|Year : 2016 | Volume
| Issue : 1 | Page : 44-47
Forensic Dental Identification: Practice in Indian Context Compared to Western Countries
Sudheer B Balla
Department of Forensic Odontology, Panineeya Mahavidyalaya Institute of Dental Sciences, Hyderabad, Telangana, India
|Date of Web Publication||3-Feb-2016|
Sudheer B Balla
Department of Forensic Odontology, Panineeya Mahavidyalaya Institute of Dental Sciences, Hyderabad, Telangana
Source of Support: None, Conflict of Interest: None
Today, in most of the countries forensic dental identification is considered as one of the most accurate and reliable method of identification of human remains. This application of forensic dentistry has proven successful in both single identification cases as well as in multiple fatality incidents such as world trade center disaster in 2001, the Asian tsunami in December 2004 etc. Comparative dental identification is one of the primary means of identification along with DNA and fingerprint analysis and also the most common method of identification of human remains. Identification of human remains from dental records is mandated by the law in some countries. India is one of the most disaster-prone countries of the world. It has had some of the world's most severe droughts, famines, earthquakes, road accidents, and rail accidents. In this paper, few multiple fatality incidents that took place over the last decade in India are reported. A brief analysis of all the reported cases and difficulties encountered during identification were discussed. The purpose of this paper is to discuss some of the issues involved in body identifications following disasters in India. The author also discussed to what extent Indian government is successful in utilizing the expertise of a forensic dentist in body identifications and also compared the present practice of forensic dental identification in India to Western countries. The goal is to cite situations and to bring issues into better focus, and hence that the identification procedures can be refined and changes can be made as necessary.
Keywords: Availability of dental records, disaster victim identification, forensic dental identification, means of identification
|How to cite this article:|
Balla SB. Forensic Dental Identification: Practice in Indian Context Compared to Western Countries
. J Forensic Sci Med 2016;2:44-7
| Introduction|| |
Forensic odontology is the overlap between dental and legal professions. Through the specialty of forensic odontology, dentistry plays a small but significant role.  The resilience of teeth and its supporting structures to various assaults and teeth as a source of DNA, mainly contributes to successful dental identification.  In the process of victim identification following disasters, teeth also employ comparison of postmortem findings with the ante mortem data along with other methods such as DNA and fingerprint analysis. In most of the countries usually either in single identification cases or multiple fatality incidents, identification by comparative dental analysis plays an equal and important role similar to fingerprint and DNA analysis. 
Comparative dental identification has long been regarded as reliable and accurate.  This in turn is dependent on the quality and accuracy of the dental records.  The identification of human remains takes place because of a number of reasons such as during criminal investigations, monetary, marriage, burial, social, closure  and in a number of situations in which human remains require dental examination.  It was successfully utilized in many disasters such as world trade center disaster, Indian Ocean tsunami disaster in December 2004  etc. However, in Indian context this is relatively a young science and still in budding phase.  This article will cover the aspects related to forensic dental identification, few case examples that showed the potential scope for dental identification in India and to what extent the government officials utilized the expertise of forensic dentists.
Forensic dental identification most of the times are dependent on the availability of the dental records. A forensic dentist can reliably establish the identity of an individual by analyzing the teeth and the oral cavity, which is called as dental profiling.  Dental records are available in various forms such as dental notes, dental charts, radiographs, photographs, and models. The professional, ethical and legal responsibilities dictate the documentation of patient's dental care.  The dual purpose was served if the records are accurately maintained such as providing quality dental care and fulfilling forensic purposes. 
Record maintenance is mandatory in the Western countries.  Different countries have different guidelines regarding the retention of dental records. According to the Department of Health for National Health Service organizations in England, community dental records should be maintained for a period of 11 years for adults and children and hospital records need to be maintained for 8 years.  The retention of records is for 7 to 10 years  must be kept for 10 years from the most recent date of patient discharge. , But in Indian context, the Dental Council of India (DCI), which is the regulatory body, has not prescribed anything specific and there is no regulation in force for a professional administration. 
| Case Reports|| |
For the purpose of this paper, few cases which are closed disasters that can utilize the expertise of forensic dentist are being considered.
Case 1: Mangalore flight crash
An Air India express plane IX812 from Dubai overshot the tabletop way runway at Mangalore Airport on May 22, 2010 and plunged over a cliff into a wooded valley; killing 158 persons and 8 passengers were survived.  This was a closed type of disaster, in which the information of victims involved can easily be retrieved from the flight manifest. Standard procedure of identification was initially adopted by which relatives sought to identity using personal effects.  Details of this incident were discussed in a later section.
Case 2: INS Sindhurakshak disaster
INS Sindhurakshak was an armed submarine. This disaster was considered as India's biggest naval disaster that took place on August 14, 2013. It was all started as fire on the board, followed by a series of blasts resulted in the death of 18 crewmen who were on board at that time. The bodies were sent for post-mortem after taking the records of dental patterns from the bodies. The patterns were matched with the archived dental records to expedite identification of bodies.  As it was closed disaster; the details of all those 18 crewmen were available. One more advantage was, as it was a naval disaster and because of the availability of dental records in the naval database, it is easier to do body identifications using the dental records. The bodies which were severely burned were also sent to DNA identification.  Later it was nowhere mentioned whether it was the successful forensic dental identification or not.
Case 3: Bengaluru-Hyderabad bus accident
It is considered as one of the worst ever road accidents in the recent past in Andhra Pradesh, in which 45 people, including an infant were burnt to death when a bus caught fire on October 30, 2013.  It was a closed disaster. Three bodies which were partially burnt were visually identified by the relatives and for those which were not visually identified, were sent for DNA testing, which almost took up to 2 weeks of time to come up with identification. Relatives of victims have been told by the police to submit a DNA sample for verification.  There was no source available mentioning the involvement of the forensic dentist in this incident.
Case 4: Bengaluru-Nanded train incident
On December 28 2013, an AC coach of the Bengaluru Nanded express train caught fire during the early hours near the Anantapur district of Andhra Pradesh (South India). It was a closed disaster. 26 people, including two children, were killed in the fire.  The bodies were so charred that only nine of the victims have been identified by visual means.  For remaining bodies, authorities conducted DNA tests at Bangalore's Victoria and Bowring Hospital for identification before handing them over to the rightful families.
| Discussion|| |
During any disasters or mass fatality incidents, determining the identity of victims starts with reports of missing persons. A disaster can be divided into open, closed or both, depending on the population involved. In closed disasters, the probable names of all the victims are known, as the number of individuals belonging to a fixed identifiable group and there is basically a question of determining which body belongs to which person.  In open disasters, deaths of a number of individuals take place, for which no prior data nor records are available. The focal point of ante mortem investigations in open disasters is to establish missing persons list and to collect ante mortem data accordingly.  Identification may be simple or complex depending on the type of disaster and so the collection of ante and postmortem data. 
All the case reports that were presented in this article were closed disasters (mass fatality incidents). Even the victim belonged to closed, identifiable group, why the identification of the deceased took so long than usual. In Indian context following any disaster or mass fatality incident, authorities do the body identifications either by personal identification or by DNA analysis. However, in Western countries, irrespective of disaster type, comparative dental identification accompanies with DNA and fingerprint analysis. In cases of impaired visual identification because of traumatic tissue injury or lack of fingerprint record or when the deceased person is skeletonized, decomposed or burned, the dental identification assumes a primary role.  It is accurate, less time consuming and usually simple, but the procedure requires a great level of expertise to execute its efficiency.  But why the authorities in India choose to do the only DNA analysis and no importance are being given to dental identification. The reason behind this was the unavailability of dental records and improper maintenance of dental records by clinical practitioners in India. An awareness study conducted in a part of India concluded that the dentists are not at all prepared for any kind of forensic (victim identification in mass disaster and homicide investigations) and medico-legal needs because of overall poor quality of record keeping. 
In most of the Disaster Victim Identification (DVI) cases, the preferred methods of identification are technical such as fingerprints, DNA and Odontology, over visual identification since it has been long realized error prone.  An example of this phenomenon is the Mangalore flight crash, in which Air India flight was plunged over a cliff into a wooded valley and 158 persons were killed in this incident. The authorities handed over the bodies of 136 victims to the claimant relatives whose identification was based on secondary means of identification such as morphological features of, and/or personal effects on the victims.  Remaining 22 victims were not able to carry out visual identification with any degree of confidence and DNA analysis was carried out and compared with DNA profiles of 32 claimant relatives. This DNA analysis permitted the identification of 10 of the victims, whereas for the other 12 victims remains, it was conclusively shown that they were not biological relatives of any claimants and the data had shown that the original identifications of the victims had been erroneous. 
In the extent of any national disaster, the local police will ask for the assistance from national DVI team. DVI is an intensive and demanding task involving specialists from various disciplines such as forensic pathologists, forensic odontologists, forensic anthropologists, anatomical pathological technicians, fingerprint and DNA specialists, radiographers, photographers, etc. 
From the above cited situations, the following issues can be raised:
The first issue raised was why there is no importance for forensic dental identification? Although there was no exact answer for this issue, but many opine that it was because of unavailability/improper maintenance of dental records and also because of nonavailability of forensic dentists in India. In many countries, it was legally mandated to retain records over a certain period of time ,,,, and there are no such specific guidelines in India.  However, how far this is true? A successful dental identification depends on the availability of contemporaneous and clear note of dental findings.  Due to lack of proper guidelines in record retention, the forensic application of records is not possible. It is also the responsibility of regulating governing bodies such as the DCI and Indian Dental Association (IDA) to bring some regulations regarding retention of records.
- Why still there is no importance for forensic dental identification?
- What is the reason for this unavailability or improper maintenance of dental records?
- Even it was told that personal identification was erroneous and prone to mistakes, why it is in practice in India?
- Nonexistence of dental DVI team at national level.
Growth of any field depends on the availability of expertise and also on its application. Is a lack of expertise in forensic dentistry deteriorating the application of dental identification? At present, only a handful of forensic odontologists present in India. Currently in the Indian dental education programme (Bachelor of Dental Surgery), forensic odontology taught under specialties of oral pathology and oral medicine. To increase its practical application in future, steps should be taken by DCI regarding: (1) Introduction of coursework in forensic dentistry and (2) Commencement of formal training in forensic dentistry. Perhaps some casework experience should be given to those who wanted to become a part of the forensic identification team.
Victims of large scale disaster are identified on the basis of assessment of multiple factors such as the degree to which bodies are damaged, the time bodies have been left exposed, and the associated changes and conditions of the bodies.  Methods of identification used in disaster conditions should be scientifically sound and reliable. Both primary and secondary means of identification are available. Secondary means (clothing, personal description, etc.) serve to support identification by other means and are not sufficient as the sole means of identification.  In Indian context, body identification carried out by secondary means, which was shown in Mangalore flight crash.  This is because of widespread public desire to identify visually a body based on personal characteristics. To reduce these error-prone identifications, it is preferred to base identifications on two method, just to insure that there has been no mistake either in the collection or comparison of data.  These identification procedures need to be refined and changes can be made as necessary.
Across North America and Europe, teams of forensic dentists train to participate at the times of mass casualty incidents to determine the identity of victims.  This team of dentists is lead by dental identification manager. It is recommended that the forensic dentist should also be involved in the recovery phase of disaster management as he has a better eye for dental evidence.  The deployment of this team at the time of disaster management is the responsibility of the national DVI agency. The number of personnel in the team will be based on the type of disaster, whether it is major or minor. No such dental team is present in Indian context.
| Conclusion|| |
This review emphasizes the need of forensic dental identification in India during actual disaster management situations. It is the responsibility of the governing bodies in India such as DCI and IDA regarding the retention of dental records and also to introduce course work in the field of forensic dentistry. It is also important to train forensic dentists in the process of setting up a separate dental DVI team at national level in India.
The author thank Principal, Professor & HOD Dr. P. Karunakar, for his continued support to the subject of Forensic Odontology and also to research in the subject.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
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