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ORIGINAL ARTICLE
Year : 2021  |  Volume : 12  |  Issue : 2  |  Page : 90-94

Awareness of forensic odontology among general dental practitioners in Mumbai: A survey study


Department of Oral Pathology, D.Y.Patil School of Dentistry, D.Y.Patil Deemed to be University, Navi Mumbai, Maharashtra, India

Date of Submission21-Jan-2021
Date of Acceptance21-Sep-2021
Date of Web Publication28-Feb-2022

Correspondence Address:
Dr. Treville Pereira
Department of Oral Pathology, D.Y.Patil School of Dentistry, D.Y.Patil Deemed to be University, Navi Mumbai, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/mjmsr.mjmsr_3_21

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  Abstract 


Introduction: Forensic odontology is the application of dental knowledge in human identification. It has major implications in criminal investigation, and human remains identification. Objective: The aim of this study is to introspect the attitude and knowledge of forensic odontology among general dental practitioners (GDPs) in Mumbai. Materials and Methods: A cross-sectional study was conducted in a sample size of 225 GDPs of Mumbai with the help of an online questionnaire comprising 11 questions. Results: GDPs were found to have a lack of exposure and poor knowledge regarding the subject of forensic odontology. Only 13.3% of dentists have had a formal training in the subject. About 29.3% are unaware that they can testify in the court and support the investigation. Conclusion: The lack of awareness and knowledge among dentists will hinder the criminal investigation. Hence, awareness should be created among young dentists and more courses should be available in the field.

Keywords: Bite mark, forensic odontology, rugoscopy


How to cite this article:
Mistry RG, Pereira T, Shetty S, Gotmare S, Anjali A K, Vidhale R. Awareness of forensic odontology among general dental practitioners in Mumbai: A survey study. Muller J Med Sci Res 2021;12:90-4

How to cite this URL:
Mistry RG, Pereira T, Shetty S, Gotmare S, Anjali A K, Vidhale R. Awareness of forensic odontology among general dental practitioners in Mumbai: A survey study. Muller J Med Sci Res [serial online] 2021 [cited 2022 Nov 27];12:90-4. Available from: https://www.mjmsr.net/text.asp?2021/12/2/90/338497




  Introduction Top


Forensic odontology refers to that branch of forensic science which deals with the application of dental sciences for the identification of deceased individuals. Keise Neilson had defined forensic dentistry as “that branch of dentistry that in the interest of justice deals with the proper handling and examination of dental evidence and the proper evaluation and presentation of dental findings.”[1] The significant uses of forensic odontology incorporate ID of human remaining parts through dental records and helping at the area of wrongdoing. As of late, forensic odontology has advanced as another beam of expectation in helping scientific medication, be that as it may, this imperative and fundamental field of legal medication is as yet in a condition of early stages in India.

Forensic is a Latin word which means a place where all the legal issues are discussed. It can be characterized as the part of dentistry that tends to the legitimate taking care of and the assessment of dental proof and the assessment and introduction of dental discoveries in light of a legitimate concern for equity.[2] A forensic odontologist uses various methods for human identification such as facial reconstruction wherein the face can be reconstructed by clay on available anthropological knowledge or with the help of advanced computer technology. In cases, where the majority of the body is harmed but palate is found intact, rugoscopy, i.e., study of palatal rugae pattern can be done as a method of identification. Radiographs and photographic studies are a very useful method along with saliva, from which DNA can be extracted. Bite mark is one the most important and frequently used aspects for investigation. They are often found on the skin of victims, and they may be found on almost all parts of the human body.[3] A representative human bite is described as an elliptical or circular injury that records the specific characteristics of the teeth.[4] Any possible bite mark, if identified, should be included, and the possible role of a dentist should be made available with the required skills, training, and experience to assess the value of this type of evidence and perform scientifically valid analysis.[5]

Dental specialists could assume a fundamental job in helping scientific agents in giving data that would help in the recognizable proof of culprits or survivors of wrongdoing and common or then again synthetic debacle circumstances. These data would be effectively accessible and available through well-maintained tolerant records that are under dental consideration.[6] The dental calling has a moral and legitimate duty for understanding consideration. An appropriately kept up patient record is a significant part of this patient consideration. In general, a “record” can be characterized as data produced in the course of an association's true exchanges and one that is reported to go about as a well-spring of reference and a device by which an association is administered.[7] This article will deal with the maintenance of the dental records, identifying the parameters, awareness among the dental practitioners in Mumbai.


  Materials and Methods Top


A cross-sectional questionnaire study was conducted among 225 participants in Mumbai. The questionnaire [Questionnaire 1] is created and distributed among the participants who were practicing and nonpracticing dentists (postgraduates and graduates) in and around Mumbai and Navi Mumbai. Nonhealth-care professionals were excluded from the study. The set of questionnaires includes demographic data of the participants and questions based on the awareness of forensic odontology, maintaining the records of the patient details. The participants were asked to fill the Google forms. The results and data collection were analyzed using the SPSS software. The sample method used is a simple random sampling method. The descriptive analysis was carried out, and Chi-square test was used for inference and P value calculated. The obtained results are converted into pie charts and graphs accordingly.


  Results Top


In response to the question asked as to whether the dental clinics maintain dental records of the patient, 95% of general dental practitioners (GDPs) maintain patient details and also took medical history of their patients. Forty-four percent of GDPs did not take family dental history. About 90% of GDPs compiled clinical findings and treatment plans for every patient treated. About 58%, i.e., 112 GDPs stored photographs and 103 stored the stone cast too. Along with all the other data, about 92% store the radiographs and only 50.9% store the investigational finding during the course of the treatment [Figure 1]. The approximate time frame of the maintenance of dental records in a clinic was contemplated and found that 31.8% of GDPs maintain the records of their patients for 1–3 years and 7–9 years each. While 23.2% stored it for 3–5 years and 13.2% stored, it for 5–7 years [Figure 2]. About 15.1%, i.e., 34 out of the 225 GDPs surveyed across Mumbai did not know how useful maintaining the dental records collected by them of their patients is important for criminal investigational purposes and even in case of mass disaster. About 75.6% of GDPs had knowledge about bite mark patterns and their significance. Only 13.3% of observed GDPs of the metropolitan city have had formal training in collection, evaluation, and presentation of dental evidence and thus can be of judicial help in case of criminal investigation [Figure 3]. According to 70% of the participants, fingerprints and dental identification are the most accurate method of identification of humans. About 57% of GDPs believe visual identity, DNA comparison, and photographs to also be primary parameters to identify an unknown individual. While 93% and 38% of dentists believe physical anthropology and serological analysis should also be obtained under consideration for identification [Figure 4]. One hundred and ninety-five practitioners are affirmative to have knowledge about them testifying in court as an expert witness to present forensic dental evidence. About 60% of the surveyed dentists were confident enough that they can identify the age and gender of the deceased in the event of mass disaster. About 35% were unaware of forensic odontology courses available across the country by various private and government universities. About 92.4% of GDPs were in favor of forensic odontology being included in the BDS curriculum as a separate subject.
Figure 1: The graph depicting dental records taken in clinics

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Figure 2: Pie charts shows maintenance of dental records in clinic

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Figure 3: Formal training in evidence preservation

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Figure 4: Pie chart shows the primary parameters used to identify the individual

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  Discussion Top


Interest in forensic dentistry was generally lethargic until the 1960s, when recharged interest was started by the main formal instructional program in measurable dentistry given in the United States at the Armed Forces Institute of Pathology. The first-ever written criminal case solved with the help of a GDP was in November 1849 in the Parkman-Webster case wherein human remains were found in Webster's laboratory which was identified to be of Dr. George Parkman by his dentist Dr. Nathan Cooley with the help of dentures he made for Dr. Parkman 3 years ago.[8] In 1897 a major fire broke out in Bazar de la Charite, Paris that led to the death of 124 people, which included public figures. About 30 bodies were left unidentified after an extensive identification search. The consulate of Paraguay asked the dentist of possible victims for identification. The search was led by Dr. Oscar Amoedo Y Valdes, who after successful identification presented a paper in the 12th International Congress of Moscow in which he proved the role of dentists in human identification for mass disaster. After his further work in the field, he was then called the “Father of Forensic Odontology.”[9]

Forensic odontology has come a long way in proving its applications in legal proceedings. A dentist can be a witness in court in a case of criminal investigation as the dentist of either the victim or suspect with the help of dental records maintained during the treatment. An investigation has various aspects. It includes bite mark analysis, facial reconstruction, DNA analysis, anthropology of teeth, prosthesis or endodontic procedure, and other oral cavity abnormalities.

In the survey, the GDPs were asked if they maintain dental records of their patients, 96.9% maintain proper records. Among the 96.9% of dentists, an average of 90% collect patient details, medical history, clinical findings, treatment plan, and radiographs. Similar survey was done in Rajasthan on maintaining dental records. A very low percentile of about 38% only maintained dental records.[10] Just 31% of them maintain these records above 7 years. The majority of practitioners tend to discard their dental records after a few years because of the lack of digitalization of clinical records as it is a space-consuming task to store case papers of all the patients for a long time in their limited space clinics in the city. About 84.9% of dentists were aware of the significance of them maintaining dental records but lack advanced knowledge in the field. More awareness and knowledge can be acquired by attending conferences and webinars on maintaining and presenting dental records. Only 75% of GDPs had knowledge about bite mark patterns and its significance in criminal investigation. Bite mark analysis has helped a lot in solving many criminal cases in India. Analysis and complete knowledge of bitemark evidence can assist the justice system to answer crucial questions about the interaction between the suspect and victim. Only 13.3% of the surveyed GDPs in Mumbai have undergone formal training in forensic Odontology. In a similar study conducted in Karnataka among oral Pathologists, only 7% of the surveyed dentists had formal training.[11] This indicates that the current level of formal training in forensic odontology is not sufficient in the country. More awareness and availability of formal forensic training should be available at the undergraduate level. Among all only 68% consider dental identity to be a primary parameter for unknown human identification whereas it is the most sensitive and accurate method of identification. About 30% were unaware that they can testify in the court of law as an expert and help the judicial system by presenting forensic dental evidence. This inference the lack of importance given to judicial usage of dentistry in the dental curriculum.

About 40% of GDPs were not confident that they could identify the estimated age and gender of the deceased in an unfortunate event of mass disaster. This is due to a lack of practical knowledge about forensic odontology. Only 65% of the surveyed dentists in Mumbai have knowledge about various forensic odontology courses in India. When asked about including forensic odontology as a subject in the BDS curriculum, 92.4% agreed that new graduates should have sufficient knowledge on the subject so that they can be useful in the identification and maintain proper clinical records.


  Conclusion Top


The findings in the survey showed that the GDPs in Mumbai do not have sufficient knowledge about the subject of forensic odontology, and the role they would play in forensic investigation. Dentists need to be more aware of how they can aid forensic investigation and incorporate these values into their practice. Digitalization of clinical records should be done to store patient details for a longer period of time. With the advancement and awareness in the subject, there are many diploma, fellowship, and specialization courses available across the country in the field of forensic odontology. Special forensic odontology conferences and webinars are held by dental agencies such as the Indian Forensic Society, Indian Dental Association, and Dental Council of India.

Acknowledgment

I am sincerely thankful to D.Y. Patil Dental College for providing me the opportunity to write a case study on the above topic.

I am also thankful to Dr. Treville Pereira for guiding me in every stage of this research paper. Without his support, it would have been extremely difficult for me to prepare the paper so meaningful and interesting.

I am also thankful to Dr. Subraj Shetty, who has helped me during this course of research paper in several ways.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.


  Questionnaire: 1 Top


Q.1. Do you maintain dental records in your clinic? Yes/No

Q.2. If yes, which of the following dental records are taken in your clinic?

a) Patient details b) Medical history c) Family History d) Clinical Findings e) Photographs

f) Investigational findings g) Study Cast h) Radiographs i) Treatment Plan

Q.3. Choose the approximate time frame of maintenance of Dental record in your clinic:

a) 1 to 3 years b) 3 to 5 years c) 5 to 7 years d) 7 to 9 years

Q.4. Are you aware of the significance of maintaining dental records in investigation of deceased and crime suspects? Yes/No

Q.5. Are you aware of the bite mark patterns of teeth and their significance? Yes/No

Q.6. Have you had any kind of formal training in collecting, evaluating and presenting of dental evidences? Yes/No

Q.7. Choose the primary parameters used to identify an unknown individual:

a) Visual identity b) Serological analysis c) Finger Print d) DNA comparison e) Dental Identification

f) Photographs g) physical anthropological examination of bones and teeth

Q.8. Are you aware you can testify as an expert witness in court of law to present forensic dental evidence? Yes/No

Q.9. can you identify the age and gender of a deceased in the event of mass disaster? Yes/No

Q.10. Are you aware of any forensic odontology courses available in India? Yes/No

Q.11. Do you think forensic odontology should be included as a separate subject in BDS curriculum? Yes/No-



 
  References Top

1.
Stark MM. A Physician's Guide to Clinical Forensic Medicine. Spain: Springer Science and Business Media; 2000. p. 326.  Back to cited text no. 1
    
2.
Singh K, Bhullar RK, Agrawal A, Chaudhary H, Anandani C, Thakral A. Teeth and their secrets--forensic dentistry. Med-Leg Update 2012;12:85-9.  Back to cited text no. 2
    
3.
Sweet D, Pretty IA. A look at forensic dentistry--Part 2: Teeth as weapons of violence--identification of bitemark perpetrators. Br Dent J 2001;190:415-8.  Back to cited text no. 3
    
4.
Greene D, Williams D. Manual of Forensic Odontology. Boca Raton: CRC Press; 2013. p. 461.  Back to cited text no. 4
    
5.
Bowers CM. Forensic Dental Evidence: An Investigator's Handbook. University of Southern California, Los Angeles, CA: Elsevier; 2010. p. 327.  Back to cited text no. 5
    
6.
Hinchliffe J. Forensic odontology, part 5. Child abuse issues. Br Dent J 2011;210:423-8.  Back to cited text no. 6
    
7.
Who Regional Office for the Western Pacific, World Health Organization. Regional Office for the Western Pacific. Medical Records Manual: A Guide for Developing Countries. University of Sydney: World Health Organization; 2002. p. 90.  Back to cited text no. 7
    
8.
Christen AG, Christen JA. The 1850 Webster/Parkman Trial: Dr. Keep's forensic evidence. J Hist Dent 2003;51:5-12.  Back to cited text no. 8
    
9.
Riaud X. National Academy of Dental Surgery, Free member of the National Academy of Surgery, 145, Route de Vannes, 44800 Saint Herblain, France. Dr Oscar amoëdo y Valdes (1863-1945), founding father of forensic odontology. Glob J Anthropol Res 2015;2:22-5.  Back to cited text no. 9
    
10.
Astekar M, Saawarn S, Ramesh G, Saawarn N. Maintaining dental records: Are we ready for forensic needs?. Journal of forensic dental sciences, 2011;3:52-7. https://doi.org/10.4103/0975-1475.92143.  Back to cited text no. 10
    
11.
Shetty P, Raviprakash A. Forensic odontology in India, an oral pathologist's perspective. J Forensic Dent Sci 2011;3:23-6.  Back to cited text no. 11
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Abstract
Introduction
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