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Review Article
DOI: 10.17354/cr/2016/210
Relationship between the Dental Characteristics and
General Profiling of the Decedent: A Review
Tanu Tewari1, Sulabh Jain2, Praveen Samant3, Charu Tandon4, Anika Bhasin5
Assistant Professor, Department of Conservative Dentistry & Endodontics, Babu Banarasi Das College of Dental Sciences and Research Centre,
Lucknow, Uttar Pradesh, India, 2Post-graduate Student, Department of Oral Medicine and Radiology, KD Dental College, Mathura, Uttar Pradesh, India,
3
Professor and Head, Department of Conservative Dentistry & Endodontics, Saraswati Dental College and Hospital, Lucknow, Uttar Pradesh, India,
4
Assistant Professor, Department of Periodontics, Babu Banarasi Das College of Dental Sciences and Research Centre, Lucknow, Uttar Pradesh, India,
5
Post-graduate Student, Department of Conservative Dentistry & Endodontics, Babu Banarasi Das College of Dental Sciences and Research Centre,
Lucknow, Uttar Pradesh, India
1
In the field of forensics, the use of dentition for identification has been well established. The dental analysis has been employed mainly for the
positive personal identification of the person. Therefore, the purpose of this review is to show the possibility of using the dental characteristics,
for example, caries and dental restorations for the general profiling of the decedent. It was found that many significant relationships existed
between the dental characteristics and the sex, race, age, and socioeconomic status of the person identified. The socioeconomic status is
having the least number of correlations while the age and race were seen to have the most.
Keywords: Antemortem, Anthropology, Odontology, Perimortem, Postmortem
INTRODUCTION
When the human remains are found, the priority of the
investigators is to identify who the individual was. To
a ain this goal, investigators and researchers use methods
from various fields of science. In cases where the remains
are completely or mostly skeletonized or in which the soft
tissues have been completely decomposed, deformed or
have become such that the possibility to perform an autopsy
or collect fingerprints, have become negligible. In those
cases, the identification is determined by utilizing physical
anthropology and odontology.
Anthropologists, especially those trained in forensic science,
first analyze whether the skeletal remains are complete or
incomplete. Many different techniques are used to gain
different types of information. These techniques vary
depending on the part of the skeleton being examined.
For example, age can be estimated from dentition, suture,
or epiphyseal closure, changes in the pubic symphysis,
auricular surface of the ilium, and sternal end of ribs (These
techniques involve the jaws, cranium, long bones, pelvis,
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and ribs). Using these methods, along with each other helps
the anthropologist to reach a more accurate estimation of
age, but the completeness of the skeleton may limit the
techniques that can be utilized (anthropological analysis
provides an estimation of age, race, and sex. Analysis can
also include conclusions about antemortem, perimortem,
and postmortem trauma).
Most dentists, or odontologists, have the basic knowledge
and skill to perform dental analysis for forensic purpose.
The analysis of dentition generally includes an examination
of position and shape of fillings, presence or absence of
teeth, and shape of molar roots. Usually, this information
is gained through the use of radiographs. Forensic
odontologists also perform a comparative analysis between
postmortem information of an unknown individual and
antemortem information of an individual who has been
missing. By comparing these data, it is often possible to
identify an unknown individual.
Presently, there are three types of dental identification
procedures that are considered:1
Comparative dental identification: A empts are made
for a conclusive identification by comparing the dead
individual’s teeth with presumed dental records of that
individual.
Reconstructive postmortem dental identification or dental
profiling: A empts are made to find out the race, gender,
Corresponding Author:
Dr. Tanu Tewari, 205, Chandralok Colony, Aliganj, Lucknow - 226 024, Uttar Pradesh, India. Phone: +91-9838399926. E-mail: [email protected]
IJSS Case Reports & Reviews | March 2016 | Vol 2 | Issue 10
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Tewari, et al.: A Brief on Forensic Odontology
age, and occupation of the dead individual. This is done
when there is no clue leading to the identity of the deceased.
Dental profiling to oral tissues: This method is undertaken
when the dental records are not available for comparison.
The technique uses modern forensic DNA profiling methods
of oral tissues to establish the identity.
In this review, the possible use of dentition for determining
the general profile information has been done. Only the
dental features that have been utilized previously for
positive identification, such as filling shape, have been
incorporated in this article for correlations to sex, race, age,
and socioeconomic status.
The importance of forensic dentistry was officially
recognized, in 1969, along with the establishment of the
American Society of Forensic Odontology, and in 1970,
when the Odontology Section within the American
Academy of Forensic Sciences was formed.2
After fingerprints, teeth are the most useful tool in
determining positive identification of human remains.
Teeth are the most durable portion of the body and have
the ability to resist erosion, deterioration, and fire long
after death. Teeth must be exposed to a temperature of
over 500°C (932°F) to be reduced to ash. Teeth demonstrate
a variety of form and varied conditions of wear, trauma,
disease, and professional manipulation. Approximate age
and useful indications of probable sex, race, occupation,
personal habits, medical history, and environment can often
be revealed by analysis of only teeth.3-5
DISEASE, RESTORATION, AND ATTRITION
The mouth houses a wide variety of microscopic organisms:
Bacteria, viruses, yeasts, and protozoa. Many different
habitats for these invaders can be found in the mouth: Pits
and fissures, cuspal surface, proximal surface of the crown,
area between teeth, and gingival crevice or sulcus around
the neck of the tooth. Caries, periodontal disease, periapical
osteitis, antemortem tooth loss, and malocclusion are the
disease processes of the jaws and mouth. A structure is
termed as diseased only when it can no longer operate
efficiently. The site at which an abnormality is observed is
known as a lesion. Damage to the structure may be limited
to soft tissues; it may or may not involve the hard tissue
destruction and repair.6 The common causes of tooth loss
are dental caries in the younger population and periodontal
disease in the older population.
Dental caries is the name used for tooth decay. It represents
the irreversible and progressive destruction of tooth
structure due to the bacterial acid formation. A carious
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lesion is characterized by the demineralization of enamel,
dentine, and/or cementum by microorganisms that are
present within the plaque on crown surfaces. Caries is found
to begin at the enamel surface of the crown or exposed parts
of the neck of the tooth, proceeding through the dentine
into the pulp cavity. It may also start from the roots exposed
by periodontal disease. The crown may be completely
destroyed and other periodontal difficulties, such as the
formation of a granuloma or an abscess, may arise. If left
untreated, the affected tooth may loosen and fall out, and
the alveolus will heal in time. Although, the inflammation
can spread into the surrounding bone.7
A carious process on the crown surface is visible first as a
microscopic opaque spot in the enamel. This spot may be
white or brownish in color. With time, the spot becomes
larger, the enamel surface becomes rough and, eventually,
a small cavity appears. Hillson6 noted the variation in the
results of different observers when opaque spots were
included in a study. Due to this reason, these spots were
not included in this research, only the visible cavities have
been included. These cavities continuously grow until
they are treated. If the cavity reaches the pulp chamber,
the soft tissues become exposed to infection thus leading
to inflammation, bone destruction, and tooth loss. Severe
a rition or a traumatic fracture of the crown may also
cause a similar result. Local inflammation occurs leading
to pus collection in that area. Pus is often restricted by a
wall of fibrous tissue, forming an abscess or cyst. The pulp
chamber does contain the inflammation for some time,
but eventually the pulp is completely necrosed by the
progressing lesion. When this death of the pulp occurs,
the infection might proceed down the root canal into the
bone and connective tissue. Due to its location at the apex
of the root, it is known as periapical inflammation. Chronic
periapical inflammation results in bone resorption. Pus
accumulates in the lesion to form an abscess. The pus has
to be removed in for the lesion to heal. Eventually, the bone
and soft tissues get resorbed, thereby forming a channel to
the surface called a sinus or fistula that usually penetrates
the gum on the buccal side of the alveolar process.6
One of the main purposes of the regular dental check-up is
the early detection and arrest of dental caries. Once caries is
detected, the carious lesion is removed while restoring the
structure and function of the tooth. Most of the cavitated
lesions caused by caries have to be restored after the affected
tissue has been removed. Restorations or fillings can be
comprised a variety of materials. The preferred materials
change with time, geographical region, personal preference,
and affordability. Probably, the most common are amalgam
fillings. This type is used mostly on posterior teeth because
of esthetic reasons, though it is used in about 80% of all
restorations.2 Resin and ceramic fillings are more esthetic
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Tewari, et al.: A Brief on Forensic Odontology
and natural in appearance. If a carious lesion infects the
pulpal tissue, the only treatment of choice is either root canal
treatment or extraction. A crown is required on teeth that
have been extremely damaged by a carious lesion or have
been treated with a root canal treatment. Crowns replace the
entire natural crown of a tooth. They can be metal, acrylic
resin, or porcelain. The resin or porcelain, again, provides
a more a ractive or natural look to the restored tooth.
The host’s resistance and dietary factors affect the extent of
dental caries. Morphological crown complexity, tooth size,
trace elements in food and water, developmental defects,
dental wear, and immunologic characteristics of saliva are
all factors of host resistance.8
Dietary factors that cause caries progression include
the types of foods eaten, methods of food preparation,
eating habits, and duration and degree of mastication.8
Between 1945 and 1951, a series of experiments were done
that demonstrated a correlation between annual sugar
consumption and the frequency of carious lesions.6
For the anthropologists, caries has become the most
important dental disease because of its association with
the evolution of food production. Numerous studies have
revealed many important facts about caries such as it has
been observed that the parents and their off springs tend
to, have similar caries experiences. Women have been
found to be more affected by the disease than men, also
in one individual, left and right sides are usually equally
affected.6 The first molar is generally thought to be the most
commonly affected tooth. Although, this opinion has not
been supported by any extensive data. It has also been found
that the upper molars are usually less affected than their
lower counterparts, and posterior teeth are more affected
than anterior teeth.7
The occlusal a rition, or occlusal wear, has been studied
widely to find any correlating factors of sex, age, tooth
position, and dental caries. The sex of the individual was
found to play a major role in tooth wear and have a higher
degree of a rition which in females. The older individuals
had the most heavily worn teeth, but this relationship
was not constant since a few differences were seen. Tooth
position was also an important variable in determining the
degree of destruction due to tooth grinding, mastication,
and occupational use.9
SEX, AGE, SOCIOECONOMIC STATUS, AND RACE
According to past studies, a few differences have been found
to exist consistently and for obvious reasons between the
teeth of male and female individuals such as size and rate
of dental growth. Tooth eruption was found to be more
IJSS Case Reports & Reviews | March 2016 | Vol 2 | Issue 10
affected by hormonal disturbances and dietary deficiencies
than by racial differences.10 Hence, the teeth provide a lot of
information in various ways such as the age of an individual
at the time of death. Teeth are also the most reliable indicator
of age if an individual is 14-year-old or younger, due to the
consistent rate with which teeth erupt.
Although naked-eye observation of emergence and
a ritional changes can be adequate for an estimation of age.
Radiographic methods or histological techniques may also
be used to supplement these observations and reveal tooth
deterioration more accurately.
Dental restorations often indicate the economic, regional,
and racial background of an individual. The amount of
expensive restorations found in an individual may suggest
their social status.11 The wear pa ern and staining of teeth
can also suggest the occupation or personal habits of an
individual such as smoking.
Main Body
Researchers and investigators agree that dentition aids
in positive identification and may prove just as valuable
for general identification. Dental conditions also help
to conclude the sex, race, and age when many standard
methods cannot be performed satisfactorily. In this review,
it has been discussed that many significant relationships
have been found to exist between the dental conditions and
their identifier’s sex, race, age, and socioeconomic status.
The canines and incisors are the most commonly and
severely worn teeth. Usually, the lower right lateral incisor
is involved. This conclusion was drawn and concluded
to be obvious because, as the first stage of the digestion
process, these teeth encounter foods in their most tough
form. Anterior teeth are also commonly used for holding
nails or pins and tearing or opening objects other than the
masticatory function. The teeth of males are worn more
than those of females. This result was not consistent with
the study done by Molnar, in 1971,12 or with the idea that
the teeth of females may be more worn earlier due to earlier
eruption than the teeth of the males. Perhaps this can be
explained by the fact that men tend to have more manual
labor jobs than women and, thus, more likely use their
teeth as a tool. Furthermore, the fact that women are not
usually pipe or cigar smokers and would also contribute
to this fact.
The correlation between socioeconomic status and tooth
wear is not as it is expected to be. It would be reasonable to
think that individuals of a lower status exhibit more tooth
wear because of more manual labor jobs. However, in a
study, the teeth of individuals of middle socioeconomic
status were found to be more worn out. This correlation
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Tewari, et al.: A Brief on Forensic Odontology
might be thought of being present due to dietary differences
or the choice of the method of smoking, for example,
smoking a pipe instead of a cigare e. The upper incisors are
the most common teeth to be crowned, because these are
the most visible teeth in the mouth, and a crown is certainly
more a ractive than a filling or diseased tooth. Because it is
easier for the people of middle socioeconomic status to be
able to afford a more expensive and more esthetic porcelain
crown, but for the people of lower socioeconomic status it
is very difficult. This might be the reason for the account of
association of crown type and socioeconomic status.
The difference in the amount of tooth wear in individuals
according to their age is predictable because the older a
person gets, the more wear his or her teeth will get. The
caries rate is affected by tooth type, race, and age but not
by socioeconomic status or sex. In a study,7 it has been
suggested that the first molars are the most affected by
caries. In the same study, the second molars were found
to be more affected, although an insignificant difference
was present between the first and second molars. It has
also been stated that mandibular teeth are more affected
than the maxillary teeth. As stated by Hillson in his study,6
carious lesions of teeth are found to be more in females as
compared to males and the occlusal surface of the crown is
usually more affected because it is the chewing surface also
the posterior teeth have pits and fissures that hinder proper
cleaning. It was also found that the males preferred to get
their teeth restored with silver amalgam while the females
preferred to opt for more esthetic restorations.
least amount of effect on the dental characteristics. The
age and race have been found to have the most number of
connections with the characteristics studied. Though the
fact remains that more studies must be conducted for more
accurate assessment of the possibilities of this topic.
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CONCLUSION
The goal of presenting this review was to determine if
the dental conditions could be used to establish or help
support the sex, race, age, and socioeconomic status of
unknown skeletal remains. According to various studies,
it can be concluded that the socioeconomic status has the
48
How to cite this article: Tewari T, Jain S, Samant P, Tandon C,
Bhasin A. Relationship between the Dental Characteristics and
General Profiling of the Decedent: A Review. IJSS Case Reports &
Reviews 2016;2(10):45-48.
Source of Support: Nil, Conflict of Interest: None declared.
IJSS Case Reports & Reviews | March 2016 | Vol 2 | Issue 10