CSI & Dentistry

Have you ever watched one of the popular detective shows like CSI or Criminal Minds?  If you have, you have probably seen an episode where Dental Records were used to identify a body.  Forensic Dentistry has been around for a long time, but it has just been in the last 50 years that it has become a dental / medical specialty.  From the view of a private dental practice, like the office of Dr. Mark Freeman & Associates, record keeping is one of the most important parts of Forensic Dentistry.  At our office, every new patient is given an hour and a half first appointment (if possible with the patient’s schedule).  This extra time is used to collect data and develop a patient base line chart.  This chart includes a Full Mouth Series (FMX) of x-rays or a panorex.  Which one is taken is usually decided on by the Doctor or Hygienist based on the patient’s needs at that time.  Both films will show all of the patient’s teeth and bone levels, but the panorex shows more of the bone relationships with the jaw bone / sinus / and nasal passage.  These films are usually taken every 3-5 years to note changes in bone and dentition.  Between these times, Bite-wing x-rays will aid in indicating any changes which take place in the mouth, such as new restorations.

Also part of the first visit is the Existing Oral Conditions.  When charting or drawing the existing restoration, we are making note of what the patient already has in their mouth on that specific date.  Our charting acts as a marker of what the patient’s teeth physically look like at that time.  A complete charting is redone every 3-5 years, but in between those markings, a list of new restorations is also kept to indicate any work done post the first visit.  Dates, the materials used, the tooth numbers, and sides of the restoration are indicated on the Treatment List.  Along with Existing restorations, we also indicated missing teeth, impacted teeth, root exposure, and pocket depths/defects that the patient may have.  All of these things are specific for that individual and, therefore, can help identify a person much like a fingerprint.

Records should also include thing in or around the mouth such as scars, tattoos, and lesions noted during a comprehensive extra-oral examine.  This is part of what is called the Head And Neck Exam.  Small moles, freckles, and unusual markings may be measured and noted in your chart along with the color and shape of the lesion.  Other oddities such as root morphology and evidence of previous oral surgeries are also noted.  All of this creates a specific record and image of the patient’s oral condition in case needed by a Forensic Team.

When are records needed for identification?  It is unfortunate that some patients do not pass away at home surrounded by their family.  Some people die in fires, car accidents, or are not found for a long time and are hard to identify do to decomposition of the body.  Sometimes it is foul play, but other times it is just an unfortunate circumstance.  At this time, if the police and the Medical Examiner believe they know who the John Doe is, they can call for their dental records.  Like a finger print, the exact arrangement of teeth / fillings / and other oral markings can identify a body, and give the police a name to work with.  Knowing who the deceased is gives the family peace of mind to move forward with arrangements for the body.

I have been in practice 24 years as of September 2013, and in that time, we have only been involved with two (2) forensic identification cases.  Both of these men were long time patients of our practice, and although we were very sad that they passed, we were proud to be part of the process which identified them and brought closure to their family.   We are very dilagent about our record keeping.  Please know that this is why we need to take the time to keep YOUR records so up to date and accurate.


Who Makes You Smile?
Dr. Mark Freeman & Associates
3290 Church Road
Henrico, VA  23233



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