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Dentistry Uncensored with Howard Farran
Dentistry Uncensored with Howard Farran
How to perform dentistry faster, easier, higher in quality and lower in cost. Subscribe to the podcast: https://podcasts.apple.com/us/podcast/dentistry-uncensored-with-howard-farran/id916907356
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1481 Dr. Sigrid I. Kvaal on Solving Mysteries with Forensic Odontology : Dentistry Uncensored with Howard Farran

1481 Dr. Sigrid I. Kvaal on Solving Mysteries with Forensic Odontology : Dentistry Uncensored with Howard Farran

10/16/2020 3:00:00 AM   |   Comments: 0   |   Views: 263
Sigrid I. Kvaal has worked actively as a forensic odontologist since 1987 and taken an active part in the identification work after mass disasters and in dental identifications following the recovery of single unidentified bodies. She has published articles on dental identification, age estimation and PDT (Photodynamic treatment) of oral lesions. Since 1995 she has been registered as a Forensic Medicine Expert in Odontology by the Ministry of Justice and Police, and The Commission for Forensic Medicine, Norway. Since 2001 been a member of the Norwegian Identification Commission (DVI) and at present she is the responsible forensic odontologist for the national team. She is also a clinical instructor at the Institute of Clinical Dentistry, Faculty of Dentistry, Oslo.


VIDEO - DUwHF #1481 - Sigrid Kvaal


AUDIO - DUwHF #1481 - Sigrid Kvaal


A Death in Ice Valley: https://www.bbc.co.uk/programmes/p060ms2h

Subscribe to Dentistry Uncensored on Apple Podcasts:  https://podcasts.apple.com/us/podcast/dentistry-uncensored-with-howard-farran/id916907356  Subscribe to Dentistry Uncensored on Google Podcasts:  https://podcasts.google.com/feed/aHR0cDovL2RlbnRhbHRvd24uZmFycmFubWVkaWEubGlic3lucHJvLmNvbS9yc3M



**Please excuse any typos as this was digitally transcribed.

It is just a huge honor for me today to be podcast interviewing Dr Sigrid Ingeborg Kvaal DDS. Dr Odontology associate professor institute of clinical dentistry faculty of dentistry university of Oslo Norway which has to be one of the coolest towns in the world was qualified with a bds from university of London united kingdom in 78 was created dr odontology PhD at Oslo in 95 after qualifying she worked for three years in England before returning to Norway she has been employed by the faculty of dentistry university of Oslo since 1988 and has worked in private practice for 30 years she has worked actively as a forensic odontologist since 87 and taken an active part in the identification work after mass disasters and in dental identifications following the recovery of single unidentified bodies she has published articles on dental identification age estimation and pdt which means photodynamic treatment and don't ask me what that is of oral lesions since 95 she has been registered as a forensic medicine expert in odontology by the ministry of justice and police and the commission for forensic medicine Norway since 2001 been a member of the Norwegian identification commission and at present she is responsible forensic odontologist for the national team she has been a teacher on the iofos international organization for forensic odon stomatology courses in forensic odontology since 2001 for the Norwegian armed forces medical services she has been project coordinator for dental age estimation of unaccompanied asylum seeking children she has been teaching forensic adult odontology and ethics to dental students as well as general and oral path she is also a clinical instructor at the institute of clinical dentistry my gosh she's been ruling it in dentistry for 42 years and of course you probably already know all about her because um she was the very famous woman on solving a 40-year-old mystery with odonatological techniques about a mysterious death in 1970 the woman from ice valley had several gold crowns and bridges on her teeth which were not typical of Norwegian dental work um we posted that on dental town forensic dentistry and most of the comments are like wow and um and i asked her to come on the show and I’m so excited you granted us you know there's so many people that want to talk about fillings root canals and crowns but there's hardly anybody in the world that does what you do um what was your journey that led you to forensic dentistry oh just by coincident i wanted to do some more than just drilling and fillings and i contacted the faculty here in Oslo and most of all i wanted to do surgery uh but at that time it wasn't open for anybody else so i tried to do look at pathology and the professor in pathology said i want you to do forensic work and there i am well um since we have so many kids listening to show a quarter of our viewers are still in dental kindergarten school so they're not even old enough probably to remember when you were an international media about this case so just for the kids will you review that solving a 40 year old mystery uh technique that went viral no i haven't sold it and nobody has sold it you're thinking of the death in ice valley um yeah the mysterious death in 1970 oh that that is still unsolved to this day that's still unsolved but BBC did the beautiful podcast of it and i just looked at it it's still available on BBC you just google this in ice valley so it's BBC world service death and ice valley it was a cooperation with nark which is the cleveland Norwegian BBC yeah um BBC um amazing journalism do you like the journalism of the BBC yes you think it's pretty professional very professional that's fantastic and that's in fact this podcast got a prize is that right well tell us about the podcast we'll and we'll put the podcast in the link uh when we push this out um so they can listen to it but give how long is the podcast it's um it's nine episodes it's nine and i think i was from the seventh one six or seven one we'll sum it up for us no that must be four is tell pay truth so it must be about that there okay tell us about the case there's also a Facebook page to it and lots of ideas is coming up on the Facebook so the unidentified woman from isdalen and you said is dylan was a valley in in Norway yes Israel is a violin no way when they found her that this is something like this uh what they think she's found in November 1970 and ha had all her eye items uh of identity removed and she traveled with several different identity and all were fake and this what i found she was partially burned it's quite difficult to sort of identify a woman from this but this is a picture of the eye style in on the west coast of nowhere near to bergen which is the next biggest town in Norway they also found her some biopsy some pot slides and they were then able to get some dna from that but this is such teeth so so island that's real that that's the most northern part of Norway no no no no no it's it's just a valley on the west coast not very far from bergen it's a very popular walking area close to berg and it takes about i suppose between 20 minutes half an hour by busa to that area from bergen wow so he was definitely troubled by bus so whoever killed her was tried to burn her and take away her identity and was really trying to well we don't know whether she was killed or not i haven't been able to establish that or whether it was a suicide but quite a lot of points point to the fact that she was murdered but that hasn't been clearly established and her identity has not been established this has are her teeth and the pictures taken in 1970 and this is a odontogram which my professor bang did in bergen in 1970. you see she's got crown lots of clowns and bridges and i got some pictures of that but first i will show you the x-rays uh normal standard periapical x-rays full mouth x-rays i said she was traveling with um uh false identity in her suitcases which were left on the railway station they found her fingerprints but there were a wig in there there was glasses without correction seven fake passports and coded letters and 500 deutsche mark which was the currency in Germany at that time and these are one of the coded letters and we think it's the way she travels and this is the map of where which way she did travel she did travel around nowhere and nobody really knows why she traveled throughout Norway uh this is how she um from the hotel where she signed in and the fingerprint expert says that they her handwriting look rather French rather than German I’ve got a newspaper cutting from the police but that's all in Norwegian so it doesn't say that it was on the front page of the local paper when she was found and then questioned who is this woman uh it's a black notice sent out in 1971. black notice is a notice they sent to the Interpol about missing people or people has been found and here you see part of the teeth that she's got amalgam fillings which you would expect in 1971 and she's got a gold crown but it's rather crude looking uh crown and it's uh i think it's what's called a color crown in in in English I’m not quite certain about the terminology there it's called the ring decay chroma in in German and it's um in Norwegian but I’ve never been able to find out the English terminology for it well someone please enter the term in the notes in the YouTube the comments in the YouTube are fantastic okay if anybody knows just put the notes in yeah and then they also examined the crown and she had a post which was soldered to the crown now to the core um she's buried in an unmarked grave in one of the graveyards in Bergen but they reopened the case in 2016 and this is my colleague the professor in forensic medicine in Bergen looking in the archive and they then managed to find the tissue specimen and the dentition and from the specimens they were able to take DNA they we tried from the teeth but we didn't manage to get extract any DNA there and when they looked at the DNA she's most likely of European descent the black notice i mentioned and here is where they open the teeth and I’ve got some better picture of the teeth there you see the teeth it's uh some of the teeth has been taken out postmortem that means after she was dead for ace estimation you see the gold bridges and amalgam and metal bonded crowns on the front teeth and there are side views and the way these crowns are made um they're not made like full gold crowns like i was told to do it in in the seventies um and that's why people say they are ring decker I’ve also had an English German dentist looking at it and he also said that that was it there's also silicate fillings which were normally used before 1970 [Music] more of the teeth acrylic veneer crowns on the premolars and on the front teeth they done element analysis on the colored fillings they have that was another one they've done age estimation and uh that was early 30s the c14 anal analysis that was done a little bit later um then they thought she was much older but i think that was an overestimation that's why i put a question mark on it and then we took out teeth for analysis and did that to a campaign they looked at the trace elements in the teeth which could be that where they could see that they had where the water supply was and that was done in Australia and what they came up with was this map here some map here some in Germany and also over in wales writing and dental treatment are definitely not English because i was in England in the 70s um but with the French connection she might be from the French German border she might have grown up in Nuremberg and then being during the war being moved to the French German border that's their hottest guess at the moment um but that is um that's another isotope they looked at and you see the wells area comes up quite clearly and that's as far as becomes there are the websites uh and you see you can get it in many different languages and what year what years were you working on this case uh i was working it on it in 2000 and they opened it in 2016 2017 2018. and when did you start doing forensic odontology uh 1987. so that that's the year i graduated from dental school so from 87 to 2020 you know in in the last three decades what's really changed uh how you do it today versus three decades ago the examination not much because that's virtually the same but of course we use now electronic registration and electronic uh pictures and it's rather nice to be able to see the dental pic the dental x-rays straight away and not having to wait till they've gone back to your office and develop them nice um yes and you can see whether oh straight away oh here was a root filling it probably more x-rays in the dental records the other big change is of course that we get electronic records uh which is rather than handwritten records and the electronic records they are possible to read they're not always possible to understand i just had one in which i didn't understand anything of and it was written in Norwegian uh but i could at least decipher it now um you're uh you're from Oslo so you're a Viking um has there ever been any forensic odontology from the Vikings i know i know they um claim they found evidence uh in Canada they're Greenland Iceland no i haven't looked at any Vikings i looked at some excavations from Oslo i suppose that was the Viking time that was before 1150 and that was from a churchyard and they knew that the burial was before 1150 because the church pillar was on top of that grave that was a woman so which i called mother Oslo mother Oslo so um so Norway has um about five and a half million people so how many forensic odontology cases does would they have in a year how many out of five mil 5.5 million that has really changed since i started because when i started we got all the identifications but as the ss passed more and more is done by DNA and now we get very few cases a year i suppose we are up in 30 40. 30 or 40 cases a year yeah well that's still a lot of cases i mean 30 or 40 that's for the whole country and that includes accidents so you can if a helicopter goes down you get four or five straight away so what do you what do you think the um you know there's uh they say there's a million dentists around the world that practice like you and i do and probably another million dentists that it's their full-time job i mean if you go back in history uh 200 years ago we were we were barber surgeons uh so the uh the range of dentistry but there's about two million people that are that are a dentist in real life and what do they need to um know about this i mean if they're never going to be a forensic odontologist what do they need to be thinking about as a dentist that's the record keeping because that's the one i i the records which i collect to do their identification is equally important to the examination i do in the motory because unless you have something to compare with it you can't do an identification so two questions what records would you like us to be uh taking to help you and number two what lack of records have been the most challenging for you that we dentists uh didn't do right uh well i would you want the written record which most of us do all the x-rays i would like um models i would like photographs and the only other informations that you would have now we just changed from using cadaver specimens to having model electronic models for our teaching and that's coming up uh as a possibility now that you can send me a usb stick with the electronic uh model um in the computers like you store the x-rays like the uh like the scanning uh like like three shape over dextoria and denmark coping so now that they're taking oral scans um for like um um clear aligner therapy like invisalign has the itero three shape um has that um you're saying the the digital models are um very important that's equally important to the written record on the x-rays so you need photographs is also very good i remember from uh working in when i was working in thailand after the tsunami i very often came across an american record which had beautiful pictures in it and suddenly i see these postmodern pictures and they are the same so i just had to compare the pictures it was fantastic so written records photographs and oral scans or uh models preferably digital uh models uh okay models either stone or digital yeah oh yeah and then the same with the x-rays if you've got older x-rays so i i showed you from the eyestalk movement um they are equally good to the electronic ones in fact in some ways i think they are better because when i had them in the hand i could say whether they were flipped a lot i can't do that with the electronic ones and and how many record sets do you think you've seen in your entire three decade forensic career i don't have to be a guess what would the gas be what would the range if you uh if i take 10 a year that would be 30 well we had three how many were missing in thailand um yeah so up to 500 i suppose okay well let's just for simple math 500 um give them a letter grade you're a professor with the average records that you saw over three decades be in letter grade a b c d or failing uh so d is failing it sometimes the the the the grading go the other way okay we'll all accept the d is a fail so what a b c or d what what letter grade would you give them uh leverage uh uh well in like in any case uh when you some of them are very very good and very detailed and other ones are crap but on but on average what would you say a b a b well that's good my homies are doing good and and um and how do what are you thinking when you approach a single specific case like here's one person versus going to thailand and it's a mass disaster how how does that does that change what you know it just doesn't change uh you work in the same way except for the fact that when you have got a single one very often the police can think oh this is the one uh mrs x has been missing after she walked in the woods and now that found a body in the woods um but uh when you've got mass disaster you you have to look through so many files to get it right so they say the the difficulty increases exponentially um that is um that is very very interesting um there's been a lot of stuff in the media over here you know the lawyers will have a theory that they'll use in court for a while and for a long time they were saying that if you had uh fingerprints that there's only eight billion people so it's like greater specificity than one in eight billion and they were saying the same thing with dental records um first of all to compare to like if you had someone's fingerprints is that like absolutely guaranteed that person or is that just well i think fingers to print experts but through the interpol they say that the fingerprints are equally good to any other identification and what about if you just had t and the same with DNA okay so fingerprints and DNA again if you got your own DNA uh for instance from a tissue specimen then you can identify it if you use family to identify it mother is the best one because no mother is normally a mother father is usually father uh and the same with the children uh but if you go to siblings it makes it much more difficult well i would trust the mom over the father because being a dentist for 33 years if i asked the mother any information like what is your child's birthday she tells me right now but if i ask a dad he's like ah and I’m like you know when the kid was born was there a christmas tree in the house or was there a halloween pumpkin and they're like ah but the mom always knows but i was asking about fingerprints of DNA to compare it to like models like if you just had models is that almost like DNA or fingerprints not quite and we don't get it very often uh but i have had models in where i could look at the shape of the fillings and the shape of the [Music] cusps and fissure pattern and that sort of thing the rotation of the teeth and my colleagues are now trying to look at specific features which we could look at which can be identifying features like that because they're normally not told in the record you would say that you have got an occlusal filling but it doesn't say what sort of occlusal filling it is i mean what shape it is they will tell the material and that it's on the occlusal surface but not the outline or nato and they won't tell me when they have got three or four or five cups on the molars but that could be an identifying feature and that is especially important now you get more and more people who doesn't have feelings and doesn't have advanced dental work huh now um if you were uh listening to you right now in dental school and you were gonna graduate this year and you're 25 and you're gonna practice 40 years to 65 how likely is it that someday they're going to get a knock on the door and say we had a plane crash or a car rack or an um unidentified body found in the woods is this something that will happen to every dentist once because it actually did happen to me from a northwest airlines it was a crazy story it was northwest airlines and um the um it was coming back to phoenix and i don't know how many people were in the plane but i was right across the street from the lutheran church and there were uh i think there was one or two people um but anyway that they asked for records of three people and um and i and i thought wow but it never happened again i mean 30 30 years sunset i mean it happened one time and it was a northwest airlines flight um but um so do you think the average dentist will have this happen to him well when i have been I’ve been in practice for 30 years they never asked me for a record or i never asked myself for a record but again it's it's just a chance of suddenly somebody might knock on the door and ask for it um i know the grenfell tower in London when that burned the local dentist virtually lost all these patients huh that is interesting so fingerprints and DNA and your mom is better than dental models probably probably but we never know which one will come in because again you will have to have comparison if you don't have if the the person with the fingerprints hasn't got a fingerprint record and i don't have fingerprint records in Norway i have a new usa but not in Norway because my fingerprints has to go in when i visit it to usa but it doesn't have to go when I’m here i i want to ask you i want to ask you a very um i don't ever like to discuss uh religion politics violence or sex because those you know those are trigger things but i always notice i I’ve had the huge opportunity to lecture in 50 countries around the world for the last 30 years and i always noticed that despite politics the the the other dentist they're they're always tight they're always they always cooperate get along they're always fun to go to dinner with regardless if um our president or their president is whatever crazy thing they're doing do you see that international cooperation among dentists or are they like oh you're uh you're a socialist or you're a communist or yeah i don't ever see it either uh and when we were in thailand we worked together from dentists from all over the world and we all learned a lot from each other and from that sort of uh angle it was a very interesting experience um and that has developed so when i meet him again at international conferences or we discuss uh how we go forward that comes up again and we know how these works but of course they are when you get into forensic dentistry you get into legal uh requirements the the German has got different ways of financing different way of looking at it uh i mean the philosophy of dentistry so they did very little amalgam but they do a lot of gold fillings whereas in England they would do a lot of amalgam fillings so I’m um I’m 58 so and a dentist so all my fillings are gold i think i have like seven i just think they're the best um love them um but i do notice um you know the the low cost uh like soccer will always be the biggest sport in the world because it's the lowest cost you just need a ball in a field as opposed to hockey or even a ball of rags that's how they started soccer started as a bowl of rice rags oh rags okay i you know i love eating rice whenever i have the urge to eat 2 000 of the exact same things i just eat rice uh whereas if uh but uh okay that was a bad joke but um so so whenever i hear a dentist bad-mouthing amalgam i i seriously want to take them over my knee and spank them because i mean there's entire continents that can't afford a rubber dam and suction and adhesive dentistry and and and i always notice that around the world rich people who have many options are always trying to take away the one option a poor person has like I’m a poor person I’m at a dentist in somalia and and they're gonna do an amalgam and it's always some rich person in canada that wants to take the the amalgam away from him like well yeah you can take your amalgam away because you could have gold like rich howie he's a dentist in america or a a pretty dazzling white filling because you're rich from Oslo but um do you think um amalgam should be discontinued do you um because a lot of americans i have to tell you a lot of americans say well you know they banned all this amalgam in scandinavia and I’m like i I’m not allowed to use amalgams so they're going to i don't have to take them out if they're already there so my mouth is full of amalgams and and what do you i mean you're as smart as they come i mean do you think those amalgams in your mouth have increased the chance that maybe you're gonna die early of another disease well explain that because the kids listening to you right now i mean if you they they think mercury is a something you do with the devil i mean it's just it's just all bad mercury-free and um and when they say metal-free i always say well do you fly in plastic airplanes i mean i i mean it's almost like now metal is bad I’m like I’m pretty sure there's a lot of metal in your car and your airplane and so so talk about that because a lot of you're talking to a lot of people in the united states canada Australia new zealand scandinavia who just think amalgams are just evil what would you say to that kid well you now you come into politics because the argument here was that you polluted the environment by the mercury so they banned or faced amalgam out so it wasn't the health of the patient like you have them in your mouth it was because of the processing and i agree i agree 100 because when i look at the mercury pollution in the air the studies i read is about seven percent of it comes from cremating dead people who have amalgams in their mouth and i i thought well wouldn't the obvious solution right now is that all the governments try to get their dental societies to have someone go in there and extract the tooth out of the dead person that has an amalgam before you cremate them i mean that seems like you could drop seven percent of mercury contamination because if your country is rich enough to be able to cremate someone certainly there's a dentist in your village that could come extract that tooth yeah or drill it out yeah well if you drill it out it makes vapor though right or not very much yeah not so much mercury but of course you have to suck it away and it then goes into the field the water did test what how much mercury has the fish got in the fjord yeah i also eat all the mercury did they have more mercury in the blood and but they couldn't show it and and kids i i in dental school before you get before you drink the kool-aid and and you know because once you drink the kool-aid and believe something no one can get it out of your head but I’ve been and i it was it was in tanzania and this dentist amazing was telling me that he on YouTube he learned that you know amalgams were toxic so he stopped doing him out he's doing composite and the patients in basically a chair and he has a bucket next to him and he drills out the cavity and um and then he acid atches and then the girl sits up rinses spits in the bucket leans back then he puts on the bonding agent cures it and then she rinses spits in the bucket and then he puts on the composite and I’m just like oh my god this is just it's just been so much better because amalgam that you know you could have just put it in there and it would have just worked and i just that this is just amalgam has been a very very good filling material and I’m convinced that it saved a lot of people's teeth so going forward how do how do you get a global policy when you have eight billion people where you have everything from a high-speed operatory with high-speed evacuation a dental assistant under a rubber dam versus probably well yeah because i mean if you take the eight billion people and you condense them down to three one has a smartphone one has a cell phone that's not connected to the internet it's just a cell phone and one has nothing so if you're one of the three people who lives in a village without a cell phone or a smartphone they need amalgam yeah do you agree yeah yeah i mean but my colleagues would kill me if yeah but i never cared if my colleagues kill me because they're always um they keep it dental you know what i mean that if i say if they disagree they're not gonna say you know well that's because you're short fat and bald they're just they'll just say well we just disagree that's what i love about dentists they can completely disagree and then go eat fish and chips and drink beer till three in the morning um so but the the health authorities here well i can't even buy them album any longer and i can't get developers for x-rays either so i have to do electronic x-rays yeah and that's amazing and the people who always are leading those charges you always know who they are because they're always flying around in jets and staying in resorts [Laughter] it's like they they fly in a jet all the way to a conference to ban amalgam uh for some poor person but internationally is there just like one person that kind of is in charge with the international organization for forensic odon stomatology is that the the apex leader of forensic dentistry it's more an umbrella organization it's more of an umbrella organization yes but it is the international organization yes then you have to be member of the national organization to be a member of the international one so i believe the american board of forensic coordinology is a member of our office okay so so that website so if you're listening to this and want to learn more um one website would be the i o f o s for the international organization forensic odon odonto stomatology um so odonto that's what greek for dentists yes so what's the difference between odonto adon odontology and stomatology are those just synonyms ones but they wanted to include what stomatology was used very much in eastern europe by the time when the organization was formed so they wanted to include that group as well and is this um is this is the word an acronym which you can say so are you um are you is your group successful in getting the young kids i mean out of every dental school class is there at least one kid that's interested in learning more about this uh normally more than one normally more than one yeah and i can't i can use them all because i don't have that many cases and and what um what do you think attracts them to it why um why did they get interested in dead people instead of bleaching bonding in veneers yes sometimes they want to do other things and ex i suppose in the same way as i did expand my knowledge within on the field and just dentistry so i love and i'll tell you um i love the international cooperation among denis my favorite meeting is the clone meeting um for international i mean you go to cologne it's only every other year but there's usually a hundred thousand dentists and they're from all 208 countries i mean it's it's just crazy fun um is this um do you guys have a yearly annual no but nice is it bi-annual or every third year every third year we have a meeting and it should this year have been in the bronx uh but of course as any everything else it was cancelled and um i wanted you to there is a new textbook coming up out later on in the year which i officers put together inferencing ontology so you mentioned a word earlier that a lot of people might not have ever heard of or thought about but um you mentioned interpol and um and on the website there's an interpol disaster victim identification i actually before when i was studying to talk to you i thought interpol was um to pick up a criminal like i i did a crime in Norway and I’m catching a flight to paris and interpol picks me up but i i did not know they had an interpol disaster victim identification program yeah because so talk about it this is i think i think it's the same it's a police international police organization and um i don't think america is part of it but I’m not absolutely certain about it um but it's in certainly in the scandinavian countries it's the police is responsible for identifying unknown persons who are being recovered and so when you have international accidents uh then you want the cooperation and so the interpol had there is a steering group uh which work to facilitate that among them having a computer program uh and how that should work and what should be included in the computer program etc yeah so the american society of forensic odontology is president roy sunken uh from nyu um have you ever met roy no yeah um he's um gosh there's so many in arizona where i am at it's on john um he's the maricopa county medical examiners uh there's just a lot of them um a lot of very interesting people uh that do this there's and also there's a book on it i do know um there's a manual of forensic odontology that dr richard a williams dmd and diplomat of the american board of forensic ontology from birmingham alabama is that the the go-to textbook these days or yeah or the new i office book which is coming out but that's what's coming out would expect that the american ones i haven't got that the american one because uh the legal system in america is very different from the Norwegian legal system so does that mean they take bribes differently or yeah it's just one you can put you can put it that way now uh the the the you've got the adversarial system whereas we have got a napoleonic system okay explain it to you I’m a dentist um but you say you are yeah but if you if you have a case and it's taken to court then each party would have their own expert witness but I’m in no way i would be appointed by the court as the expert witness and not having two expert which is fighting against each other it's also uh i don't have to go to court and witness that and show what I’ve done I’ve just presented to the police what I’ve done as in identification cases so i wouldn't have a coroner's inquest well I’ve had i'll have to admit I’ve had many many many fantasy dreams before in my lifetime it's happened at least a dozen times where they switched out all the lawyers and government and replaced them with dentists and we all lived happily ever after because we're based on math physics biology chemistry as opposed to uh bribery and no i wouldn't say that um i disagree with some of my colleagues uh especially when it comes to age estimations um but that it's also a driving force forward can i can are they right or am i right or it's none of us right it doesn't mean we're not friends but we can disagree on the case so um about aging of teeth um i i I’m at the age now where a lot of the things that i learned you know in college in the 80s like the three laws of thermodynamics well now they have four in fact in fact the first law is now the zeroth law so they left the three laws of thermodynamics and added zero now there's four and i just love it when i see how much it's progressed but um you know when i was in dental school my anatomy biology teacher dr bernard butterworth who i love said you cannot tell from a skeleton if it's a boy or a girl and nowadays some people say that's change has that changed no not from a boy or a girl but from a man or a woman because we change it in puberty you change change shape okay so so uh a child at what age are we changing enough where you could say that's a boy that's a girl uh I’m not an osteologist yeah uh but they but they do change eventually you change in puberty uh and it will vary because you always have that bio biological variation and what about the age of teeth where um what tell us how that works and how how um is it common to get a bunch of dentists to agree that this is the age of the person based on their teeth yes you can normally do that but how accurate it is is more the question i mean very often i find i can use different tables and get very much the same age but it isn't accurate because of the biological variation and also we just talked about it today uh quite a lot of methods use regression regression analysis and that isn't accurate enough today when we have got computers you can make all the advanced uh date data analysis so just uh explain it to me like I’m five because your phd's flying over my head but it's something i struggle with myself is the statistics behind it um but i have found out that it depends how how how many you put into the your research it repeats the age range it depends how many in each age group you put into your research and then when you've done all your examination it depends how you use your statistics and do you ever see um whenever i think of statistics i always think of uh um when i was in grad school i took a course in a 500 level course in statistics and i thought the most interesting book was the book called lying with statistics like um like one bar is 98 and one bar is 97 so they cut it all off to like 96 so it looks like the 98 is twice as big as you know just things like that do you see any ethics issues in forensic odontology um no it's more the way they interpret it we're they interpret it where it involves ethics where someone i mean is are there any ethical issues in forensics yeah yes absolutely how do you deal with a dead body is it as you suggested would it be ethically right to extract all the teeth before they were created oh i didn't even think of that no exactly that's right i mean i remember when they exposed king tut's tomb that was extremely controversial you know there's a lot of people that didn't think you should be bothered how do you weigh in on that um i feel that you should treat a dead body in the same way as you would treat a living person but you can't always do that in a post-mortem examination that's the the way the examination is done but you have to do it as much as you can in an ethical way yeah and we we have that issue here in arizona because we have a a quarter of the state or native american indians that the first arrivers and um so many of their areas are ancient burial grounds and sometimes i always thought about that and i always think about it like would there really be any land over the last you know ten thousand years that no one really ever lived and died on i mean technically if you they say a hundred and ten billion human beings have lived and died and there's eight billion alive that well if 110 billion lived and died don't you think they pretty much died everywhere on earth yeah but they will disappear because of uh composition decomposition composition i i mean some so many areas it goes very quickly and the other areas um i mean in in thailand it went very quickly because it was hot and humid but if it goes to spitsbergen where it's permafrost they will keep quite a long time well i read a study the other day and at first i thought it was a joke but it was serious that dennis sent it to me that if you lived in a village the same time if a town was a thousand years old um everyone would have eaten everyone because of the decomposition breaks down into the plants the animals that these people if they you know if there's a village for a thousand years these people are completely eating each other over the centuries and millenniums that could well be that depends on the composition of the ground because in some compositions of the ground and i don't know what it is it will decompose much quicker than in other areas so some of the areas in the middle east you'll find very old burial ground and i know the one that i looked at in Oslo that was in sand that the decomposition goes much slower than than it would be in the good compost earth so um what do you what are you talking about when you say pdt of oral lesions photodynamic treatment that is you apply substance which contain a substance which is sensitive to light when you apply light it breaks down and released oxygen singlets which are toxic to the tissue interesting um the united states when i got out of school there were nine specialties and now it's up to 12. i mean they've had a ration um forensic odontology um how do you legally i mean is it legally a specialty is that especially recognized in Norway or any countries no it's not a speciality so i can't call myself a forensic ontologist but i do because it does explain what I’m doing but i can't put it on on the cv or my letterhead but there isn't a need for that many dentists who are forensical ontologists so the dental association won't recognize it as a speciality we have a um forum on dental town for forensic ontology and just recently it was um when was that it was just um in 2018 and it was November 2018 almost 2019 uh where dr jim wood um was a dentist mission to identify victims in the campfire but i mean it's a somber day he says i was with a principal of paradise high school when he first saw the remains of his home but anyway they you know we we have these devastating um fires in california at the moment well they're still burning in california that's what this was that this was a case posted on there where um i guess the fires um build up so fast people get trapped and burned yeah and uh or try to try to get uh or try to get out too late so my question was okay if if i lived in house number 101 on a street and you go in there and the i got caught in the forest iron as a burned up person um do you pretty much just assume well that's no you know you look up the address that's where howard lives the police wouldn't do that here and certainly not under those circumstances because it could be the woman three doors up who had tried to get into the cellar of your house um and i didn't reach it so someone could have been trying to run to get out even behind a locked door they do want to establish that that is the right person well you know the real reason i wanted to bring you on the show the most i mean not only are incredibly interesting but uh i was blown away when um archaeology um when Germany um claimed they found a tooth in Germany that could rewrite all of her human history that the archaeology fossil teeth discovery in Germany could rewrite human history where they were saying a 9.7 million year old discovery has left a team of German scientists scratching their heads the teeth seem to belong to a species only known to have appeared in africa millions of years later did you ever it was on and now it's uh in the rhine museum um did you um did you follow that case or no i didn't see that case um i'll i'll email you the link it was in the uh posted in the uh under the forensic dental um deal but um i loved forensic um the most because again back to our anatomy teacher in dental school dr bernard butterworth um you know you have your normal anatomy physiology and all that stuff but he but he said first day class he goes by the way if you just want to read something fun read the naked 8 by desmond morris and he goes i'll loan my copy to anybody so i jumped out of the chair and grabbed it and um forensic odontology and anthropology it's i mean it seems like that's that's fascinating and and there you link different subjects together and you cooperate with other people like i showed you with from the ice valley you have used specialists in Australia you used specialists in Germany to see could we find a solution for this and do you is it one of your hobbies since you're a dentist and a forensic odontology do you just have a natural love to read anthropology because when you know when they find you know human remains it's usually going to be teased not soft i find it rather fascinating to see how the what i find in the human body can be linked to the history books i read this emperor won this war and this king won that war and that sort of thing but what was the normal life like in in back in 1100. and what what do you think it was like i know i know it was a civil war because the history book says it and then i find this skeleton which has got sword cuttings on the jaw yeah and and this um dates back i i thought it was pretty funny when i posted this case i just found the uh um just recently a 14 000 year old two shows oldest form of dentistry and it's pretty grim but anyway there was this um article about a 14 000 year old tooth and they were saying it was the earliest evidence of dental dental caries manipulation removal in the late upper paleolithic area nature published it and it's just amazing i mean do you think there's been people like us that think we're dentists for 14 000 years yes they have got quite some evidence of that phoenicians did some gold work their wide teeth together some of the american indians had stones put into their teeth and grinding teeth is has been very common and i went to south africa and they had um presented us with the cap gap there were youngsters who had the two front teeth extracted and i notice um whenever um I’m talking to my egyptian dentist friends or over in that region um whenever i see them a lot of the egyptian dentists tell me uh well howard you don't you know they don't think that that dental work from egypt 5000 years ago was for functional work like that bridge isn't for eating and chewing it was preparing them as a mummy uh for the afterlife um so it's uh is it hard is it kind of hard to tell um if these um several thousand-year-old dental cases or decorations for the afterlife are for functional dentistry while you're still living that that can be diff i i think uh some of the stones which are put on the teeth i think that is for decorations and certainly the grinding of the teeth is for decorations uh whereas trying to wire the teeth or even use wall rust teeth or something equivalent uh for for to make teeth and look as teeth i think that's for vanity whether it's whether it's in life or after death um and there was another um out of London because you went to school in London where uh woman's murder conviction is thrown out after expert testify's bite mark evidence was junk science uh and that was flying around uh oh yes that's you remember that case yes it's still flying around and that's uh they've used uh bike marks to do convictions and then they later on been able to do DNA and prove that they the one who was convicted for the case wasn't the perpetrator so so um so are you saying that bite marks they're not like DNA and models no photographs but you can do exclusions by bite marks and that's equally important say that exclusions by exclusions by bank marks he can't possibly have made this mark or see for that matter and the exclusion is just as important as convicting yeah so um i also it's difficult to to to convict somebody in bite marks today and i would be very careful about doing it i they i i read and again I’m so old now that you know i learned this in dental school so that was three decades ago so it could be totally wrong by now but they were saying that if the person bit you on the back it was a different type of person than someone who bit you on the front is that is that silly not suddenly how can he bite you back no I’m saying the the guy that murdered you if the the person who murdered you bit you on your back versus someone who bit you on the front i haven't heard that oh you haven't heard that one but so some of these serial murders they bite in the same way and i just heard today that somebody bite the buttocks or the victims so serial murders now when you talk about surreal murders are you talking about corn flakes or rice krispies or get it cereal breakfast cereal oh gosh okay horrible horrible joke it's a bit slow I’m gonna keep my day job as a dentist because my comedy career is not gonna take off but um so you're saying sir if you're a surreal murderer they this was actually it wasn't murder this was um rape cases yeah so as so a specific raper you're tying the rapes together because of a bite on the butt yeah huh in any any other so back to that case um so it said the fayette county judge john wagner overturned the murder conviction on thursday citing bite mark evidence he found to be junk science is junk science the correct terminology is that what you call bite mark science junk science or not by no means but um there has been cases where they have drawn conclusions which is more than you can see in the bite and and and you're you're saying that the uh the one good thing about bite evidence is it could disclude someone they could say absolutely that person that's that person didn't bite you uh yeah that's uh and string um my gosh um it's amazing the other thing i find interesting is how they're able to scrape plaque off of ancient teeth and then tell you what they were eating yes um tell us more about that i don't know much about it uh but uh when you build up pluck or calculus on your teeth you incorporate some of the elements from your diet and that when you scrape it off you can analyze it and see whether it's a vegetarian diet or a c uh diet or whether it's a meat diet because of the composition of the calculus did you ever read the book taking a bite out of crime an interview with forensic dentist dr michael tabor uh did you ever uh no i haven't uh but it sounds like a good taste uh he is dr mike tabor is a forensic dentist who writes true crime thrillers his novel walk of death is available on amazon and if you're a dentist uh it's a forensic novel uh it's in this anyway it's a novel but um mike did a really great job it's a great route he's from the university of tennessee but i would think if you're a forensic dentist you ought to write you ought to read this novel written by a forensic dentist dr michael tabor walk of death as a student i read one from a dentist and that was quite fascinating um back back to bite marks um i all uh remember forensic dentist dr richard barbaro who has specialized in the field of forensic ontology for 30 years testified in the murder trial murder trial for child tiguan skiba who had 66 bite marks covering her body you were talking about this one serial killer tied together because it was a common bite on the glutes um yeah a rapist um what does it make you what comes to your mind when someone bite like kills someone but bites them 66 times i mean i my personal i my personal best was six bites i always stopped at six um who keeps going to 66 i don't know but that's that's not my job to to to analyze why they do 66 job fights my job is to analyze who did it or he didn't do it yeah so so that's that's great advice for everyone stay in your lane your advice is identifying your body um it's someone else's uh field psychiatry of why he went on to need the urge to bite him 66 more times but i think that it applies to to all what you do as a dentist stay with what you can and then seek advice where you can't yeah and you know when i see these forensic cases and they're like this one about 66 bike coverings i i wanted to ask you this question also because it's philosophical we don't know um they say um that person that did that was evil and i always wonder um obviously their brain is broken i mean like i remember the case of jeffrey dahmer where he kidnapped like 18 different joggers that jogged by his house and pulled him in his house and killed them and ate them and they said well that guy's evil and I’m like man when you when you eat 18 people is that really evil or is your is your iphone just completely broken do you do when from your knowledge of three decades of this is it just safe to say that when you rape kill bites on the butt or 66 times or whatever that it's just pure brain health breakdown i mean it's purely the brain is gone hey why or do you think they could have a perfectly normal brain like yourself and just decide they just want to do really bad things and be evil you know no but i think i think they can be like myself but they have one point where it breaks down or two points depending if they kill and eat maybe say two points but if he goes to the local grocery shop he's just like everybody else but when he does kill the person do you think do you think you could have total brain health and just decide I’m going to be a really bad evil monster and just go kill this person or do you think their brain obviously is not working correctly and it's a a pathological brain that does these evil things because some leaders some leaders history that where they were saying i don't want to mention names because such a trigger word but one man who was completely evil also was an intense methyl memphetamine drug addict you know and so they're sitting there thinking would he have would he have been that evil if he wasn't a meth addict you know what i mean so I’m just wondering so i guess we don't know do we yeah i always wondered could a perfectly normal brain healthy mind but just then then you see people do strange things suddenly and then years later they wonder why on earth did i do that yeah the brain it's a uh i imagine it's gonna be another thousand years uh before we uh really figure that out so um someone asked on town i already asked you this question but it says hello i am a general dentist practicing two years out and i was curious about dental forensic as especially when i searched the web and the associations i generally cannot come up with answers to how the logistics of specializing works how long it takes how does one become a forensic dentist how much is the average salary the demand and it is is it a full-time specialty or one that is done part-time with general dentist and most of my colleagues are are part-time and do the occasional work yes the salary well we're discussing that at the moment we think part of the reason why we have so few cases at the moment is because we ask for money per case whereas the other ones are paid an annual fee and to and has to do all the cases it's part of their job well like say in the year um 1900 there were no specialties in dentistry or medicine by 2000 the dentist had eight or nine and the physicians had 58 and now now the general dentists are it's 20 20 and they're up to 12. do you think um given enough time forensic dentistry will be a specialty say in the before this centuries before it's 20 um before it's um before it's uh 20 uh 2100 i i don't like to predict the future but i think thinking back uh when i started we were still using typewriters right we didn't have computers we didn't have zooms we didn't have uh electronic uh x-rays of files uh we couldn't telephone to america um we didn't have ct we didn't have mri a lot of things and yes we did use drills with water but it just been introduced i mean it's it's got such a lot of things which we wouldn't dream about 40 years ago so predict for another 80 years no way so i i one of the things um i love the most about um travel like some people think they're into architecture uh or art and i what i see it is is everyone's into variants i mean i love it when you go around the world and there's two million dentists they'll have you know the same brain the same patient the same disease carries gum disease but i love the way they they try to treat it a little differently you know what i mean and you just said uh you just brought up drills and that's another one like i notice in america almost everyone uses an air driven handpiece but of the hundreds of dental office i went into in europe the majority were electric um what variances have you seen around the world where same dentist same patient same disease and they they treat it differently that you found very interesting and and do you use electric hand pieces or do you use air driven uh i i i don't you do drilling up fillings any longer um but in your school yeah but when i because when i teach i teach in surgery so so they use both they use both yeah but my father qualified in 1936 38 sorry and he used a pedal drill yep uh we we call that that's in my home now but uh did he call it a jackrabbit no that's the they they called it over here the old dentist that um i kept that called it a jackrabbit uh but i always think it's interesting um um the the variance um so would you say you don't know for a fact but if the five and a half million people live in Norway the number of dentists would you say if someone was going to get a filling done it would be more likely to be done with an electric handpiece or an air driven handpiece in Norway driven hunties oh it would be yeah it would be air drum that that uh that is surprising what um so um i can't believe we went over an hour and it what time it's got to be late there's got to be what 8 30 what time is it uh no it's 20 past 10. so the bars are closed so you're not in a hurry then right no yeah you can't go to the bars now they're all closed um um yes no no they don't close till midnight in Oslo oh so um speak you're speaking to dennis in many countries um what is dentistry like in uh in Norway how would you describe it to someone who's in indonesia india or brazil what is the dental industry like is it more mostly free enterprise where i set up my own business or is it more i work for the government um or um yeah it's split into because the children from the age of three until 20 they got free dentistry and because it's free and it's no alternative most children will go to the uh to the the local to the government dentists or municipalities as it is okay so it's not like um the government's saying we'll pay for children's dentistry but you just go to a private practice and we'll pick up the bill they're saying we'll pay for the dentistry but you have to come to our facility our government facility yes and and um and it used to be like a school dentist but it's now in in they're more than just working together in in a multiple practice in a central area in the district and what are your thoughts of that system what letter grade would you give it would you give them an a a b or a c uh that i would given b i i in England they most like you said you could either go to the local one the local national health dentist or you could go to a nation your own dentist and he would be reimbursed to fee and he ended up with quite a lot of children not being taken to dentists at all whereas here virtually everybody goes to the dentist so England is the best example because uh you know they had the biggest um uh organization in the world i mean that they always said the sun never set on the british empire and the one thing I’ve noticed from lecturing around the world is that no matter what city you go to and wherever you're lecturing you know at least 10 percent of the class is from London i mean or went to school in London i mean it's just so international so that would be the perfect question they probably the ones listening around the world are very familiar with England i mean everybody knows London the nhs all that kind of stuff so compare nor the the system of dentistry in Norway to the system of dentistry in the uk London yeah um the i think well I’m a bit out of date but as it was it was the national health service and you you had school dentists or community dentists would chew it to the children or the children to go to the local dentist and have the fees back for the adults you could get the dentistry done by a national health dentist or you could have it privately done in no way the children will go to the community dentist and they don't have an option if they don't get it free but all the adults in principle should pay for the dental treatment and then that that comes in then it's a social status that you had nice white shiny teeth and people are embarrassed when they don't have that so there are a few diseases and conditions where you can get some support for dental treatment since we've gone over an hour I’m going to ask you this question and if you say i don't want to answer i can cut it off no one will even know this is the most controversial question um in all of dentistry and that is water fluoridation i mean there's um there's people who well i mean because you know you said your government pays for dentistry for the kids um water fluoridation i don't think anybody's doing water fluoridation to save grandma and grandpa and and the thing in america it's so controversial i mean it we we should just talk about politics and and putin and russia and chi and trump it's just so controversial and i always i always looked at i don't want to get into a big water fluoridation debate but you know the um if you really think water fluoridation is so bad you can always drink bottled water because the people that i think it targets is the people who can't afford bottled water and it's the poor and i remember when i was little i had five sisters and we were so poor i mean i most of my memories when we were playing outside we went drank out of the water hose and thought it was the best water in the world it was so tasty and my gu again it's rich people who can afford bottled water taking away the one option of getting fluoridated water to this poor kid who has to drink out of a garden hose or a public sink but i want to ask you to weigh in on that does Norway practice water community water fluoridation no no no hasn't been an issue here as long as i have been a dentist there are a few private wells which has natural fluoride in it but that that's all on the other hand you can't you can't get toothpaste which hasn't got fluoride in it so so ozo won't sell is it illegal to sell unfluoridated toothpaste no but you can't get it so how does that work so you don't have in america there's a lot of uh natural people that they always want everything natural so those people i always tell them oh my gosh if you love natural you know how the universe is 75 percent hydrogen and 25 helium well when those stars collapse and a supernova explodes that's where fluoride is made and it's it's the 13th most common element of the earth's crust and it shows up naturally in the water of the ocean at one point three part really and if you if you just keep saying natural every third word they'll love it even though i think natural is a horrible word i mean black widows and praying mantises are natural and they eat their mates a black hole is natural and it eats an entire galaxy uh but for some reason they don't think of all the bad things of nature but uh what what do you what do you think of um water community i knew there are in specialist shops you can get a few few toothpastes but normally you wouldn't get a toothpaste without fluoride so they also stopped advising children to take fluid tablets yeah because they get over fluoridation when they can't they always get fluoride with the toothpaste and and another thing I’ve noticed um when I’m in countries like europe when I’m in any major city near the sea there's a lot of seafood in the diet whereas if you get a thousand miles inland like in central united states like kansas or you go a thousand miles in from the ocean of china um you know the seafood it's mostly cow pig chicken uh but do you think um does the average Oslo what do you call them Norwegian do you guys would the average Norwegian eat how many times a week would a Norwegian eat seafood uh at least twice a week about twice a week and do you think that's probably where they're getting enough fluoride anyway from the ocean from seafood since the ocean's 1.3 per million i i think i think it's more from the the toothpaste because the toothpaste is a thousand part per million uh i can't remember yeah yeah that's that's amazing uh my gosh um was there any when you're coming on the show was there anything you want to talk about that i didn't bring up no but i had another show uh which i made up today about something i'll um something i did last year that's a discovery on the south coast of Norway which was done in 2019 and somebody was out and he wanted to grow some more potatoes and he found part of a skull and they sent it in to make it to to do a c14 dating on it and it said it was from the 18th century and then it went over with a metal detector and he found something more he found rubber boots and he found a gun and the rubber boots is definitely not from the 18th century so then they started digging they pull it he called the police and they started digging a bit more and they did recover quite a few remnants from from the skeleton and also the teeth and jaws and it was most of the mandible and fragments from the maxilla and i took x-rays of it and then they had the dental record which was from 1948 and i could compare the dental x-rays from 1948 with the dental x-rays they took in 2019 and might make an identification of it wow and that's so so important it is to have the dental records and uh i um my gosh i was a very bad boy i usually had my dental assistant uh write up all the records um i guess it depends on i you just need really good records i don't know i don't know if I’m a really good role model for that because i delegated that out something i insisted on doing myself because i am legally responsible for what is written in the dental record and that's my responsibility yeah um well jeffrey tonner is a dental lawyer he's been on the show several times and he always talks about records records records you just can't no and that's i know i mean the chances of me knocking on the door and wanting the records is small but it might be somebody else saying what what did you do why did you do this couldn't you have done this one differently and you end up in a legal case and then the record is your only defense well i'll tell you what um dr secret Ingeborg cavall associate professor Oslo Norway it was just an honor to have you come on the show today thank you so much for coming on the show and sharing all things forensic ontology and my final question is um halloween do they have halloween in Norway is that a is that well that's something we had to have uh adopted from america that's america so it's certainly been the last i suppose 20 years because i i don't know I’m just kind of thinking if you have the interest in uh forensic odontology you probably like halloween and scary movies and murder murder mysteries do you kind of like murder mysteries like sort of uh murder mistress not so much halloween uh but murder mysteries you know that is uh an american mission from all saints yeah and i used to always say it's we do celebrate all saints i always thought it was very little weird when i was little about two of my five sisters they love to watch scary movies and then it scared him and it altered their sleep and freaked him out and i never liked scary movies at all and i always thought why would anybody want to watch a scary movie or a murder movie but i guess who likes to parachute who likes to we're all we all like weird things but uh I’m not a big fan of scary movies or murder mysteries but i love forensic code ontology and i just love the fact that you came on the show Sigrid thank you so much uh for staying up uh uh past your bedtime and i hope you can uh have time to get to the bar uh before it closes at midnight thank you so much for coming on the show thank you very much for having me on your show all right well have a great evening secret thank you very much good night
Category: Oral Pathology, Pharmacology, and Cariology
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