Outcome 4 - Forensic Odontology Flashcards
(24 cards)
What is the role of a forensic dental team?
The role of a forensic dental tem is to collect, preserve and interpret evidence and then to provide this information to the judicial authority in the form of a report
What does forensic dentistry involve?
It does not always involve the investigation of a crim or identification of human remains. More often it involves malpractice claims, investigation of dental diagnosis and treamment, and post-accident insurance claims that involve oral and dental injuries
Define Forensic Odontology
“Forensic dentistry, or forensic odontology, is the application of dental and paradental knowledge to the solution of legal issues in civil and in criminal matters.”
Other uses of Forensic Odontology
- To identify the victims of a mass disaster
- When facial recognition is inconclusive
- DNA extracted from the teeth can be used to help identify victim(s)
- Comparing the dentition of the remains with dental records
- Abuse Cases
What antemortem records can be used to identify individuals postmortem?
Antemortem records such as radiographs, photographs, impressions, presence of pathologies, and periodontal health can be used together with post-mortem findings to identify individuals
What can a persons teeth and condition of their oral cavity asses?
A person’s teeth and the condition of their oral cavity can be checked to assess their socioeconomic status, sex, and ethnicity.
Teeth and DNA
Teeth are a valuable source of DNA because it is sealed in a calcified box the is protected from extreme environmental conditions. The enamel on the tooth helps to protect the DNA from assault such as: incineration, immersion, trauma and mutilation.
Preferred method of extracting DNA from a tooth
The preferred method of extracting the DNA from a tooth is through a horizontal section through the cervical route. This allows a rotary instrument to gather the DNA material from the inner dentin in the root canals and still preserves the coronal structure that is vital for morphological identification.
Determining Sex through teeth
Teeth can be used to identify males and females. The mandibular canines have the most significant dimensional difference in males verses the canines in females. Tooth crown diameters and root lengths can also be used for sex determination.
DNA in blood grouping
Each person has a unique blood type. The tooth pulp contains a lot of blood vessels so the blood group antigens are bound to be present in the pulp. Post- mortem changes in the pulp can be seen very late because the pulp stays protected in the tooth cavity. Blood groupings taken from a child’s deciduous tooth and compared with the blood grouping of the children’s parents yielded positive results.
DNA and age estimation
Dental maturity is not affected by nutritional and endocrine status so it can be used as an ID tool.
Factors used for age determination:
Exfoliation of primary teeth and root resorption
Appearance of tooth gem
Earliest detectable mineralization
Degree of unerupted tooth completion
Rate of formulation of enamel
Attrition of the crown
Transparency of root dentin
Size of the pulp chamber indicating the amount of secondary dentin formation
Pulp chamber diameter ration with the crown diameter
Fully erupted third molars
Attrition, and
Apical migration of periodontal ligament
Teeth in determination of race
Caucasians have a higher prevalence of cusp of Carabelli and Asians have a higher prevalence of shovel incisors.
Assessment of socioeconomic status, personal habits, oral health status and occupation:
Low-income individuals will have poorly maintained teeth. Higher number of cavities, inadequate fillings and prosthetic appliances made from cheap materials. Higher income individuals will have better treated and esthetically pleasing teeth. Orthodontic appliances could indicate a higher socioeconomic status. Open bite, crossbite and protruding incisors could indicate habits in children such as thumb or finger sucking.
Personal habits such as smoking and tobacco chewing, erosive changes due to bulimia and anorexia can be determined by looking at teeth. Glass blowers, and musicians who play wind instruments could have a worn incisal edge.
Several important steps required to identify and report a bite mark:
-Identify
-Document
-Preserve
-Profile the evidence and suspect DNA profiling through available saliva swab
-Reporting crucial evidence
The College of Alberta Dental Assistants has adopted the Canadian Dental Assistants Associations (CDAA) code of ethics, which states:
“Dental Assistants shall endorse and uphold their legal obligations (local, provincial, territorial and federal) as they pertain to dentistry and the laws of Canada.”
The 4 categories of abuse are:
- Physical
- Emotional
- Sexual
- Neglect
The most susceptible to abuse are:
-children
-spouses
-geriatric persons
-persons with disabilities
Which Act establishes a duty to report caes of possible abuse of an adult in care?
Protection for PErsons in Care Act
Which Act establishes a duty to report cases of children in need of intervention services?
The Child, Youth, And Family Enhancement Act
The Permanent Record Consists of:
All examination records, diagnoses, radiographs, consent forms, medical histories, copies of medical and/or laboratory prescriptions and any correspondence to or about a patient.
What is NOT apart of the patient’s records?
Financial Records
Guidelines for Charting Entries in Clinical Records:
-Keep a separate chart for each patient
-Financial information is not part of the clinical record
-Better to chart too much information than not enough
-Make the chart entry during the patient’s visit. The grater the time lapse between the procedure and the charting entry, the greater the chance of error to the entry
-Write legibly and accurately in blue or black ink.
-entry should be complete and indicate the date, reason for the visit, tooth number, details of the treatment, record of all instructions to the patient, prescriptions and referrals
-after each entry the dentist and or clinical staff involved in treatment signs and dates the entry
-never change the chart after a problem arises. IF an error occurs correct it properly
