Maintenance of dental records and awareness of forensic odontology among pakistani dentists: a mixed-method study with implications for dental data repository.

OBJECTIVE: Dental records and forensic odontology play an important role in both healthcare and the legal system, aiding in personalized patient care, human identification, and legal proceedings. This study aims to investigate dental record-keeping practices and assess the awareness of forensic odontology among Pakistani dentists over 12 months. This study aims to collect data from 500 dentists, identify areas for enhancement, and develop a strategic action plan to improve record-keeping quality and forensic odontology application, culminating in a comprehensive dental data repository to support legal and criminal investigations in Pakistan. METHODOLOGY: This study employed a mixed-method approach conducted at Hamdard Dental College from January to March 2023. The quantitative phase involved distributing questionnaires to 463 dentists, chosen through stratified random sampling. Out of these, 413 responded, yielding an 86% response rate. These questionnaires focused on dental record-keeping practices and dentists' awareness of forensic odontology. Subsequently, based on the questionnaire results, face-to-face interviews were conducted with 20 purposively selected dentists to gain deeper insight into the challenges and potential solutions. Data from both phases were integrated and analyzed accordingly. RESULTS: The study included 413 participants, mainly females (79%), with ages ranging from 27 to 65 years and an average age of 46.4 years. Most dentists had 5-20 years of work experience (53%), and most (87.4%) were practicing in private clinical settings. All the dentists generated medical and dental records, but the duration of their record-keeping varied, with some maintaining them for up to a year and others for two years or longer. Five themes were generated from the qualitative content analysis. These themes were dentists' perceptions, barriers and challenges, knowledge and awareness, and improvement strategies. CONCLUSION: Our study revealed that local practitioners in Pakistan exhibit subpar practices in dental record-keeping and maintenance of patient history, irrespective of whether they use a digital or traditional file-based system. Even though dentists are cognizant of the importance of record-keeping, they do not actively maintain comprehensive records. This suggests the need for improved training and system improvements to address the gaps in record-keeping practices.

Intersection of forensic odontology and psychology.

Forensic odontologists are expected to deal with challenging demands which can affect their mental health while dealing with forensic activities. This study aimed to explore the psychological impacts of forensic activities on forensic odontologists and students undertaking training. Firstly, it of an integrative review (part I) on the psychological effects of forensic odontology practice. The review was performed on Scopus, Medline and Web of Science. Next, an anonymous online survey using JISC Online Surveys tool (part II) was performed to assess the inherent opinions of forensic odontologists from the the International Organization for Forensic Odonto-Stomatology (IOFOS), and Association of Forensic Odontologists for Human Rights (AFOHR), and Dentify.me. Results were quantitatively evaluated by means of descriptive statistics and qualitatively upon reflection using Microsoft Office Excel (2010). Part I, only one full-text article out of 2235 (Webb et al., 2002) was found eligible indicating a low number of eligible studies. Part II, 75 forensic odontologists and 26 students (49.9% male; 50.5% female) from over 35 countries participated. Results showed that forensic dentists are more psychologically or emotionally affected by child abuse cases and least affected by age estimation cases. Most experienced forensic odontologists reported the lowest scores of discomforts. Males were more comfortable than women in dealing with stress. 80.77% (n= 21) of the students have not experienced any behavioural changes following mortuary sessions but 19.2% (n= 5) witnessed stress. All respondents support the inclusion of a module in Psychology or stress management in training programmes in Forensic Odontology. Suggestions to maintain mental health are considered by the respondents and topics to be taught suggested by a psychologist.

La importancia de la formación del odontólogo para actuar en el rol de perito / The importance of the dentist´s training to perform the forensic expert role

Este artículo está dirigido a aquellos profesionales odontólogos que tengan inquietudes en el aspecto legal de nuestra profesión. El trabajo principal del odontólogo es restaurar la salud bucal y la función de la cavidad oral. Sin embargo, los profesionales dentales también pueden participar en actividades médicas legales como odontólogos forenses o ser testigos expertos para testificar en casos de responsabilidad profesional, accidentes automovilísticos y lesiones relacionadas con el trabajo. Se puede desarrollar esta actividad siendo perito de parte en forma privada o como perito judicial siendo auxiliar de justicia. Para ello es muy importante la capacitación del profesional, que brinda las herramientas para un desempeño ético y competente en la confección de informes periciales, que permiten al juez emitir un dictamen (AU)

This article is aimed to those dental professionals who have concerns about the legal aspect of our profession. The main job of the dentist is to restore oral health and function of the oral cavity. However, dental professionals may also participate in legal medical activities such as forensic dentists or be expert witnesses to testify in cases of professional liability, car accidents, and work-related injuries. You can develop this activity as a Private Auxiliar or as a Judicial Expert as an Assistant to the Justice. Therefore, the training of the professional turns into very important tool, which provides the experience for an ethical and competent performance in the preparation of expert reports, which allow the judge to issue an opinion (AU)

Forensic odontology in the 21st century - Identifying the opinions of those behind the teaching.

From the 19th century, society has been aided by Forensic Odontology and the teaching practice has rapidly expanded in the last 30 years. Information about academics and teaching topics can be found in literature but any research has never investigated the basic profile of lecturers by survey. The aim of this study was to explore the lecturers' opinions on teaching the subject in the 21st century and its current standing. Even though the number of forensic dentists is not low worldwide, not all are involved with teaching. A total of 36 dentists (26 males, 10 females) from 19 countries answered to a survey of eight-questions. Results showed a high prevalence of males (84.6% postgraduate) as opposed of 100% of women postgraduate. Forensic 'dental identification', 'overview of forensic dentistry' and 'DVI' were topics widely taught and 'bite mark analysis' was considered the most difficult one. The 'lack of funding' was the greatest limitation (36.1%) followed by 'lack of recognition and case work' (equally 30.6%). Past problems continue to jeopardize this field and forensic dental bodies should formally liaise with universities and dental councils for the complete expansion of it.

Docencia e Investigación en Odontología Legal en Chile: Situación y Desafíos Actuales / Teaching and Research in Legal Dentistry in Chile: Current Situation and Challenges

RESUMEN: El objetivo de este estudio es describir las características de las instituciones y el equipo de investigación y docencia que imparten Odontología Legal (OL) a nivel pregrado en Chile. Estudio cualitativo realizado durante el 2017. Desde las páginas web institucionales de las universidades que imparten la carrera de odontología en Chile, se obtuvo información sobre el cuerpo docente del ramo de OL a nivel pregrado. Cuando la información no estuvo disponible, se solicitó vía correo electrónico. Se realizó una búsqueda de publicaciones chilenas sobre OL y Forense en las bases de datos Medline, SciELO, Lilacs y Cochrane, y se identificó aquellas realizadas por docentes ejerciendo en Chile. La asignatura de OL se imparte a nivel pregrado en 17 de las 21 universidades que imparten la carrera de Odontología, siendo un curso obligatorio en 16 de ellas, y electivo en una de ellas. De los 29 docentes que imparten el ramo a nivel pregrado en Chile, sólo tres tiene la especialidad de OL. Se encontraron sólo 28 publicaciones científicas en el área en los últimos diez años, cuya autoría corresponde a cinco de los docentes del ramo a nivel pregrado. En Chile, la docencia de OL, a nivel pregrado, es impartida mayoritariamente por cirujano-dentistas no especializados en el área, en concordancia con que la especialidad comenzó a impartirse en el año 2015. Es imperioso aumentar la investigación en OL entre los docentes, de manera de desarrollar el área a nivel universitario, aumentando el conocimiento en la disciplina y consolidándola como ciencia.

ABSTRACT: The aim of this study was to describe the characteristics of the universities and the research and education teams imparting "Forensic Odontology" at undergraduate level in Chile. A qualitative cross-sectional study was conducted during 2017. Information was sought from the institutional websites of universities that impart Dentistry degrees. When the information was not available, it was requested via email to the respective authorities. A search was conducted to identify Chilean publications that deal with the topic of forensic dentistry, in the Medline, SciELO, Lilacs and Cochrane databases. Those authored or co-authored by academic(s) teaching in Chile were identified. "Forensic Odontology" is taught at undergraduate level in 17 of the 21 universities that impart the career of Dentistry in Chile, being mandatory in 16 of schools, and an elective in one of them. Of the 29 academics who teach the subject at undergraduate level in Chile, only three have the specialty of OL. Only 28 scientific publications in the area were found in the last ten years, whose authorships correspond to five academics in the field, teaching at undergraduate level. In Chile, "Forensic Odontology" at the undergraduate level, is mainly imparted by dental surgeons not specialized in the subject, in accordance with the fact that the specialty began to be taught in Chile only in 2015. It is imperative to increase the amount of research in forensic odontology conducted by the academics, in order to develop the area at the university level, to improve knowledge in this discipline and consolidate it as a science.

Epidermis and Enamel: Insights Into Gnawing Criticisms of Human Bitemark Evidence.

Critics describe forensic dentists' management of bitemark evidence as junk science with poor sensitivity and specificity and state that linkages to a biter are unfounded. Those vocal critics, supported by certain media, characterize odontologists' previous errors as egregious and petition government agencies to render bitemark evidence inadmissible. Odontologists acknowledge that some practitioners have made past mistakes. However, it does not logically follow that the errors of a few identify a systemic failure of bitemark analysis. Scrutiny of the contentious cases shows that most occurred 20 to 40 years ago. Since then, research has been ongoing and more conservative guidelines, standards, and terminology have been adopted so that past errors are no longer reflective of current safeguards. The authors recommend a comprehensive root analysis of problem cases to be used to determine all the factors that contributed to those previous problems. The legal community also shares responsibility for some of the past erroneous convictions. Currently, most proffered bitemark cases referred to odontologists do not reach courts because those forensic dentists dismiss them as unacceptable or insufficient for analysis. Most bitemark evidence cases have been properly managed by odontologists. Bitemark evidence and testimony remain relevant and have made significant contributions in the justice system.

Forensic odontology education:from undergraduate to PhD - a Brazilian experience.

BACKGROUND: Forensic Odontology is a topic present in the majority of Dental Schools in Brazil, and due to this reality, some universities develop activities related to undergraduate and graduate students, from the Dentistry course until the Ph.D. degree. AIM: To present the education experience related to Forensic Odontology at School of Dentistry of Ribeirão Preto (USP - University of São Paulo), showing the strategies and activities in the different degrees (Dental course, Forensic Odontology Specialization Program, Specific Professional Training, Master, and Ph.D.). RESULTS: To the undergraduate students, many activities are developed in order to demonstrate all the possibilities that Forensic Dentistry allow, including theoretical and practical activities; in the Forensic Odontology Specialization Program, the dentists are trained to act as Forensic Odontologists in all its amplitude; in the Specific Professional Training, some courses are available, related to specific topics as DVI, Forensic Facial Reconstruction, Auditor in Dental Care Insurance and others; and in the Master and Ph.D. Programs, the professionals receive training in skills like teaching, research, student's guidance and others. CONCLUSION: In Brazil, Forensic Odontology is a well-known field in Dentistry and universities develop an important role in training a qualified workforce.

Competencias genéricas para la educación en odontología forense: pensamiento crítico y responsabilidad social / Generic skills for education in forensic dentistry: critical thinking and social responsibility

La Educación Basada en Competencias representa una estrategia de enseñanza-aprendizaje donde se busca que el estudiante logre un mejor desempeño en los entornos sociales cada vez más complejos a través del desarrollo de sus propias habilidades. Esto requiere que las instituciones educativas ofrezcan oportunidades curriculares que desplieguen Competencias Genéricas (CGs) transparentes y explícitas. Los desafíos contextuales de las ciencias forenses en general, y de la Odontología legal y forense en lo particular, han determinado una necesaria adaptación de sus contenidos conceptuales, procedimentales y actitudinales en la búsqueda de definición de sus campos específicos, desarrollo holístico de sus áreas de conocimiento, la adquisición de habilidades y experiencia, orientación hacia valores profesionales éticos, e integración de todos esos contenidos. Se presentan al Pensamiento Crítico y a la Responsabilidad Social como las CGs más idóneas para una educación focalizada en la Odontología legal y forense, como maneras de asumir el desafío de mejorar la calidad, consistencia y suficiencia de no sólo de futuros nuevos peritos sino también del profesional asistencial generalista, y se discute la trascendencia de formalizar estos aspectos según las realidades y paradigmas imperantes hoy en algunos países de habla hispana.

The competence-based training nowadays represents a strategy of teaching-learning, which supports the student to prepare him/her for better performance in the increasingly complex social environments through the development of their own skills. This model requires that educational institutions must offer curricular opportunities to develop explicit and transparent generic skills (GSs). The contextual challenges of forensic sciences in general, and of the legal and forensic dentistry in particular, have to determine a necessary adaptation of their conceptual, procedural and attitudinal contents to define their specific fields, holistic development of their areas of knowledge, the acquisition of skills and experience, orientation toward professional ethical values, and integration of all these contents. We present Critical Thinking and Social Responsibility as the more suitable GSs for a training focused on the legal and forensic dentistry. To take up the challenge to improve the quality, consistency and adequacy of not only of new future experts but also of the professional healthcare practitioner, and the significance of formalizing these aspects with the realities and prevailing paradigms today in some Spanish-speaking countries is discussed.

The use of incinerated pig head in dental identification simulation.

PURPOSE: The aim of this exercise was to simulate a disaster victim identification scenario to allow training in documentation of postmortem incinerated remains and reconciliation of dental data. METHOD: Varying number of restorations were placed in ten pig heads. The teeth and restorations were charted, with the restorations radiographed and documented, creating an ante-mortem data set. The following day the heads were cremated. Following cooling and recording they were transported for a post-mortem examination by trained specialist odontologists who were not involved in the initial antemortem phase. Recordings included the charting of teeth, restorations, lost teeth, and radiographs to simulate a post-mortem examination. A reconciliation of postmortem to antemortem information was attempted. RESULTS: There was an unacceptable amount of error in the postmortem examination of the heads. The errors related mainly to avulsed teeth and incorrect opinion of which charted surfaces the restorations were placed upon. Also noted were a considerable number of root fractures occurring beneath the crestal bone. This observation does not mimic the evidence observed in human incinerated teeth where the crowns tend to fracture off the roots at the dentin-enamel junction. CONCLUSION: The use of incinerated pig (Sus Scrofa) heads is not an ideal model for forensic odontology training in disaster victim identification. Differences in both anatomy and behavior following exposure to heat were shown to hamper documentation and subsequent comparison to antemortem data.

Forensic dental identification in mass disasters: the current status.

Dentists continue to play a valuable role in the identification of victims in a mass disaster. Individuals and multidisciplinary teams are available to assist authorities in the process. Training, experience and advances in technology continue to improve the efficiency of the identification process.

Expert witnesses in dentistry: a comparison between Italy and Croatia.

A dentist is frequently required to translate dental trauma into monetary value, for example after car accidents and/or work-related injuries. When called to act in this capacity a dentist should combine his/her biological and technical knowledge with a quality medico-legal knowledge. Calculation of economic (pecuniary) damages and non-economic (non-pecuniary) damages requires specific training in medico-legal matters and awareness of the inherent pitfalls. Expert Witnesses registered in Court are usually asked to perform this duty. Nevertheless, European countries have differences regarding dental damage evaluations as well as significant differences in the conditions required for registration as an Expert Witness in Court. A dental Expert Witness has precise responsibilities and is subject to civil or criminal proceedings (depending on the judicial system) if found wanting. In forensic/legal dentistry a medico-legal doctor should not work in isolation from a dentist in dental cases nor is it wise for a dentist to work in the courts without having had specific training regarding judicial disciplines relating to dental damages. In this preliminary work the authors investigate the principal differences in the judicial systems regarding the appointment of Expert Witnesses in both Italian and Croatian courts. The next step will expand this investigation through to European countries in order to marshal knowledge towards harmonization, best practice and a common ground for dental evaluation and claim compensations (in accordance with the Council of Europe Resolution 75 ­ 7 Compensation for physical injury or death).

La ficha de identificación estomatológica para internos: un asunto aún pendiente en México / A ficha de identificação dental para internos: um caso ainda pendente no México / The dental record card for inmates: a matter still pending in Mexico

Los dientes proveen información valiosa que ayuda a identificar a una persona con los métodos propios de la odontología legal y forense. A nivel penitenciario, el expediente del interno, al ser un documento de identidad del infractor, deberá integrar toda la información posible que permita a las autoridades judiciales cerciorarse de que se trata de la misma persona registrada, ya sea en calidad de procesado o sentenciado, con todas sus características físicas posibles en las denominadas fichas antropométricas, con el propósito de evitar suplantaciones o errores en la imposición de las penas a delincuentes. Sin embargo, en México, al efectuar una revisión de las leyes actuales, iniciativas o reformas en la materia (tanto estatales como federales), sobre el registro de internos y la conformación de sus expedientes, no hay una homologación sobre los datos que debe contener la ficha antropométrica; mucho menos, en ningún apartado o sección, se considera la ficha estomatológica como medio de identificación. En el presente artículo se exponen las razones por las cuales debe incluirse en los centros penitenciarios de México la ficha de identifi cación estomatológica, puesto que también tal registro odontológico es una opción de control para procesados y sentenciados, y no solo un potencial documento para cotejar en el caso de infractores reincidentes o fallecidos

Teeth provide very valuable information serving to identify individuals with the use of methods pertaining to legal and forensic odontology. At the prison system level, an inmate’s dossier, because it is the offender’s identity document, must gather and integrate any and all available information enabling legal authorities to make certain that they are dealing with the same individual they have registered either as prosecuted or sentenced, with all of the physical features likely to be found on the so-called anthropometric index cards for the purpose of preventing identity thefts or impersonation or errors in the imposition of punishments to offenders. However, in Mexico, at the time of reviewing laws, initiatives or (both state and federal) amendments in this area with respect to the registration of inmates and the constitution of their dossiers, no homologation exists of those data that the anthropometric card should contain, and in no paragraph or section whatsoever the dental card is taken into account as an identifi cation means. In this article, the reasons why this card should be included in Mexican penitentiary facilities are exposed, since this kind of record is, in addition, a control option for both prosecuted and sentenced inmates and not only a potential matching record to be used in the case of recidivist or deceased infringers

Os dentes fornecem informações valiosas que ajudam a identifi car uma pessoa com métodos próprios da odontologia legal e forense. No nível de prisão, o registro do preso, sendo um documento de identidade do infrator, deve integrar todas as informações possíveis que permitam às autoridades judiciais certifi car que é a mesma pessoa registrada, seja na qualidade de processamento ou do condenado, com todas as suas características físicas possíveis nas chamadas guias antropométricas, a fi m de evitar a falsifi cação ou erros na condenação dos criminosos. No entanto, no México, para empreender uma revisão das leis, iniciativas e reformas neste campo (estatais e federais), sobre o registro dos presos e a conformação dos seus registros, não existe nenhuma homologação sobre os dados que a guia antropométrica deve conter; muito menos, em nenhum ponto ou seção, a guia de dental é considerada como meio de identifi cação. Este artigo discute as razões por que a guia de identifi cação dental deve ser incluída em prisões no México, já que tal registro dental é uma opção de controle para jul gados e condenados, e não apenas um documento potencial para comparar no caso de infratores reincidentes ou falecidos

Dental identification by comparison of antemortem and postmortem dental radiographs: influence of operator qualifications and cognitive bias.

Dental forensic identifications based on comparison of antemortem and postmortem radiographs provide effective and reliable evidence. There are no standardized procedures for assessing similarities between different types of dental radiographs (e.g. orthopantomograms, bitewings, and periapical radiographs), and the operator's subjective judgment can considerably affect identification. The purpose of this study is to evaluate the potential influence of experts' qualifications, training, and cognitive bias on the accuracy of identification. Seventy-eight differently qualified and experienced experts underwent an identification test. The expert sample was composed of 10 specialists in emergency care (ER), 10 specialists in legal medicine (ML), 20 pregraduate dental students (STU), 12 dentists (DENT), 20 dentists educated in forensic odontology (DENT-TRA), and 6 experienced forensic odontologists (FOR). The simulated cases required participants to assess the possible matching of 42 postmortem intraoral radiographs with 16 antemortem panoramic radiographs. Accuracy and specificity for the different operator groups were as follows: ER, 0.76-0.70; ML, 0.76-0.88; STU, 0.89-0.82; DENT, 0.87-0.97; DENT-TRA, 0.88-0.92; and FOR, 0.97-1. As evidenced by high rates of accuracy and repeatability, the most experienced forensic odontologist consistently outperformed operators less or differently educated and trained, especially for difficult cases. In our sample, the dentists who received additional education in forensic odontology did not necessarily perform better than dentists who had not received this additional education. Some cognitive bias, mainly the so-called observer effect, emerged as a possible source of outcome variability among the operator groups.

A model for forensic dental education in the predoctoral dental school curriculum.

Forensic odontologists play an important role locally and nationally in assisting in the identification of the victims of mass fatality incidents, whether natural or human-made. With the recent passage of legislation by Congress identifying dentists as a first-responder resource, knowledge of their expanding role in disaster response is particularly important. The purpose of this article is to describe the forensic dental course being taught at Creighton University School of Dentistry in Omaha, Nebraska, as a model for providing a fundamental education in forensic dentistry and disaster preparedness at the predoctoral dental level. This model is designed to 1) provide students with a broad view of forensic odontology; 2) give them a functional knowledge of the tools and techniques of the modern forensic dentist; 3) provide basic knowledge of their potential role in disaster preparedness and response; and 4) encourage students to pursue further forensic education, become active in national forensic organizations, and get involved in disaster preparedness/response in their home communities following graduation. This article includes lecture topics, demonstrations, and hands-on exercises being used at Creighton to teach students the fundamentals of forensic odontology and disaster preparedness.