The Interesting Field of Forensic Dentistry (Odontology)- Part Two


As discussed in part one of this blog series, forensic dentistry is a fundamental part of forensic science. Forensic dentists know as Odontologists, aid in the identification process of the deceased and the living. Part two of this blog will discuss bite mark analysis in the living in relation to crime solving, and with heroes who perish because of their high-risk career.

A bite mark is the pattern teeth make when they come together, also known as occlusion. Everyone has a unique bite which can be reproduced and compared. Criminals can be identified from the bite mark they’ve left on a victim. Additionally, high-risk employees such as military personnel, firefighters, police, EMT’s, and search and rescue teams usually have their bite registration on file in case of a deadly consequence. Their premortem and postmortem registration can be examined, and a positive ID made.

With criminal investigations, bite marks are left on victims in instances such as rape, homicide, assault, domestic violence, elder abuse, self-defense, and infanticide. The marks on the victim are compared with the suspect's bite registration for a positive ID. Odontologists commonly evaluate evidence, consult, and testify in court as an expert witness.

Some odontologists specialize in bite mark analysis and identification and must follow rigorous guidelines and standards for analysis developed by the American Board of Forensic Odontology (ABFO). Additional education, experience, and training are required as well as proficiency with digital imaging.

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The Interesting Field of Forensic Dentistry (Odontology)- Part One

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Forensic dentistry is a fundamental branch of forensic science using dental experience in recognition of human remains and evaluation of the bite. A forensic dentist is a DMD or DDS who have furthered their education and specialize in the field of forensic dentistry.

Part one of this blog will be focused on tools such as clinical exams, radiographs, DNA, and Ameloglyphics in the examination of the deceased. Part two will explore the use of bite mark analysis in the living and post-mortem.

Comparison of fingerprints is the first step in the identification process.  However, fingerprints are often destroyed by decomposition, trauma, or fire. With natural disasters such as tornados, hurricanes, tsunamis, and wildfires, the odontologist joins the recovery team to investigate when fingerprints have been destroyed. Furthermore, caskets can become unearthed due to floods, and bodies may have to be re-identified.

The assessment of the deceased when fingerprints aren’t available begins with charting existing and missing teeth. Special attention is given to implants, unusual restorations, bone patterns, and any anomalies that would help with a positive ID. Radiographs are also taken and compared to premortem dental records if they exist. The age of the individual is determined based on eruption patterns and occlusal wear.

Another way Odontologists authenticate findings is by retrieving DNA from the pulp chamber for cross-matching and with a relatively new process called Ameloglyphics. Ameloglyphics is a promising new approach that involves studying the enamel rods of the tooth which are like fingerprints in that they are unchangeable and very resistant to destruction.

Although forensic dentistry is quite an odd job, it has become more commonplace with the number of television shows dedicated to the identification of victims and crime scene investigations.  This specialty is held in high regard with helping families put loved ones to rest, and in the prosecution of criminals.

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A Patient's Perspective - Why Are Dental Implants So Expensive?

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When considering a dental implant, you may have experienced some sticker shock if you’re not aware of what’s involved in the process. Three pieces are normally used in the entire implant procedure, and they include the fixture, the abutment, and the restoration (crown). Even if your insurance covers implants and restorations(crowns), the average fees can range from $2500- to $5000 for the completed project. With most plans maxing out at $1500-$2000, you can be left with a pretty hefty remainder. 

First of all, the implant itself consists of two segments which are the fixture and the abutment, and because it’s considered a surgical event, it’s usually performed by a  periodontist or an oral surgeon. The fixture is screwed into the bone where it becomes integrated and acts as the root of the tooth. The abutment protrudes from the gumline and serves to secure and support the restoration (crown). Sometimes the specialist positions the abutment, and sometimes it’s placed by your dentist. The fixture and abutment are made of titanium as a result of it being a lightweight, strong, and long-lasting metal. Titanium is the choice of metal because the implant is a prosthesis that’s integrated inside of the body, and therefore, must be medical grade. The fee for the fixture and abutment varies between $1500-$3000.

The third portion of an implant is the restoration (crown) and is usually performed by your dentist after the implant has been established for a designated period. As soon as the specialist gives the clearance,  it’s time to fabricate a crown on top of the abutment so that the “tooth” is functional in your mouth. An implant crown is usually more expensive than a regular crown because your dentist may have to purchase special materials and instruments to install it properly. The cost of the restoration (crown) of a single implant can be anywhere from $1200-$2000.

There are some other factors to examine when thinking about an implant because, at times, surgeries such as a bone graft or a sinus lift are necessary to ensure a successful outcome. A bone graft is required on the lower jaw and upper anterior jaw when there’s insufficient bone to support an implant. Cadaver or synthetic bone is normally used, and the price varies from $500-$3000. A sinus lift can be mandatory on the upper jaw in the posterior if the bone is inadequate or if the sinuses are low and encroaching on the bone. The sinus is “lifted” to make room for bone to be inserted between the upper jaw and the sinus cavity. The charge of a sinus lift fluctuates between $500-$3,000. As with the bone graft, cadaver or artificial bone is commonly used. Additional expenses you may incur are radiographs and occasionally, a CT scan.

Although typically uneventful, an implant is a complex surgical method usually including a specialist and your general dentist. Years and years of education and experience go into the whole operation, and you’ll want clinicians who are proven to deliver excellent results. Although in reading this blog, it may seem that the bottom line can be upwards of $8000. However, the entire price of an implant and restoration is generally between $2500-$5000. Price discrepancies depend on where you live and if the additional surgeries are required.

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Orthodontic Treatment Without Ever Stepping Foot Into An Office?

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Who is a candidate-

  • Patients presenting with simple to moderate malocclusion cases. When choosing this method, personal information will be submitted on a website, and a starter kit will be provided which identifies if the patient is a suitable candidate.
  • Patient must be 12 years of age or older, and all permanent teeth must be erupted.
  • Patients who don’t want to physically see an orthodontist every 4-6 weeks for evaluation and adjustments.
  • Patients who are seeking orthodontic treatment at least 60% off traditional therapy.

Who isn’t a candidate-

  • Children under the age of 12 with mixed
  • Patients with a complex malocclusion and cases requiring surgery.
  • Patients with moderate to severe decay and/or periodontal disease.
  • Patient’s with dental implants. Although not impossible, each case will vary.
  • Patients who need constant in-person supervision.

What is at-home orthodontics?

  • A series of trays (aligners) are manufactured using a series of 3D printed models. These aligners are mailed to the patient over a period of months or all at once to guide the teeth into proper alignment gradually. Specific instructions are given as to when to advance to the next tray.
  • The trays (aligners) are clear and tight fitting. They must be worn continuously except for when eating, drinking, and practicing oral hygiene.
  • Although the patient won’t be physically seeing the orthodontist monthly, companies who offer treatment ensure that each patient is paired with a state licensed orthodontist or dentist who will evaluate their medical history, models and/or 3D scans, and photographs. Furthermore, these licensed professionals are available throughout treatment to assist the patient with any questions or problems.
  • Some dental insurance and FSA’s (Flexible Spending Account) will contribute to the cost.

Where do these treatments take place?    

  • Oddly enough, most if not all of the treatment happens in the privacy of the home. In some cases, the patient may have to visit a satellite office for a 3D scan of their teeth.

How does at-home orthodontics achieve straighter teeth?-

There are three steps to acquiring the perfect smile:

  1. The patient receives a starter kit in the mail which includes supplies to make an impression of their upper and lower teeth. The patient may also visit a satellite office, if they are close in proximity, for a 3D scan of their upper and lower teeth.
  2. After receiving the impressions and/or 3D scans, the manufacturer fabricates a series of aligners that are designed to move teeth gradually. These trays may be mailed all at once or every 4-6 weeks.
  3. When optimal results are achieved, the patient moves onto a maintenance phase where they will wear trays usually at night to keep teeth from shifting. Many times, these trays can double as bleaching trays so that the patient can whiten their teeth as well.

What are the concerns when choosing to use this method of straightening the teeth? The ADA (American Dental Association) and the AAO (American Association of Orthodontics) don’t seem to be in favor for several legitimate reasons. The absence of radiographs with this approach before and during treatment is very disturbing. X-rays are extremely necessary to evaluate bone level, decay, and abnormalities detected only on film. Furthermore, it’s difficult to predict the manner in which the bone will respond to movement of the teeth and the appropriate protocol if the patient’s teeth aren’t responding to treatment. The bottom line is that the consumer should consult with a dentist or orthodontist before considering orthodontics at home.

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Is Teledentistry Really a Thing?


Teledentistry is dental consultation, education, and treatment without the presence of a dentist using the aid of telecommunication and information technology. With dentistry being a hands-on process, how does teledentistry work without the patient physically being in a doctor’s presence?

Teledentistry began in the nineties by the U.S. Military to assist the troops stationed far from dental care. Digital images were captured during deployment in remote areas and transmitted to a dental specialist. These images were examined by a dentist and suggestions were given for the alleviation of pain. The patient would then be seen by a medic or surrounding dentist using the best available approach with limited supplies.

In the civilian world, teledentistry is becoming more popular because of some states in the U.S. passing legislation making it legal for specially trained hygienists and assistants to be supervised by a virtual dentist. Practicing in this manner is primarily being implemented to assist low-income families by creating access to affordable dental care while stressing preventative education. Teledentistry is also utilized throughout the world and even in third world countries where dental education and provision doesn’t usually exist.

With the passage of legislation, specially trained hygienists and assistants may provide basic therapy without a dentist’s direct or indirect supervision. Temporary clinics such as nursing homes, schools, or community centers are the setting for offering services such as prophylaxis, placement of temporary fillings, fluoride application, and other aid depending on the laws of the state. The provider of the assistance corresponds with the supervising dentist primarily by the internet. The interaction between the hygienist or assistant and virtual dentist consists of treatment planning and guidance throughout the appointment. Patients are referred to a participating dentist for more complex needs. While this type of delivery may be controversial, it can be very beneficial to those who otherwise wouldn’t have access to dental care as long as the provider operates within the laws of the state.

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