3. American Society of Forensic Odontology (ASFO)
• Founded in 1970, the society promotes interest and research in
the field of forensic odontology (forensic dentistry).
• Provides various opportunities for continuing education
through course listings and online case presentations.
4. International Organization For Forensic Odonto-Stomatology
(IOFOS)
• Born in 1987 with these objectives:
o To provide a liaison between societies of (legal) forensic
odontology on a global basis.
o To promote goodwill, advancement and research in
forensic odontology.
o To publish a newsletter on a regular basis.
5. American Academy of Forensic Sciences (AAFS)
Forensic Odontology Society of the Philippines (FOSP) / Bachelor of
Forensic Sciences (BFSC)
1. 2010 integration of fo in the school curriculum & creation of fosp
2. June 2013 university of baguio was the 1st school that offered
bachelor of forensic science
o A 4 year and non-board course open to fresh graduates of
senior high school or degree holders. The course is under the
cluster of criminal justice education by ched.
NBI
• a stakeholder of the Philippine National Police (PNP) and PRC
Accredited Continuing Professional Development (CPD)
Provider offering specialized training/course in investigation,
law Enforcement, Security and Safety, Para-Legal, and Forensic
Science.
✓ Raquel B. Del Rosario-Fortun, the first Filipino woman forensic
pathologist.
✓ Dr. Maria Corazon de Ungria, head of the DNA Analysis
Laboratory, Natural Sciences Research Institute University of
the Philippines Diliman
M1 L2 Main Aspects of Forensic Dentistry
Forensic dental fieldwork
✓ requires an interdisciplinary knowledge of dental science. Most
often the role of the forensic odontologist is to establish a
person's identity.
✓ Teeth, with their physiologic variations, pathoses and effects of
therapy, record information that remains throughout life and
beyond.
✓ The teeth may also be used as weapons and, under certain
circumstances, may leave information about the identity of the
biter.
✓ Forensic odontology has an important role in the recognition of
abuse among persons of all ages.
✓ Dental professionals have a major role to play in keeping
accurate dental records and providing all necessary information
so that legal authorities may recognize malpractice, negligence,
fraud or abuse, and identify unknown humans.
✓ Forensic dentists are responsible for six main areas of practice:
1. Identification of found human remains
2. Identification in mass fatalities
3. Assessment of bite mark injuries
4. Assessment of cases of abuse (such as child, spousal or elder
abuse)
5. Civil cases involving malpractice
6. Age estimation and sex determination
CANVAS: M2 Human Identification From Teeth and Facial
Structures
✓ The primary utility of forensic odontology is in the identification
of human remains based upon the individualistic characteristics
present in the teeth of different individuals.
o This discipline plays a significant role in the identification
of human remains in incidents such as tsunamis,
earthquakes, landslides, bomb blasts and terrorist
attacks, airplane crashes, train and road accidents, etc.
where highly mutilated and dismembered dead bodies
are recovered which are beyond recognition.
 ✓ Facial feature points such as eyebrows, eyes, nose and mouth comparisons employs established methodologies that will support (or
are prominent landmarks surrounding facial components. They refute) the identification.
depict critical information about facial expression and head
movement. M2 L2 Methods of human identification
o Hence accurate and perfect detection of facial features is General methods of human identification
important in several applications like face recognition, face
tracking, criminal identification, security and surveillance 1. Personal identification
systems, Human-computer interaction(HCI), model-based
video coding. • Tattoo, scars, birthmarks, belongings, id card, color of eyes, body
✓ Dental structures are the hardest and well-protected structures piercing
in the body.
2. DNA-based human identification
o These structures resist decomposition and high
temperatures and are among the last ones to disintegrate 3. Forensic odontology
after death.
o The principal basis of the dental identification lies in the 4. Fingerprint
fact that no two oral cavities are alike and the teeth are
• The broad classification pattens
unique to an individual.
or ridge formation classes of
o The dental evidence of the deceased recovered from the
prints used are:
scene of crime/occurrence is compared with the
o Arch
antemortem records for identification.
o loop
o Dental features such as tooth morphology, variations in
o whorl.
shape and size, restorations, pathologies, missing tooth,
wear patterns, crowding of the teeth, colour and position 5. Forensic anthropology
of the tooth, rotations and other peculiar dental anomalies
give every individual a unique identity. 6. Medical records

7. Visual id
M2 L1 Theories of human identification
8. X-rays – implants & fractures
Identification
Human Identification from teeth and Facial structures
• is defined as the characteristics by which a person may be
• Antemortem Data form
recognized.
o Consist of the following:
• It is the establishment of a person’s individuality and this can be
1. Personal data
accomplished by way of several methods.
a. Medical/Dental records
Personal Identification 2. AM Radiographs
3. Model Cast
1. Identification is the establishment of a person's individuality 4. AM Photographs
2. Required for legal and humanitarian reasons
3. Help in settlement of property, facilitate remarriage of a • Postmortem data form
surviving spouse and allow cremation or burial of the body, o Consist of the following:
according to relevant religious and cultural customs 1. Examination of dentition
2. Fabrication of Study Cast
2 basic types of human identification:
3. PM Photographs
1. Confirmation 4. PM Radiographs
• In confirmation identification, the deceased is thought to be
DNA in the teeth can be obtained from odontoblastic processes of
a particular person. Ex. A person is killed and burned in a
dentin, cellular cementum, neurovascular tissues of pulp, radicular
rented car. The deceased is thought to be the person who
canals, periodontal ligament, and alveolar bone. DNA is present in
rented the car. The consultant compares antemortem
adequate quantity in the crown body, root body, and root tip of the
records of the renter with postmortem records of the
teeth
deceased.
2. Unknown STUDY MODELS
• Unknown - In unknown identification, the deceased is found
in a situation in which no clues at the scene lead to any • Study models present the following:
particular person e.g. a skeleton found in a field. o Crown morphology
o Missing teeth
A common but unreliable means is by visual identification of the o Teeth present
remains. The authorities will also attempt to confirm the identity by o Dental restorations
using more reliable scientific methods like the use of DNA, fingerprint o Occlusion
comparison and dental, anthropological or medical records to o Anterior nasal spine
positively identify the unknown remains. Each of these scientific o Gingival morphology
 o Rugae structure 2. Possible identification: The antemortem and postmortem
o Tooth position data have consistent features but, because of the quality of
o Bony edentulous conditions either the postmortem remains or the antemortem
o Arch form evidence, it is not possible to establish identity positively.
o Palate form 3. Insufficient evidence: The available information is
insufficient to form the basis for a conclusion.
SPECTROSCOPY
4. Exclusion: The antemortem and postmortem data are
• Mass spectroscopy, also called mass spectrometry, is a scientific clearly inconsistent.
method that analyzes a sample of material to determine its
M2 L3 Rationale for Positive Identification of Human Remains
molecular makeup.
• Mass spectrometry has become a valuable tool in forensic Teeth - The hardest part of the body attached to jaws. It serves to help
science, where it can provide clues from the barest traces left by digest food, act as a defense mechanism, etc.
a suspect.
• Example: material used in fabrication of crown, dentures and Why teeth?
restorative materials
1. Every human body ages in a similar manner, the teeth also
SKELETAL SYSTEM follow a semi-standardized pattern. These quantitative
measurements help establish the relative age of the person.
• Features presented are:
o Tooth anomalies 2. Each human has an individual set of teeth which can be
o Tooth restorations traced back to established dental records to find missing
o Ridge condition individuals. Thus, human dentition is never the same in any
o Bone piercing two individuals.
o Fractures
3. Teeth are made of enamel (hardest tissue of the body) so
o Condylar abnormalities
it can withstand trauma (decomposition, heat degradation,
The processes of human identification are performed by a team in water immersion, and desiccation) better than other tissues
the following manners: in the body.

1. Examination and recording of all details of an unknown body and
living persons.
• Clinical examination - includes a visual examination, x-rays,
models and photographs.
• Microscopic examination – teeth and body
• Chemical examination – stains (blood, food chemicals, etc.)
2. Collection of information of a sinister character from missing
persons
3. Matching of data obtained from the body with the record of the
missing person.
Techniques of Human Identification using the Dentition:
1. Comparative Dental Identification: identification by comparing the
antemortem from postmortem data
2. Reconstructive Dental Profiling: based on the postmortem data
gathered attempts are made to elicit age, sex, race, occupation, etc
leading to a probable identification.
3. DNA Analysis of dental evidence: teeth, saliva
• A range of conclusions can be reached when reporting dental
identification. The American Board of Forensic Odontology
recommends that these should be limited to the following
four conclusions or degrees of certainties:
1. Positive identification: The antemortem and postmortem
data match in sufficient detail, with no unexplainable
discrepancies, to establish that they are from the same
individual.
4. Teeth are a source of DNA: dental pulp or a crushed tooth
can provide nuclear or mitochondrial DNA that to help
identify a person.
Teeth are very much valuable during postmortem identification of a
recovered human remains that is beyond recognition.
Classifications of recovered human remains:
1. Viewable:
• usually one that has recently died a nonviolent death, little
physical change between the appearance while alive and the
appearance upon being discovered dead.
• The victim may be viewed by family or friends and have
open-casket funerals
2. Traumatized:
• a fairly recent but violent death, the victim usually have
suffered some amount of physical trauma and the removal
of the maxilla and mandible is done to present the best
possible view.
3. Burned:
• similar to a traumatized victim, condition varies from slightly
reddened skin to badly burned with charred or incinerated
remains, the fragility of the remains requires special
handling
4. Drowned:
• can range from viewable to decomposed, cold water victim
– appears severely bloated but basically well preserved,
warm to hot water – badly bloated and decomposed
5. Decomposed:
• the remains will present with most, if not all, soft tissues
gone, care must be handled with dental structures.
6. Skeletonized:
• the absence of ligaments, cartilages, tissues and organs
leaving the hardened tissue forming the supporting
framework of the body.
Why the need to positively identify a person?
1. Provide closure - a positive ID is vital for family members in going
through the grieving process knowing that their loved ones have been
found.
2. Assist in legal matters - a positive identification and subsequent
death certificate are necessary in order to settle business and personal
affairs like disbursement of insurance proceeds, estate transfer,
execution of the will, settlement of probate, child custody and others.
CANVAS: M3 The Dental Triad
• Identification of human remains is not an easy work for forensic
examiners. Countless cold cases remain unresolved because of
lack of information regarding the victims. Forensics has paved the
way in investigations like this using the dentition.
• The study of teeth and the surrounding tissues of the oral cavity
for the purpose of establishing the identity of a victim is called
dental profiling. Dental profiling—also known as ‘reconstructive
dental identification’—describes the process of extracting
information from the teeth in an attempt to piece together a
profile of the deceased individual. This is used when antemortem
data is not available.
• The triad of information that could be extracted from dental
profiling is age, gender and race or ethnicity. By applying the
dental profiling techniques, not only age, gender and race of an
individual can be determined, but also the data about their socio-
economic status, personal habits, oral and systemic health,
occupation, diet, familial relationship as well as psychological
characteristics. This is found very useful in mass disaster
investigations.
• A dental profile is more detailed and reliable if more than one
technique is applied. Each individual has their own dental profile
which makes them unique and one of a kind. Education in the
field of forensic dentistry and techniques of dental profiling is
necessary since it contributes greatly to the reputation of the
dental profession in other related disciplines as well as in public,
and it encourages dentists to view their own achievements from
a wider perspective. The information gathered from dental
profiling will allow for an intense search for ante mortem
records.
M3 L1 Age Determination
• Age is one of the essential factors, which play an important rol
e in every aspect of life.
• Person identification is an important aspect of forensic
medicine and dentistry. Age, gender, race, and so on are used
for identification of a person.
• Dental age is considered to be vital as tooth development shows
less variability than other developmental features and also low
variability in relation to chronological age. Hence, dental age is
considered to be vital in establishing the age of an individual.
Age determination
• is the final step in the triad of dental profiling.
• It is applied in postmortem identification as well as in living
individuals in whom the chronological age is under dispute.
• Various methods of dental age estimation are divided into 3
categories: morphological, biochemical and radiographic.
1. Morphological methods
• Different morphological stages of mineralization
correlate with the different developmental stages.
• Morphological method is based on an assessment of
teeth (ex-vivo). Hence, these methods require
extracted teeth for microscopic preparation.
• However, these methods may not be acceptable due
to ethical, religious, cultural, or scientific reasons.
✓ Gustafson’s Method (1950)
✓ Maples Method (1978)
✓ Solheim Method (1993)
2. Biochemical methods are based on the racemization of
amino acids.
• The racemization of amino acids is a reversible first-
order reaction and is relatively rapid in living tissues in
which metabolism are slow.
• Aspartic acid has been reported to have the highest
racemization rate of all amino acids and to be stored
during ageing.
• In particular, L-aspartic acids are converted to D-
aspartic acids and thus the levels of D-aspartic acid in
human enamel, dentine, and cementum increase with
age.
3. Radiographic methods of age estimation are grouped into
three phases:
1. Pre-natal, neonatal and post-natal:
• Mineralization of deciduous incisors starts at the
16th week of intrauterine life.
• Incremental lines of Von Ebner
• Neonatal line - an indicator of birth
2. Children and adolescents:
• Tooth eruption
• Schour and Masseler method
• Demirjian Method
• Nolla’s method
• Cameriere method - Age estimation using open
apices
• 1st Molar eruption
3. Adults:
• 3rd molar eruption
• Gustafson method
 M3 L2 Sex Determination
Sex determination
• is a subdivision of forensic odontology and it is very important
especially when information relating to the deceased is
unavailable.
• Sex determination becomes the first priority in the process of
identification of a person by a forensic investigator in the case
of mishaps, chemical and nuclear bomb explosions, natural
disasters crime investigations, and ethnic studies.
• Various methods have been used for the identification of sex.
• Sex determination can be done either by Morphological
analysis (of the tooth, skull and other soft tissues of oral and
paraoral region) or molecular analysis.
• Morphological analysis can be done on hard tissues
(odontometric, orthometric, and miscellaneous) of oral and
paraoral regions or soft tissue (lip prints-Cheiloscopy, palatal
rugae pattern-Rugoscopy.
Morphological Analysis
1. Hard tissue analysis
a. Odontometric methods
• In hard tissue analysis, odontometric method involves (a)
mesiodistal (MD) dimensions and buccolingual (BL)
dimension of teeth (b) mean canine index (MCI) (dental
index), and (c) distinct tooth morphology.
• Sexual dimorphism exists in the shape and size of the tooth.
Tooth size can be measured best during early permanent
dentition because it's the stage when the tooth is subject to
less external and internal stimuli. Mesio-distal dimensions
and bucco-lingual dimension of teeth Tooth dimension is
the most simple and reliable method to analyze sexual
dimorphism.
b. Orthometric method
• Orthometric method involves morphology of skull and
mandible with a constellation of six traits and frontal sinus
dimensions. Constellation of six traits are mastoid,
supraorbital ridge, size and architecture of skull, zygomatic
extensions, nasal aperture, and mandible gonial angle and it
was said that the determination of sex using only these six
traits shows accurate results.
2. Soft tissue analysis
• The analysis of soft tissue includes the study of lip prints
(Cheiloscopy) and study of palatal rugae patterns (Rugoscopy).
a. Cheiloscopy
• The word cheilo comes from the Greek word meaning
lip.
• The study of lip prints is called Cheiloscopy. Lip prints
can be identified even at 6th week of intrauterine life.
• These prints do not change after that. Therefore, lip
prints are unique patterns on the lip which help in the
identification of a person.
• Vahanwala et al. in their study concluded that sex of
the individual can be identified by lip prints as follows:
i. Type I, I’ pattern dominant: Female
ii. Type I and II patterns are dominant:
Female
iii. Type III pattern dominant: Male
iv. Type IV patterns: Male
v. Type V varied patterns: Male.
b. Rugoscopy
• Palatal rugae possess features of an ideal forensic
parameter - uniqueness, postmortem resistance, and
stability.
• Moreover, their anatomical positioning inside the
mouth keeps them well protected from trauma and
high temperatures.
• Along with these benefits, the use of palatal rugae as a
forensic aid has added advantages because of their low
utilization cost, simplicity, and reliability.
• Thomas et al. classified the palatal rugae pattern based
on their number, length, and shape. Based on length it
is classified as follows:
i. Primary rugae (5–10 mm)
ii. Secondary rugae (3–5 mm)
iii. Fragmentary rugae (<3 mm).
• Based on the shape it is classified as:
o Straight - Runs directly from the origin to
termination
o Curvy - A simple crescent shape which was curved
gently
o Circular - A definite continuous ring formation
o Wavy - Serpentine form.
Molecular Analysis
• Since morphological patterns vary with time and external
factors, the best-suited method in the identification of gender is
by molecular analysis of DNA.
o The extracted DNA from the teeth of an unidentified
person can be compared with the antemortem DNA
samples.
• DNA stored in blood, hairbrush, clothes, cervical smear or
biopsy sample can provide a good source of antemortem DNA.
o The different types of DNA are nuclear DNA and
Mitochondrial DNA.
o Extraction of DNA can be done either cryogenic grinding
which involves cooling the whole tooth to extremely low
temperature using liquid nitrogen, and grind the tooth to
extract the DNA.
o The lesser destructive method for DNA isolation involves
opening of root canals and scrapping the pulp area with a
notched medical needle.
o The extracted DNA can be analyzed by various methods like
restriction fragment length polymorphism, polymerase
chain reaction (PCR), microarrays.
• A more recent method of sex determination from teeth is the
presence of sex chromatin or Barr bodies in the pulp of the
teeth, according to the method devised by Barr & Bertram.
o The studies have also been carried out to extract DNA from
the pulp tissue as well as dentine and its use for sex
determination using Polymerase Chain Reaction (PCR).
M3 L3 Race Determination
Human species can be categorized into 3 races: Caucasoid,
Mongoloid, Negroid.
The table shows the differences in identifying ethnic origin based on
teeth, arch and skull

Skull Face Nasal Aperture

Europeans/Cauca narrow &

rounded small
soid (White) elongated

Asian/Mongoloid(
square large/flattened rounded
Yellow)

maxilla &
Negroid (Black narrow/elongat
mandible broad
Africans) ed
prognathic

Teeth, arch & palate

• Narrow arch & crowding

• marked attrition

• large teeth

Caucasoid • parabolic arch

• shape of incisors-spatulate

• mandibular 3rd molar can be missing

• triangular palate

• missing mandibular incisors

• shovel-shaped incisors

• rounded arch

Mongoloid • shape of incisors-shovel-shaped

• enamel pearls

• mandibular 2nd molar-5 cusps

• oval palate

• diastema

• wide hyperbolic arch

• shape of incisors-spatulate

• prominent ridge
Negroid
• 3rd molar rarely missing

• mandibular 2nd molar-5 cusps

• supernumerary teeth

• rectangular palate
FORENSIC DENTISTRY FIRST Finals
Lecture (DR. FERNANDEZ) Sem

Mass Disaster • Occurs before a disaster takes place. Here, an organization will take

• a chaotic event, initiated by a destructive force, which results in the steps to protect people and property, while also decreasing risks

multiple fatalities necessitating identification. and consequences from a given disaster situation.

• The identification of a large number of casualties in a mass disaster • The organization’s main goal is to reduce vulnerability to disaster

is complex due to severe mutilation, charring and decomposition. impacts (such as property damage, injuries and loss of life)

Major Disaster Preparedness

• any natural catastrophe (including any hurricane, tornado, storm, • To take actions ahead of time to be ready for an emergency

high water (flood), wind driven rain, tidal wave, tsunami, • Occurs before a sister takes place. Here, an organization attempts to

earthquake, landslide, mudslide, snowstorm, or drought), or understand how a disaster might affect overall productivity and the

regardless of cause, any fire, flood, or explosion. bottom line.

Natural Disaster • The organization will also provide appropriate education while

• a sudden and terrible event in nature (such as a hurricane, tornado, putting preparedness measures into place.

or flood) that usually results in serious damage and many deaths. Response

Man-made Disaster • To protect people and property in the wake of an emergency,

• has an element of human intent, negligence, or error involving a disaster, or crisis.

failure of a man- made system, as opposed to natural disasters • Occurs in the immediate aftermath of a disaster. Organizations must

resulting from natural hazards. Such man-made disasters are crime, focus their attention on addressing immediate threats to people,

arson, civil disorder, terrorism, war, biological/chemical threat, property, business.

cyber-attacks, etc. • Occupant safety and wellbeing largely depends on its preparedness

Mass Disaster Victim Identification levels before disaster strikes.

• is the method used to identify victims of mass casualty incidents, Recovery

either man-made or natural • To rebuild after a disaster in an effort to return operations back to

Disaster Management normal

• is the creation of plans through which communities reduce • Takes place after a disaster

vulnerability to hazards and cope with disaster. • This phase is the restoration of a n organization following any

• does not avert or eliminate the threats; instead, it focuses on impacts from a disaster. By this time the organization has achieved

creating plans to decrease the effects of disasters. at least one degree of physical, environmental, economic, and social

Four types of Disaster stability.

Management • The recovery phase of a disaster can last anywhere from six months

1. Mitigation to a year. (or even longer depending on the severity of the incident.

2. Preparedness Examples of mass disaster situations

3. Response 1. Intact structures - buildings, ships, airplanes: victims are intact

4. recovery 2. Intact structures with victims badly burned: commingling (mixing

Mitigation of bodies)

• To prevent future 3. Bodies floating in open water (British ferry accident)

emergencies and take steps to minimize their effects 4. Bodies in open areas (e.g after a flood)

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5. Bodies in open areas spanning (around) a large area (e.g Pan Am Fit 5.1.1 Visual/Physical Identification
#103) 5.1.2 Fingerprint Identification
6. Partial destruction of the structure with some bodies destroyed 5.1.3 Radiographs
7. Complete destruction of the structure with complete destruction of 5.1.4 Dental Records/Examination of the oral cavity
the bodies (e.g Northwest Flt #255 & US Air Flt #427) 5.2 Unconventional Identification
Formation of Dental Identification Team 5.2.1 DNA Analysis
1. Team leader should be selected according to his knowledge and VI. Temporary Mortuary
experience in the field of disaster identification. 6.1 Storage of human remains
2. The team leader should be actively involved in forensic odontology 6.2 Post-Mortem facilities
3. He should have affiliation with major forensic dental associations 6.3 Planning the procedures
such as American Academy of Forensic Sciences (AAFS) 6.4 Impaction of the facial fragment
4. The team leader should annually hold a seminar to update the team 6.5 Embalming the remains
members regarding forensic activity of the team. 6.6 Repatriation of the dead
Forensic Dental Associations VII. Comparison of Ante-Mortem and Post-Mortem
• ASFO – American Society of Forensic Odontology 7.1 Preliminary Comparison
• ABFO – American Board of Forensic Odontology 7.2 Detailed Comparison
• AAFS – American Academy of Forensic Sciences 7.3 Final Report
Go Team VIII. Facial Injury
• Name given to the smaller team of workers that forms the base for 8.1 Pattern of Injury
the statewide or local team POST MORTEM SECTION
Support Team I. Personnel

• This refers to dentists, auxiliaries, and dental students that 1. Section Leader

supplement the “Go Team” • With at least of three members each for the charting
I. Introduction /Definition of Terms process
1. Mass disaster • Team can be comprised of 3 dentists or 2 dentists and 1
2. Major disaster auxiliary
3. Natural disaster • Section leader should be present at all times
4. Man-made disaster II. Working Area
5. Investigating team/identification team ✓ should have good lighting, comfortable chairs and adequate
II. Categories of Mass Disasters tables.
• Natural disaster ✓ adequate water supply to wash and clean specimens in a
1. Earthquake container or bucket
2. Typhoon III. Responsibilities and Functions
3. Tsunami ✓ The postmortem section has the responsibility of examining and
4. Landslide charting all postmortem (dental) body parts.
5. Fire Disaster ✓ It is recommended that at least 2 dentists work on specimen to
• Man-made disaster reduce the chance for errors.
1. Aircraft accidents ✓ Each specimen will be charted on postmortem record sheet by
2. Sea disaster 2 or 3 individuals working together
3. bombing/war RADIOGRAPHY AND PHOTOGRAPHY SECTION
4. Fire disaster I. Personnel
III. Equipping the team ✓ made up of a section leader and alternate with 1 additional
3.1 Dental kit (portable diagnostic set) dentist and 1 auxiliary
IV. Preliminary Step at a Mass Disaster II. Working Area
4.1 Description of the disaster site ✓ X-ray units should be placed to minimize radiation to
4.2 Isolation of the disaster site surrounding areas.
4.3 Photographs / Sketch of the scene ✓ adequate tables, chairs and electrical outlets for x-ray and
4.4 Transport of the victim developer equipment
V. Processes/Techniques/Procedures of Identification III. Equipment
5.1 Conventional Identification ✓ a portable x-ray unit is necessary

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✓ number of x-ray units is dependent on the size of disaster; ✓ the most concise, least subjective and most readily
number of members and their availability available dental base sorting program
✓ proper shielding x-ray aprons ✓ developed by Lorton and Langley
IV. Responsibilities and Function ✓ with CAPMI System. dental Information obtained
✓ The section leader will meet with the postmortem section from unknown set of remains is rapidly sorted
leader to complete the postmortem record against the antemortem dental base
ANTEMORTEM SECTION ✓ forensic odontologist only spend minutes with each
I. Personnel record instead of three hours
1. Section Leader 2. Toothpics Identification System
II. Working Area 3. Identify 2.0 - Finish DVI Team Interpol Helsinki, Finland
1. Telephone 4. D.I.P -2 – Dr. S. Kogon University of Western Ontario
2. Fax machine 5. WINID – James McGivney, DMD
III. Materials FORENSIC DENTAL COMPARISON
1. Antemortem Charting Forms Three possible results for each tooth from comparison
2. Charting Diagram 1. Match – the status of the tooth is the same between records
3. Pencils, Colored Markers 2. Possible Match — the postmortem status could have evolved from
4. Charting Conversion Tables the antemortem status
5. Radiographic View Boxes 3. Mismatch — there is no possible match
IV. Responsibilities and Functions
6 sets of files that should be maintained
1. Records requested — an early attempt should be made to
determine ages of casualties.
2. Record Received — to be charted
3. Incomplete records — additional information requested by
section leader
4. Antemortem Chart File - file males and females separately
5. Postmortem Chart File – Identified by body or body part
number
6. Casualties identified – combined antemortem and postmortem
records into one folder identified by name
COMPARISON SECTION
I. Personnel
1. Team members from both antemortem and postmortem
sections
II. Working Areas
Charting Errors in Mass Disaster Dental
1. Telephones
• Records Incidence, Issues and Implications
2. Good lighting
1. Records
3. Comfortable chairs
a. Complex Records – comprised of an extensive number of
4. Table
narrative entries concerning various types of restorative
III. Responsibilities and Functions
procedures performed on numerous teeth.
✓ records and radiographs of antemortem and postmortem
b. Simple records – most easily defined as all other records
records and radiographs are compared so that proper
Types of Errors
identification can be made
1. Critical errors – defined as one which could prevent as set of dental
IV. Computer System
remains from being identified, result in an individual being
✓ use of computerization to assist in the comparison of
mistakenly excluded or lead to a misidentification in an
postmortem and antemortem records has become an important
inexperienced hand.
part of the mass disaster protocol.
a. Critical Error Type 1 – listing a tooth as being missing when it is
✓ Examples of Computer Programs
present (Example: tooth #16 is present but recorded as
1. CAPMl-4 (Computer Assisted Postmortem Identification)
missing)

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b. Critical Error Type 2 – adding a surface(s) to a restoration or

incorrectly listing the surfaces filled on for a tooth.
c. Critical Error Type 3 – listing a tooth restored when it is not.
d. Critical Error Type 4 – to completely miss some unusual or
unique feature/pathology. (Example: supernumerary tooth)
e. Critical Error Type 5 – to completely miss listing multiple
restorative procedures for a tooth. (Example: Root Canal
Therapy, Post-and-core, and Crown)
2. Moderate Errors – defined as one that should not lead to a
misidentification or prevent an identification from occurring as
critical error might.
a. Moderate Error Type 1 –omitting a restored surface (e.g. calling
MOD-amalgam a DO-amalgam instead)
b. Moderate Error Type 2 – to call a tooth unrestored when in fact
it has a restoration
3. Minor Errors – errors that will not affect the identification effort,
however it is indicative of less than perfect records preparation and
ineffective quality control.
a. Minor Error Type 1 – to omit additional restoration of similar
surfaces. (E.g. Molar has more than O-amalgam and the record
shows only one O-amalgam)
b. Minor Error Type 2 – third molar recorded as missing when
they are present, or recorded as present when they are missing

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