CHAPTER 1
Foundation knowledge in forensic odontology
Jules A. Kieser 1, â , Jane A. Taylor2, Zaf Khouri3 and Maurice Churton4
1 Faculty of Dentistry, University of Otago, New Zealand
2 Faculty of Health and Medicine, University of Newcastle, Australia
3 New Zealand Society of Forensic Odontology, New Zealand
4 Oral and Maxillofacial Surgeon (Retired), New Zealand
I'm not young enough to know everything.
J. M. Barrie, The Admirable Crichton, Act I (1903).
Introduction
Forensic odontology has been variously described as âthe application of dental science to the administration of the law and the furtherance of justiceâ [1] and âthat branch of dentistry, which in the interest of the law, deals with the proper handling and examination of dental evidence and the proper evaluation and presentation of such evidenceâ [2] and âthe overlap between the dental and the legal professionsâ [3] .
The dates of these references show us that forensic odontology has been developing as a specialist discipline for the last 50 or so years. Once the remit of the merely interested or community minded and conscientious, dentists now require rigorous training and commitment to practise within the profession. The discipline is recognised as a speciality of dentistry in a number of countries including Australia, and has a dedicated training stream within the Royal College of Pathologists of Australasia.
To the general community, forensic odontology is most frequently associated with personal identification of the deceased, and gains significant publicity at the time of disasters, natural or manmade, that claim many lives at a single point in time. The actual scope of practice of forensic odontology is considerably broader than this. In addition to human identification forensic odontologists are also involved in the examination and assessment of bite mark injuries, orofacial injuries following assault or trauma and child abuse injuries; age assessment of both living and deceased persons and civil cases involving malpractice and fraud allegations.
Practitioners must also have a sound working knowledge of dental anatomy and pathology; comparative dental anatomy; the natural sciences; legal system law and relevant legislation. An understanding of the activities and interactions of other forensic disciplines is also important in developing an appreciation of the scope and practice of forensic odontology.
On a personal level, forensic odontologists should have broad dental experience, a methodical and analytical approach with considerable patience and attention to detail. Personal honesty and integrity and emotional stability are vital. Good communication and interpersonal skills and the ability to work as part of a team, as well as autonomously, are important, as is the ability to formulate and articulate well-balanced views.
This text will work its way through current best practice in a number of these areas. It aims to support those undertaking training in forensic odontology in the development of their knowledge base, which forms alongside their clinical skills. The text is designed at the awareness level rather than aiming to be an exhaustive discourse. Contemporary excellent references are provided to extend reading beyond the introductory.
Recent reviews into the scope and reliability of all forensic evidence have seen an explosion of research and literature relating to improving the performance and professionalism of practitioners [4â6] . Recent rulings challenging admissibility of specialist evidence, recognition of specialist disciplines and the evidentiary weight of forensic evidence also highlight the need for continued research into aspects of practice and the need to establish and maintain high professional standards [7â9] .
A short history of forensic odontology
Although it was reported that forensic odontology was used to identify victims of a fire in the Vienna Opera House in 1878 [10,11] , the modern era of forensic odontology is said to have commenced with the identification of the victims of the Bazar de la CharitĂ© fire which occurred on 4 May 1897 in Rue Jean-Goujon, Paris. One hundred and twenty-six members of the Parisian aristocracy perished after an etherâoxygen film projector ignited a rapidly destructive fire. All but 30 of the victims were identified visually or by personal effects, mainly jewellery, on the day after the fire.
The honour of being the âfather of forensic odontologyâ is often bestowed on Oscar Amoedo, a Cuban dentist working in Paris at the time of the fire, but he did not in fact do any of the odontology work at this incident. The author of LâArt dentaire en Medecine Legale [12] , which was a considerable text on many aspects of the use of teeth for legal purposes, merely reported the outcomes of the work done by other dentists after the fire. The credit for the idea of using dental information to assist the final identifications actually belongs to the Paraguayan Consul, Mr Albert Haus. With the identification of the last 30 victims seeming almost impossible, Mr Haus suggested consulting the dentists who had treated the remaining missing persons. One of the unidentified victims was the Duchesse dâAlencon, who was a daughter of the Duke of Bavaria and sister of Elisabeth, Empress of Austria and Anne, Queen of Naples. A Dr Isaac B Davenport had provided dental services to the duchess and many of the other victims. He was apparently a trained botanist as well as a dentist and his detailed notes included excellent drawings of the dentition. He examined the majority of the remaining unidentified bodies and was eventually able to identify the duchess via her dentition. Subsequently, a number of other dentists were invited to examine the remains of the deceased, and eventually all but five of the victims were identified. The police accepted these dental identifications and released the bodies to the families [13,14] .
Prior to the Bazar de la CharitĂ© fire, the most frequently cited examples of the use of teeth and dental work in the identification of the deceased were those of Lollia Paulina by Agrippina using visual recognition of âdistinctive teethâ in AD 49; Charles the Bold in 1477; General Joseph Warren by Paul Revere via a fixed wire silver bridge in 1776; Dr Parkman by Nathan Keep from the fit of dentures on study models in 1849 and Napoleon the IV in 1879 [14,15] .
In 1954 Strom [16] reported that the use of teeth to aid identification in the modern understanding had in fact initially been proposed by Godon in 1887, but a report by MâGrath in 1869 [17] described the use of dental characteristics to differentiate between two incinerated females.
After the Bazar de la Charité fire many authors published case studies on the use of forensic odontology in both single and multiple fatality incidents. Rosenbluth [18] described a case in the United States in 1898 where dentistry played a pivotal role in a murder case. Ryan [19] mentioned the identification of US Sailors from an accident in 1927, commenting on the high quality of the dental records kept by the Navy, and Gustafson [11] recounted a fire in Oslo in 1938 where 29 people died. Simpson [20] summarised a number of English cases of the early 20th century. Strom [16] and Gustafson [11] reported on the identification of victims of the Second World War via forensic odontology. Teare [21] discussed the identification of 28 victims of a plane crash in 1950; Frykholm [22] described a Swedish shipping accident in 1950 where 15 were killed and Mercer, Reid and Uttley [23] and Warren [24] a rail accident in New Zealand in 1953 where 151 perished. Bradley and Miller [25] described the use of odontology in the identification of victims of a plane crash in Canada. The odontology aspects of the identification of the 118 victims of a fire aboard the SS Noronic in Toronto Harbour were described in detail by Grant, Prendergast and White [26] .
While these reports would appear to indicate that forensic odontology was well recognised as a discipline, Frykholm [22] did comment that both the German and Swedish authorities involved in his case report âreflected a certain disbeliefâ about the value of forensic odontology, and that the assisting dentists had no personal experience in forensic odontology prior to this case. It would be reasonable to assume that both appreciation of the value and experience in forensic odontology were varied across the globe, as can be expected with any relatively new and emerging area of knowledge and investigation.
Histories of forensic odontology acknowledge that the next significant publication after Amoedo was that of Gustafson in 1966 [11] . This comprehensive text covered principles of identification in single and multiple death ...