by ShriyaRathod Rathod
Published Sun, Mar 5th 2017, 15:00 | Health
Forensic dentistry is the overlap of the dental and legal professions. The most common element of forensic dentistry that a general practitioner is likely to encounter is to supply antemortem (before death) records to aid in personal identification. Forensic dentists are frequently called upon to identify the remains of individuals who cannot be identified visually. This encompasses a large number of situations such as burnt, grossly decomposed or mutilated remains. The identification is normally carried out by the comparison of antemortem (before death) and postmortem (after death) records.
The identification of the deceased individuals is an essential element in the process of death certification and is a crucial component in the investigation of homicides or other suspicious deaths. It is vital to have expeditious and accurate identification both for law enforcing authorities and relatives. Until identification can be confirmed, estates cannot be settled, death benefits cannot be paid, and surviving spouses are unable to remarry. Perhaps of most importance is that the identification of the dead is an essential component of the grieving process and is a necessary part of human dignity in a civilized society.
The police officers in charge of the case will normally call upon the dentist to provide details of dental records. It must be remembered that police officers have no statutory rights to inspect or remove a patient’s records without their consent. However, the law allows for special circumstances and it is reasonable to hand over an individual’s record if it enables them to be identified or excluded. The consent of the nearest relative or estate executor may also be sought if required.
The availability of contemporaneous and clear notes is essential in forensic dental identification. If notes are incorrectly dated, it can complicate and even negate a positive identification. It is in such situations where the errors highlighted by Borrman and others can cause crucial mistakes to be made. When a request for records is received the entire record is useful, including such items as laboratory prescriptions and study models. Many documented cases have used the unique pattern of the palatal rugae recorded on an orthodontic study model to identify young individuals with no dental restorations.
The police may require access to an individual’s record for another criminal matter. They may, for example, want to see an appointment book to establish an alibi or time line. In these circumstances a warrant is required if the patient has not agreed to the release, as it can be argued that the release of notes in this instance is not in the patient’s best interest. If in doubt always contact your legal adviser.
Doubt about what should be documented or how records need to be kept, practitioners should ask themselves: “Will this action serve the best interests of my patient? Does this action helps in my patient’s safety and the continuity of his or her dental care?” The principles applying to handwritten records also apply to Online practice management software, for example, entries must be date, time, and operator-stamped, all changes made must be traceable, and any codes used must be readily convertible to conventional language. Records must be readily accessible and understandable data needs to be controlled, for example, via use of passwords.