Age Estimation

Researchers have studied the processes of human aging by many different

methods. These include developmental, histological, biochemical, and

anthropological techniques. Anthropologists analyze the fusion of the cranial

sutures of the skull, the development of the long bones, features of the pelvic

girdle, and along with forensic dentists, features of the teeth. These techniques

can be valuable when creating a profile for an unidentified person, whether

living or deceased. Estimating an individual’s age can also be helpful in assisting

law enforcement agencies in determining the attainment of the year of

majority of a living individual that will ultimately affect the individual’s treatment

in the legal system as either a child or an adult. 

Abuse

Identification and reporting of abuse is a complex and emotional area.

Healthcare practitioners are required by law in most jurisdictions to report

suspected cases of abuse. The head and neck area is a common target in

abuse. Extraoral injuries consistent in shape and appearance to a hand or

object are identifiable. Intraoral trauma can occur as the result of strikes to

the face, causing torn frena and fractured, mobile, or avulsed teeth. Intraoral

soft tissue pathology may be noted following forced feeding or forced fellatio.

Some cases may require the consideration of whether extensive or rampant

caries are a result of the caregivers’ lack of knowledge or stem from neglect

or abuse. In areas where access to dental care is an issue there will likely be

a higher caries incidence that could further exacerbate the determination of

whether reporting of abuse may be necessary. Deciding to report suspected

abuse requires sound judgment, especially considering that the parent or

guardian may be the perpetrator. If a report is initiated, the ensuing investigation

will be difficult for all concerned (see Chapter 15). 

Bitemark Evidence Collection and Analysis

Bitemark analysis is the most complex and controversial area of forensic

odontology. Consequently, some forensic dentists are reluctant to enter into

this arena. Bitemarks can occur in a wide variety of substrates, although the

most common of these is, unfortunately, human skin. The proper documentation

of a bitemark is not overly complex, and the techniques for collecting

evidence are manageable by most forensic dentists with practice and attention

to detail. The bite site can be evaluated in the third dimension by using a

very accurate dental impression material and dental stones or resins to create

a solid model for viewing under magnification, light microscopy, or with

scanning electron microscopy. This three-dimensional model of the bitten

area can then be compared to suspects’ dental casts. Technique shortcomings

exist and include that solid models of bitemarks on skin are nonelastic. The

problems associated with bitemark analysis will be discussed more fully in

Chapter 14. 

Multiple Fatality Incident Management

A multiple fatality incident (MFI) develops when the number of fatalities in

the incident exceeds the number the medical examiner or coroner’s facilities

were designed to handle. The process of collection of dental information

on victims in a mass disaster is identical to the processes that are used in

the identification of a single fatality. The major difference in this process is

the potential magnitude of the event and the unique set of circumstances that

can surround the event. These may include the location, climate, and coverage

area of the event, for example, a plane crash in mountainous terrain, a

tsunami in a tropical area, the collapse of multistory structures in a major

city, or a hurricane in a coastal area. Each of these incidents has unique issues

that must be addressed with regard to recovery, processing, and storage of

remains. Each potential MFI will have its unique problems to overcome, but

accurately collecting and comparing the data is the common process in all of

these situations. 

Dental Identification

When considering the many processes that are involved in forensic dentistry,

most laypersons are familiar with identification of a deceased individual

through the comparison of dental radiographs. Identification by dental means

is a fast and reliable method. Dental identification is most often accomplished

by comparing postmortem dental radiographs from the unidentified person

with antemortem radiographs of a known individual. This process of dental

forensics is often interpreted on currently popular forensic television series

by the actor-dentist holding a dental radiograph backlit by the room lights

with the film overhead while standing in the elevator lobby. This generally

occurs following a brief evaluation of a body in the morgue. But, of course,

the actor-dentist is certain that the radiographs he was just handed for evaluation

are from the decedent. The positive identification is completed and

without further discussion the district attorney’s case theory is confirmed

and the suspect is incarcerated.

In real forensic cases the process of using dental radiographs and dental

charting can be an accurate and efficient method for making a positive identification

or exclusion. But, the comparison must be completed in a controlled

and methodical manner, with attention to the details of the dental structures

and restorations that may be seen in the radiographic comparison. A comparison

of an antemortem radiograph with a body in the morgue occurs only

in the virtual reality of television and film world.

In a dental identification, the initial goal of the forensic dentist is to obtain

a set of postmortem photographs, radiographs, and accurate dental charting

on the unidentified person. This can be a straightforward or difficult process,

depending on the condition of the postmortem specimen and the physical

resources available to the dentist. The problems most often involve limited

available resources in the morgue setting. 

Introduction

When the subject of forensic dentistry arises, the first reaction of many

people tends to be toward one of two extremes: either very cool or decidedly

gross. The public assumption seems to be that forensic dentistry deals

with “the dead.” This view is not totally inaccurate. Although the majority of

dental identification cases do involve the dead, there is much more involved,

including cases dealing with the living, in this interesting field of art and

science. With training, ongoing continuing education, and experience, the

forensic odontologist will find the application of this knowledge to be personally

rewarding. If dentists are interested but do not wish to pursue the

areas of forensic dentistry that are associated with “wet work,” they will find

that they can practice “dry fingered” forensic dentistry in their own offices

by accurately recording their patient’s oral information on an ongoing basis.

Forensic dentistry or forensic odontology involves several areas that will

be discussed generally in this chapter and explained in more detail in later

chapters. The general definition of this discipline is that forensic odontology

is the combination of the science and art of dentistry and the legal system,

a crossroads of dental science and law. The general topics to be discussed include the subdisciplines of forensic odontology, dental identification,

multiple fatality incident management, bitemarks, abuse, age estimation, and

expert testimony in criminal and civil litigation.