Humanitarian Forensic Odontology & iDENTIfyme Campaign

Expert Profile

Prof. Emilio Nuzzolese is a forensic odontologist, currently serving as a Researcher and Professor in Legal Medicine at the University of Turin (Italy) and HOD of Forensic Odontology, Medico-legal Institute of Turin.  He was graduated in dentistry from the University of Bari (Italy) in 1994. He holds post-graduate degrees in Legal Medicine, Forensic Sciences, and Forensic Odontology, plus a Research Doctorate (Ph.D.) in Analytic Morphometry.  He served as an Expert witness in the Civil and Penal Court for dental disputes and professional liability, and Expert before the International Penal Court. He has associative involvements which include participating as an odontologist in the INTERPOL DVI Forensic Odontology Sub-Working Group, since 2010. He is also President and Founder of the Civil Protection Association Dental Team DVI Europe. Prof. Emilio is a co-founder of the Association Forensic Odontology for Human Rights (AFOHR). He is a Fellow of the Odontology Section of the American Academy of Forensic Sciences, since 2011.  He has presented over 100 papers in national and international forensic science meetings and journals and has been invited as a speaker in several congresses in Italy and abroad (Canada, Indonesia, India, Hungary, Nepal, Romania, USA, UK), among which the forensic dentistry session of the 2006 FDI World Dental Congress in Shenzen (Republic of China).

Foreground

The session has been started with shortly introducing our speaker for the session Prof. Emilio Nuzzolese, his talk consists of the following key points which he has covered and detailed in his expert talk.

Key points of the talk:

• About AFOHR
• Goals of AFOHR
• Forensic Odontology
• Forensic Dentistry
• Humanitarian Forensic Odontology
• Identify Missing Person

Humanitarian Forensic Odontology

The first question that comes to everyone’s mind is “What are you doing for others?” as told by Dr. Martin Luther King. This is the question that is being asked to people that brings back to the various aspects of work in forensic odontology and dentistry. We can gather information such as human identification, age estimation, bite-mark analysis, malpractice, dental damage, and insurance, etc. from forensic odontology and dentistry. Application of pro bono services or forensic consultation where dental evidence is present and forensic odontology could be pivotal in crime scene investigation, age estimation, and identification of human remains, but is not yet, or cannot be applied. This subfield of forensics is deeply involved in cases such as mass disaster and victim identification, war conflicts, missing or unidentified remains, homicides, migrants and border control, violence and abuse, dental evidence, trafficking, and other malpractice. 

AFOHR was founded as a group on 5th May 2015 during the annual Interpol meeting in Leong and it became a formal association “Association of forensic odontology for human rights” in 2019. 

A few important goals that are being covered by AFOHR are

• Human rights of the dead
• Human identification action
• Promote International Partnership
• Practicing humanitarian forensic odontology
• Performing strong forensic odontology
• Provide awareness of human identification
• Quality age determination
• Dental evidence in crime against vulnerable persons

Going to a specific area in which one can use their knowledge in cases of missing and unidentified person. The information campaign is developed by the name of “iDENTify me” AFOHR which is translated into 5 languages - English, Italian, Arabic, Portuguese, and Hindi. The most important purpose of spreading the information about missing and unidentified people and how odontology and dentistry play an important role in identification. The informative campaign is to raise awareness that when filing for a missing person to the police, it is important to mention the name of oral health professionals, dental clinics, and hospital which is visited by the missing person. Dental diagnosis is usually supported by the X-Rays: on the left, a panoramic OPG of the mouth, on the right, Cephalometric radiography of the skull, used extensively orthodontics to assess the relationship between teeth, jaws, and facial skeleton. The X-Ray present in a home even the outdated images can contain extremely valuable sources of information.

A few important characteristics that plays important role in forensic odontology and dentistry are

• Dental implants are the replacement for tooth roots. It provides the foundation for fixed but also removable artificial teeth.  There are hundreds of different dental implants titanium, screws, and companies. Dental implants have an identifying label record that is being given to the patient. 

• Trauma to the face can cause mandible jaws, teeth to fracture. The fracture teeth are mostly treated using titanium plate, fixing, and screws during maxillofacial surgery. Hence, playing an important role in the identification. Also, a report of any traumas such as an accident by falling or vehicle can give a lead to police and can also lead the forensic expert to collect X-Ray images from the hospital’s maxillofacial divisions.

• A dental denture is used to transform the impression taken and a prescription issued by a dentist into a custom-made dental device for a particular individual for one-time use. It can also provide documents, clinical photographs, and certificates of conformity.

• When someone grinds their teeth while not chewing we call it bruxism and therefore night guard is recommended to the person. This nightguard can record teeth patterns and impressions of dental arches and also can have traces of DNA.

• One of the most common systems to whiten the teeth is to make a custom-made tray that is being filled with the bleaching solution and is fitted over the teeth. There is a high probability of finding DNA on these trays.

• Dentists and orthodontists take impressions from the dental arch of a patient which is used for study purposes. Study models can help in the observation of dental appliances, dentures, and orthodontic treatment. Thus, it can also help the police and law enforcement.

• Clinical photographs also play an important role in humanitarian forensic odontology as some dentists have the habit of documenting the teeth with the help of photographs of before and after treatment. Photographs of orthodontic treatment are also widespread and these images can be present in hard copy as well as digital form. This can widely help in the case.

This is to raise awareness that they can still have dental details including face and jaw trauma, denture, orthodontic retainer, piercing, mouth guards, oral hygiene status, etc. of a person that can be given to police to help in the case. Photographs especially clinical photographs also play an important role in the identification of a person.

A dental autopsy is recommended for the SARS-CoV-2 infected cases with the proper kit designed to avoid transmission of the virus. It can be required for human identification of an infected person.

Conclusion

Teeth and jaws provide a huge amount of information in the field of disaster victim identification, age estimation of unaccompanied minors, missing and unidentified persons, child abuse and neglect, domestic violence, and sexual abuse. Forensic odontologists and oral health professionals can promote Forensic Odontologists for the purpose of preventing human rights violations through the application of best practices in human identification. Human identification without complete postmortem assessment can lead to delayed identification and represents a violation of human rights and international humanitarian law.