Dental student forensic knowledge and skills

Teeth are the strongest tissues of the human body, therefore are the least susceptible to destruction,1 even when compared with bones, particularly when subject to heat. Drastic changes in bone properties during burning can cause great difficulties in forensic identification tests. These changes to burnt bone, such as heat-induced shrinkage and deformation alter the morphological indicators that are critical for identification.2 In addition to the ability to withstand a significant amount of heat, the anatomy of teeth is unique from individual to individual and, as such, is used in human identification.1 When a massive disaster happens within a population, there is one task that must be completed to assure closure for many survivors. That task is victim identification. In disasters with thousands of victims, the most common records used and available for identification are dental records,1 particularly dental radiographs. Other new and innovative techniques, such as DNA technology in forensic dentistry are also becoming very important in human identification;3 however, DNA is heat-labile, whereas, teeth, as well as restorations, are able to withstand heat unless the teeth are exposed to a direct flame.4 The foundation of identification through dental remains begins by comparing the teeth as well as the occlusion, with available dental records.4 Comparing ante mortem and postmortem dental radiographs are the most dependable methods of determining an individual’s dental remains.4 Many other techniques are being developed in dental forensics to provide higher scientific certainty for the results of burnt bone/teeth identification. These developmental applications include the use of cone-beam computed tomography,5 the identification of restorative dental materials through microscopy and elemental analyses that may be useful even with cremation,6 and computer algorithms of ante mortem and postmortem dental records.7 In a recent reliability study, raters using a cone-beam computed tomography imaging technique were able to make accurate visual comparisons with ante mortem radiographs.8 In cases where ante mortem records are not currently available, a forensic dentist can create a postmortem dental profile to be saved for any potential future availability or disclosure of ante mortem records.9 With all of these advancing technologies in forensic identification, there is still a critical need for dental professionals to be able to make comparisons of radiographs in a patient’s chart and radiographs of victims taken after a disaster. Dental students need to learn how to make comparisons. The purpose of this research was to evaluate dental student knowledge about dental forensics and to evaluate dental student skills in comparing radiographs. Our central hypothesis is that there is no difference in the ability of dental students at each level of their education in making comparisons of radiographs, and in their knowledge of dental forensics.