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      Maintaining dental records: Are we ready for forensic needs?

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          Abstract

          Context:

          Dental remains are usually the last to get destroyed among body parts after death. They may be useful for personal identification in cases of mass disasters and decomposed unidentified bodies. Dental records may help in the identification of suspects in criminal investigations and in medicolegal cases. Maintenance of dental records is legally mandatory in most of the European and American countries. Unfortunately, the law is not very clear in India, and the awareness is very poor.

          Aims:

          To assess the awareness regarding the dental record maintenance among dentists in Rajasthan, to deduce the quality of average dental records kept by them and to evaluate the potential use of their maintained records, in any of forensic or medicolegal cases.

          Settings and Design:

          A cross-sectional survey was conducted among 100 dental practitioners of different cities in Rajasthan, India.

          Materials and Methods:

          Data were collected through a structured questionnaire, which was responded by the study population in the course of a telephonic interview. The questionnaire addressed on the mode of maintaining dental records in their regular practice.

          Statistical Analysis Used:

          The data so gathered were subjected for descriptive analysis.

          Results:

          As for knowledge or awareness about maintaining dental records, surprisingly a very low percentile (about 38%) of surveyed dentists maintained records. Sixty-two percent of the dentists were maintaining no records at all.

          Conclusion:

          Nonmaintenance or poor quality of records maintained indicates that the dentists in Rajasthan are not prepared for any kind of forensic and medicolegal need if it arises.

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          Most cited references21

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          Dental records: An overview

          Dental records consist of documents related to the history of present illness, clinical examination, diagnosis, treatment done, and the prognosis. A thorough knowledge of dental records is essential for the practicing dentist, as it not only has a forensic application, but also a legal implication with respect to insurance and consumerism. This article reviews the importance of dental records in forensics.
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            Quality evaluation of clinical records of a group of general dental practitioners entering a quality assurance programme.

            This paper discusses the importance of maintaining high quality clinical records. Evidence from studies carried out in the USA, Australia and Scandinavia shows that record keeping often falls well below accepted standards. Evidence of current standards in the UK, however, has tended to be anecdotal or circumstantial. An assessment was carried out on 47 general practitioners entering the quality assurance programme of a private capitation scheme. A sample of clinical records from each practitioner was analysed, and the presence or absence of key diagnostic and treatment planning entries were recorded. Overall, the quality of record keeping was poor, and in line with the findings of the other worldwide studies. Fundamental clinical entries that could impact on basic dental care provision were missing from many records. The frequency of recording for patients whose treatment was funded under NHS regulations was significantly worse than for patients whose treatment was privately funded.
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              Audit of dental practice record-keeping: a PCT-coordinated clinical audit by Worcestershire dentists.

              A collaborative audit of clinical record-keeping standards was performed among Worcestershire dentists. Its aims were to improve the quality of National Health Service (NHS) patient care and to assist dentists to perform well during Dental Reference Service practice visits. Worcestershire dentists with NHS contracts were invited to take part in this audit. Each dentist audited a random selection of 30 of their dental clinical records against a common framework comprising eight domains. Record-keeping, and the presence or absence of key diagnostic and treatment planning details were recorded. Grading was applied in four categories, in which grades 1 and 2 were good (1) and adequate (2), captured on data-collection sheets and centrally analysed for frequency of each grade. Out of a total of 184 Worcestershire general dental practitioners, 161 (87.5%) submitted usable responses. The audit revealed wide variation between dentists in clinical record-keeping. The recording of soft tissues (36% below grade 2), periodontal status (30%), radiographic review (27%), and note-taking (25%) all fell below the standard that had been set (brackets show proportion not meeting the standard). The results provided baseline information about the standard of record-keeping in NHS dental practices in Worcestershire. The collaborative nature of the audit enabled dissemination of individual results to participants, to facilitate comparison (anonymously) against their peers. The audit provided impetus for the Primary Care Trust (PCT) to arrange postgraduate education on record-keeping and to raise awareness among local dentists about record-keeping. The subsequent report to dentists explored the record-keeping standards expected during practice inspections undertaken by the Dental Reference Service. Worcestershire PCT's method of collaborative dental audit could potentially replace the previous national programme of dental audit, formerly coordinated locally.
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                Author and article information

                Journal
                J Forensic Dent Sci
                JFDS
                Journal of Forensic Dental Sciences
                Medknow Publications & Media Pvt Ltd (India )
                0975-1475
                0975-2137
                Jul-Dec 2011
                : 3
                : 2
                : 52-57
                Affiliations
                [1] Department of Oral and Maxillofacial Pathology, PAHER University, Pacific Dental College and Hospital, Debari, Udaipur, Rajasthan, India
                [1 ] Department of Oral and Maxillofacial Pathology, People's Denal Academy, Bhopal, India
                [2 ] Department of Oral Medicine & Radiology, People's College of Dental Sciences & Research Centre, Bhopal, India
                Author notes
                Address for correspondence: Dr. Madhusudan Astekar, Department of Oral and Maxillofacial Pathology, PAHER University, Pacific Dental College and Hospital, Debari, Udaipur – 313 024, Rajasthan, India. E-mail: madhu.tanu@ 123456gmail.com
                Article
                JFDS-3-52
                10.4103/0975-1475.92143
                3296374
                22408320
                45aa7f05-586d-47f6-8180-1dbededac53f
                Copyright: © Journal of Forensic Dental Sciences

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Categories
                Original Article

                Forensic science
                dental remains,personal identification,child abuse,forensic odontology,medicolegal cases,dentists

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