Introduction
The essence of Forensic Science lies in the application of science and technology to the detection and investigation of crimes in order to bring justice is. Forensic odontology is a subspecialty of dentistry that deals with the appropriate management of dental evidence in the interest of justice as well as the appropriate appraisal and presentation of dental results, according to the Fédération Dentaire Internationale.1 Since 66 AD, identifying deceased individuals have been done using dental identification.2 Ever since, this science has developed in leaps and bounds. The field of forensic odontology sees evolving trends in identification of human dental remains as we speak. Nevertheless, all the advancements are futile if not utilized in the right manner by the right people in the right situations. Currently, forensic odontology faces many hurdles as a specialised field of dentistry which include the lack of trained personnel, scarcity of training facilities and deficient introduction to the subject during undergraduate years.2
The practise of forensic odontology differs significantly and incommensurately across dental professionals in India.3 Other investigations undertaken over the past ten years in Indian cities like Kashmir, Chennai, Pune, Kanpur, Ghaziabad, and the Delhi National Capital Region showed that the respondents' levels of forensic odontology knowledge and awareness were insufficient.3
Our study's objective was to evaluate the knowledge, attitudes, and understanding of forensic odontology in undergraduate and postgraduate students in Uttarakhand.
No study, to the best of our understanding has been conducted in Uttarakhand about forensic dentistry and its applications in practice.
Materials and Methods
Study design
This is a cross-sectional institution-based study conducted among a total of 465 undergraduate and postgraduate dental students in the state of Uttarakhand. The study included those dental students who enrolled in their respective institutions for the course of Bachelor of Dental Surgery (BDS) or Masters of Dental Surgery (MDS) and were willing to participate in the survey.
Ethical statement
Ethical clearance was obtained from the institution concerned. Informed consent was obtained at the start of the online survey from participants after they had been informed of the study's goal and purpose.
Data collection
A self-administered, structured and validated questionnaire in English language was distributed among the 465 participants online via a google form link which directed them towards our questionnaire. These included 428 undergraduate and 37 post graduate students. Males 94 (20.2%) and females 371 (79.8%) aged between 18 to 40 years were included. Out of the total respondents, 18 participants did not provide consent for the study and hence were excluded from the study bringing the total number of valid responses to 447. (Figure 1) A validated questionnaire from previously conducted similar studies was used containing 19 questions.4, 5, 6 These 19 questions were further divided into twelve knowledge-based questions, four attitude-based questions and three practice-based questions. The questions contained both yes or no and multiple-choice questions. The prepared questionnaire was distributed among the two dental colleges of Uttarakhand.
Results and Observations
A total of 447 dental students completed the questionnaire which included 410 undergraduates and 37 postgraduates. Males 94(20.2%) and females 371(79.8%) aged between 18 and 40 years were included. Questions 1-12 were knowledge-based questions, 13-15 were practice-based questions and question 16-19 were attitude-based questions on forensic odontology.
Knowledge about forensic odontology: (Questions 1-12) (Table 1)
Table 1
Results of knowledge based questions
There was a statistically significant difference in the responses received by the participants on the source of knowledge about forensic odontology where 75.6% of the postgraduates responded with workshops and lectures in college as their source of information whereas undergraduates chose Media as their answer to the question in majority. A statistically significant difference was also found among the responses received on the questions whether forensic odontology played a role in mass disasters and if teeth could serve as a source of DNA amongst both the groups. 94.5% of the postgraduate respondents were aware of the significance of bite mark patterns of teeth as opposed to 54.4% of undergraduates which was also statistically significant.
Practice of forensic odontology: (Questions 13-15) (Table 2)
Table 2
Results of practice based questions
A statistically significant result was found between the groups when asked about their practices of forensic odontology. The questions asked to the participants were if they maintained dental records of their patients where 97.2% of the postgraduates responded positively. Secondly, when asked about the method with which they maintained records, majority of the responses were found to be with all of the above in both groups which contained casts, radiographs, patient photograph, case record of the patient as a multiple-choice question.
Attitude towards forensic odontology: (Questions 17-19) (Table 3)
Table 3
Results of attitude based questions
In this section, the participants were asked about their attitude towards forensic odontology by asking them their thoughts on their confidence towards forensic odontology and their willingness to receive formal training in forensic odontology. Only 45.9% of the PG’s said that they were confident in giving their opinion on the subject whereas 80.4% of the UG’s opted for the option not confident. Both the groups (90.5% UG’s and 86.48% PG’s) showed interest in receiving formal training in forensic odontology. All the participants of this survey agreed that there is a scope of forensic odontology as a profession (94.4% UG’s and 97.3% PG’s) but they also felt that our country has limited resources for forensic science (91.3% UG’s and 91.9% PG’s). There was no statistically significant data found among the two groups in this section.
Discussion
Forensic odontology is the most misprized branch of dentistry across the world. With the rise in unemployment rate in the field of dentistry in the country, many undergraduates and postgraduates are looking towards alternatives to clinical practice and forensic odontology is one of the frontrunners in this regard. Although there are various studies discussing the knowledge, attitude and awareness of dental practitioners as well as dental students in India, our study is the first of its kind to be conducted in the state of Uttarakhand, India.
Forensic science has gained much popularity in India through television shows but the field of forensic odontology still remains unexplored. Despite the fact that there are changing trends in the career opportunities in forensic odontology, law enforcement agencies still approach dental surgeons in government service rather than dentists qualified in this field but not associated with government service. This has resulted in a scarcity of qualified forensic odontologists in India as most dentists do not see it as a profitable source of income.5
The present study showed that only 94.5% of the participants were aware of the branch called forensic odontology and 60.5% of the students said that they do no have forensic odontology as a part of their curriculum which is in contrast to a study where they found 100% awareness for the same. We observed that 91.8% of the students were aware of the role of dentists in mass disasters. On the contrary Abdul et al. (2019) reported that 77.5% of the participants were aware about it.7
Conclusion
Our study revealed that postgraduate students had superior knowledge, attitude and awareness about forensic odontology as compared to the undergraduate students. Both the groups together lacked adequate knowledge about forensic odontology but agreed that there is a scope in this field of dentistry and were interested in further courses to learn about the study of forensic odontology. Thus, the authors would like to suggest that there must be an increase in exposure of students towards forensic odontology as a field under the umbrella of career opportunities in dentistry.
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