182 Forensic dentistry
record treatments to the contralateral tooth, the tooth on the other
side of the arch, i.e., 19 to 30 (36 to 46 FDI [Fédération Dentaire
Internationale]) or 13 to 4 (25 to 15 FDI). Flops occur when restored
surface notations are transposed, i.e., MO instead of DO or OF in
place of OL. Slides occur, most commonly, when teeth have been lost
and other teeth drift into their spaces. For instance, tooth 15 (27 FDI)
has drifted mesially and is erroneously recorded as tooth 14 (26 FDI).
With the increased use of digital radiography, the incidence of lost
radiographs should decrease. Digital dental software programs inter-
nally record the date an image is entered into the file. That informa-
tion is permanently attached to the image. Dentists are encouraged to
keep complete and accurate dental records to facilitate dental identi-
fication and to protect the dentist in case of legal actions.
- The older the antemortem record, the higher the potential for inconsis-
tencies. When examining antemortem radiographs forensic dentists
should remember that additional treatment may have been com-
pleted on that patient in the interim period. Ignoring that possibility
may lead to recording points of discrepancy that are, in fact, explain-
able. Every practical attempt should be made to procure the latest
available treatment record.
- Advances in dental material science have changed dental identification
methodology. The technological advances in dental resin materials
coupled with the increased demand for esthetic restorations have
further complicated some forensic comparisons. The use of amalgam
filling material is declining and is being replaced with the use of
increasingly varied composite resin materials. Dental techniques,
including microdentistry and the use of flowable resins, have made
the postmortem examination process more complex. The radiopacity
of dental resins varies, and some are almost radiolucent. These radio-
lucent restorat ions ca n resemble toot h decay on radiog raphs. Forensic
dentists must inspect restorations during postmortem examinations
with a great deal more scrutiny than in the past, when “tooth colored”
restorations were usually only seen in anterior teeth. Technological
aids for identifying composite resins are discussed above.
- Things are not always as they appear. The restored surfaces of a tooth
may appear more extensive in the postmortem exam than is recorded
in an antemortem record for a specific tooth. The forensic dentist that
assumes this to be a discrepancy may make the error of forgetting that
additional dental treatment to that tooth may have occurred after the
latest antemortem record entry. Multisurface amalgam restorations
may have been replaced with full crowns by a different dentist. This
is a common occurrence in forensic casework. These occurrences can
