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Forensic dentistry can be defined in many ways. One of the more elegant definitions is simply that forensic dentistry represents the overlap between the dental and the legal professions. This two-part series presents the field of forensic dentistry by outlining two of the major aspects of the profession: human identification and bite marks. This first paper examines the use of the human dentition and surrounding structures to enable the identification of found human remains. Conventional and novel techniques are presented.

Background Over the last two decades, progress in prevention and treatment of caries and periodontal diseases has been translated to better oral health and improved tooth retention in the adult population. The ageing population and the increasing expectations of good oral health‐related quality of life in older age pose formidable challenges to clinical care and healthcare systems. Aims The objective of this workshop was to critically review scientific evidence and develop specific recommendations to: (i) prevent tooth loss and retain oral function through prevention and treatment of caries and periodontal diseases later in life and (ii) increase awareness of the health benefits of oral health as an essential component of healthy ageing. Methods Discussions were initiated by three systematic reviews covering aspects of epidemiology of caries and periodontal diseases in elders, the impact of senescence on caries and periodontal diseases and the effectiveness of interventions. Recommendations were developed based on evidence from the systematic reviews and expert opinion. Results Key messages included: (i) the ageing population, trends in risk factors and improved tooth retention point towards an expected increase in the total burden of disease posed by caries and periodontal diseases in the older population; (ii) specific surveillance is required to monitor changes in oral health in the older population; (iii) senescence impacts oral health including periodontitis and possibly caries susceptibility; (iv) evidence indicates that caries and periodontal diseases can be prevented and treated also in older adults; (v) oral health and functional tooth retention later in life provides benefits both in terms of oral and general quality of life and in terms of preventing physical decline and dependency by fostering a healthy diet; (vi) oral healthcare professionals and individuals should not base decisions impacting tooth retention on chronological age but on level of dependency, life expectancy, frailty, comfort and quality of life; and (vii) health policy should remove barriers to oral health care for vulnerable elders. Conclusions Consensus was reached on specific actionable priorities for public health officials, oral healthcare professionals, educators and workforce planners, caregivers and relatives as well as for the public and ageing patients. Some priorities have major implications for policymakers as health systems need to adapt to the challenge by systemwide changes to enable (promote) tooth retention later in life and management of deteriorating oral health in increasingly dependent elders.

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Near-infrared (NIR) is preferred for caries detection compared to visible light imaging because it exhibits low absorption by stain and deeper penetration into teeth. Hyperspectral images from 1000 to 2500 nm have been obtained for a total of 12 extracted teeth (premolars and molars) with different degrees of natural lesion. Analysis of the reflectance spectra suggests that light scattering by porous enamel and absorption by water in dentin can be used to quantify the lesion severity and generate a NIR caries score. Teeth were ground for histological examination after the measurements. The NIR caries score obtained correlates significantly (Spearman's correlation of 0.89, p<0.01) with the corresponding histological score. Results yield a sensitivity of >99% and a specificity of 87.5% for enamel lesions and a sensitivity of 80% and a specificity >99% for dentine lesions. The nature of the technique offers significant advantages, including the ability to map the lesion distribution rather than obtaining single-point measurements, it is also noninvasive, noncontact, and stain insensitive. These results suggest that NIR spectral imaging is a potential clinical technique for quantitative caries diagnosis and can determine the presence of occlusal enamel and dentin lesions.

The aim of this study was to determine the microbiological origin of plaque fluorescence observed during quantitative light-induced fluorescence (QLF) analysis. Plaque was sampled from dentures, because of easy accessibility and the homogeneous background provided by the denture tooth during imaging, and the acknowledged comparability to occlusal plaque. Forty removable poly(methyl methacrylate) dentures were screened for the presence of fluorescent plaque deposits during QLF analysis. Dentures were photographed, QLF images were recorded and samples of fluorescent plaque were taken. Plaque samples were cultured on fastidious anaerobe agar, Wilkins Chalgren agar and Sabourauds dextrose agar. Plates were screened under QLF and fluorescent colonies were subcultured and identified. Areas of red, orange and green fluorescence were detected on the fitting and non-fitting surfaces of dentures. The red and orange fluorescing species were Prevotella melaninogenica, Actinomyces israelii and Candida albicans, which are generally acknowledged to be secondary colonisers, present in more mature plaque. Green fluorescence was observed in streptococcal species (early colonisers) and Fusobacterium nucleatum (important organism in plaque development). Non-fluorescent colonies were also cultured. Plaque which accumulates on susceptible surfaces tends to be associated with caries, but it may be its maturity, rather than the presence of cariogenic streptococci, that is more likely to provide a microbiological link between red fluorescence and caries.

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