Contribution of Oral Records to the Forensic Identification in Yaounde

Forensic identification is defined as a discipline that seeks the identity of a corpse by general methods and odontological methods [1]. The oral record is a documentation that records all the information about the general condition and oral management of the patient [2, 3]. It was used after the 2001 World Trade Center bombing where it identified 20% of the victims [1]. In Cameroon, despite the occurrence of disasters such as that of Mbanga pongo in 2007, we have very little information on the content of our oral records (1) and it is with this observation that we proposed to determine the contribution of the oral file in the forensic identification in Yaoundé.

A descriptive and retrospective study was conducted from November 2020 to June 2021, for a period of 08 months. Included in the study were all oral records recorded over a 4-year period from January 2017 to December 2020; available and exploitable found in the odontostomatology departments of the University Hospital of Yaounde (CHUY), the Military Hospital of Yaounde (HMY) and the Adventist clinic of Yaounde. Sampling was consecutive and extensive. The data collection was done using a technical sheet inspired by the Patient Record in Dentistry published in 2000 by ANAES [2]. It was divided into three themes: patients’ personal information, medical content and paraclinical elements. The collected data was then recorded and analyzed using Excel 2016 and IBM SPSS 25.0 software. Results were reported in frequencies, averages and numbers.

Out of 2761 files registered, the proportion of archived files was 80.2%. At the HMY, we observed a staff of 1008 archived files (90.97%), while at the CHU we had 550 files (55.16%), and at the Adventist clinic 656 files (100%) (Table 1).

Table 1: Proportion of records archived by hospital.

Out of 2214 archived files, 1200 files were usable. A total of 639 were male (53.25%) and 555 female (46.25%) for a sex ratio of 1.14. The average age of patients was 36.45 ± 17 years with extremes of 1 and 85 years, The most represented age group was that of 20 to 40 years or 59.4% (Table 2).

Table 2: Socio-demographic representation of the study population.

Of the 6 elements of personal identification of patients found, we note the presence of the name in 1199 files or 99%, that of the address in 1170 files or 98.25%, that of age in 1194 files or 99.5%, that of sex 1194 files or 99.5%, the profession is present in 1183 files or 98.5 and finally the telephone number is present in 1192 files or 99.33% (Table 3).

Table 3: Patient Information.

Table 4: Proportion of patient information and X-rays.

We noted the presence of panoramic dental radiography in 25 (2.08%) files, that of retroalveolars in 101 (8.41%) files (Table 4).

We noted the presence of odontograms in 585 (48.75%) files, casts in 19 (1.5%) files, while no photographs were found in the files. It appears that the University Hospital is the only one of our study hospitals that does not use odontograms. There was an absence of photographs in all study hospitals (Table 5).

Table 5: Proportion of odontograms, casts and photographs.

Proportion of records archived

We obtained a proportion of 80.2% of records archived in our study hospitals. The hospital with the lowest proportion of archiving was the University Hospital of Yaoundé (CHU), which is very different from the study conducted by Waleed in Sudan, which showed that university students kept records better than practitioners in private institutions [4]. This difference could be explained by the fact that the university hospital has been undergoing restructuring for several years, which would cause problems in organising the record-keeping system.

Patient information

Patient personal information included name (99%), address (98.25%), age (99.5%), gender (99.5%), occupation (98.5%) and telephone number (99.33%). These results are similar to those of Krishan, et al. [5] who found that out of 100 oral physicians, all or 100% recorded all the elements of the patients’ personal history. This could be because these are essential elements in any consultation, which allow practitioners not only to identify their patient but also to follow them appropriately. This would imply that for any patient who has undergone an oral consultation, it would be possible to find him/her by having access to his/her file [5].

Radiographs

The files studied contained only 126 radiographs divided into 101 (8.41%) retro-alveolar and 25 (2.08%) panoramic. This is lower than the results of the studies conducted in Sudan by Petro, et al. [6] where 29% of the files contained radiographs. This difference could be explained by the fact that the 3 hospitals in our study gave the radiographs to their patients without making a copy, whereas in Sudan only the government hospitals gave their radiographs to the clients [6]. Our results are also lower than those of Rasmusson, et al. [7] in Sweden, who found a proportion of 50% of records with radiographs [7]. This could be explained by the fact that Rasmusson, et al. [7] conducted their study on all identification cases in the Gothenburg Police Department.

Odontograms

78.4% of the records in our study did not contain an odontogram, which is similar to the studies by petro et al where the proportion of records without an odontogram was 80% (4). Another study by Selvajothi, et al. [8] in 2014 in Chennai, India showed that only 12% of dentists maintained records with dental mapping or odontograms; this could be explained by the fact that filling out the odontogram takes a lot of time and in our country where the number of oral physicians is relatively low compared to the national population, some physicians prefer to focus on emergency management and therefore partial filling of the odontogram [8].

Casts

We found only 19 (1.5%) casts of individual patients. This is similar to the study by Krishan, et al. [5] who found that 91% of oral physicians discarded their casts as soon as the treatment was completed, while the remaining 9% kept them until the first follow-up appointment [5]. This could be explained by the fact that the casts are no longer useful to the doctors at the end of the treatment and therefore become cumbersome after the treatment is completed.

Photographs

No photographs were found in any of our hospitals, which is much lower than the findings of Waleed who, in their study in Sudan, found that 8% of oral physicians kept photographs of their patients [4]. This could be explained by the fact that in our hospitals, the photographs taken were given to the patients or kept in the doctor’s personal library but not in the medical record.

At the end of our research on the contribution of the oral file to forensic identification, we can conclude that the proportion of oral files archived in our health facilities was high and that they contained retroalveolar and panoramic radiographs, casts and personal identification elements useful for the identification of victims.

None.

No conflict of interest.

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