The Identity Of Cadavers Revealed By Their Teeth

[drmithila]

 Dentistry fulfills one of its most important social, moral, and professional obligations by applying its unique knowledge and expertise to the task of identifying countless persons who are tragic victims of fires, catastrophes, disasters, and homicides. Identification must proceed along the lines of gathering as much reliable evidence as possible and utilizing this evidence in an attempt to establish a positive identification. Positive body identification may be ascertained via visual means, fingerprint records, dental charts, radiographs, and study models. Visual examination includes hair and eye comparison, noting all distinguishable scars, tattoos, and birthmarks, and, most importantly, recognizing outstanding facial features overlying bony structure, which has maintained its anatomic outline.

When visual identification is impossible, fingerprints and footprints are taken from the body and sent to the appropriate local, city, and federal agencies for a positive comparison match. Many times, however, a body undergoing severe decomposition, mutilated via a sudden, high-impact explosive accident, and/ or subjected to high-intensity fire will make it impossible to finalize a visual and fingerprint identification. The forensic odontologist is then called upon to render his or her expertise in the area of oral identification. The oral remains and associated facial bones are identified, charted, x-rayed, and if necessary, anatomically repositioned to produce within reasonable certainty and facsimile the victim’s ante mortem facial and oral structure.

As with any investigation procedure, the forensic dentist must rely upon the evidence available at the time of ante mortem and post mortem dental comparison. Post mortem findings, whether a single tooth, bits of crowns and/or roots, or portions of jaw or facial bones, will be closely examined and compared to any available ante mortem evidence on hand. The ante mortem evidence will hopefully include the victim’s dental charts, radiographs, and, if possible, study models. All charts should include dates of treatment, with special attention given to dates of radiographs taken.

The approximate age of the victim is established as soon as possible. Approximate age may be determined by radiographs of deciduous, mixed, and adult dentition. The sequential, 8-step, third molar eruption cycle is used to determine approximate age from 14 to 23 years. Skeletal remains of the skull, mandible, and torso reveal distinct, age-related findings. Fontanelle, soft and hard depressions, closure of the cranial sutures, coronoid process, condylar head, attrition and abrasion of the dentition, and width of pubic and long bone epiphyseal growth pattern are all pathogonomic in determining approximate age. Age determination is critical to the investigative process.

Upon establishing a positive identification, a legal death certificate can be issued. From a legal standpoint, wills can now be probated and insurance claims granted. Many deaths are the result of mass disasters (plane crashes, eg, flight 800 and flight 587), acts of nature (earthquakes), mass suicides or sudden unexpected catastrophes (Jonestown), and attacks such as those involving the World Trade Center and Pentagon. These have the potential of inflicting hundreds and even thousands of fatalities. Immediate identification and subsequent burial are imperative, not only to bring closure but also to avoid typhoid, dysentery, and other health-related hazards brought on by rapidly decomposing bodies. The added threat of worldwide terrorism capable of causing many deaths has now become a major problem facing the forensic community. Citizens or aliens alike lacking fingerprints and dental records pose a serious problem of identification. Special attention when treating all patients should be exercised at the examination visit, whereby an accurate charting of all usual and unusual dental findings is noted and recorded. Our task now takes on a more urgent and magnified meaning.