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Draft standard seeks uniform nomenclature

One of the most personal and important things the profession can do for the public is to identify the deceased, which is why the ADA Standards Committee on Dental Informatics has spent the past two years working toward establishing a national forensics data standard.

Said SCDI Chair Dr. Scott Trapp, "We hope that this national specification will aid our forensics colleagues in helping to bring closure to people by the identification of their loved ones."

The goal of the new specification, which is being circulated for review and comment, is to develop uniform nomenclature for forensic dentistry.

Although the vast majority of antemortem dental material and associated attachments are submitted on paper and on radiographic film, the ultimate goal is to create a standardized electronic format to transfer this data.

Dr. Kenneth Aschheim, chair of the committee's working group, said the new standard is similar to a "Current Dental Terminology for forensic dentistry."

Dr. Aschheim became involved with creating the standard in 2003, when the ADA initiated its forensics standard effort. In 2001 he served as a dental consultant to the Office of Chief Medical Examiner in New York and helped set up the digital image acquisition section.

"Sometimes we receive charts that are difficult to interpret," he said. "Dentists are using different names for fillings, nonstandard abbreviations and nonspecific descriptors such as 'moderate periodontal disease.' The committee has set out to unify these descriptors. This is important because as we move toward electronic records, any data that cannot be coded cannot be transferred. This is similar to the difficulty dentists have when billing an insurance company without a CDT code. The goal of the standard is not to define the extent of information collected but to develop uniform nomenclature for the description of forensic dental data."

In addition, the use of electronic dental databases, such as the National Missing and Unidentified Persons System and National Crime Information Center, have expanded in identifying missing people by simply plugging in dental records.

"This is one of the reasons why a standard like this is important," said Dr. Aschheim, who is now the assistant chief forensic odontologist for OCME, as well as an associate clinical professor in the Department of Dentistry at Mount Sinai Medical Center.

Dr. Trapp praised Dr. Aschheim and his working group members for their hard work in making the standard a reality.

"Dr. Aschheim and the ADA served as a conduit for various organizations to collaborate in the development of this consensus-based draft national specification," he said.

Another purpose of the standard is to define a standardized set of uniform terms to convey this information. Establishing positive identification of unknown human remains or a living amnesiac by a forensic odontologist requires submission of supporting documentation from the dentist or dentists who treated the patient during life. This information (e.g., radiographs, charts, progress notes) can be submitted directly or through a clearinghouse.

The new standard will also make certain that common terms are used in order to aid in identifying human remains.

The Forensic Dental Data Set consists of an Antemortem Data set of six components: Familial Data, Dental History Data, Tooth Data, Mouth Data, Visual Image Data and Radiographic Image Data. The Postmortem Data Set consists of four components: Tooth Data, Mouth Data, Visual Image Data, and Radiographic Image Data.

Copies of the draft proposal (American National Standards Institute/ADA Specification No. 1058 for Forensic Dental Data Set) are available for review and comment by calling the ADA toll-free number, Ext. 2506, or e-mailing standards@ada.org.