ROLE
OF FINGER DERMATOGLYPHICS IN PREDICTING SUSCEPTIBILITY TO DENTAL CARIES
This topic has been awarded the
first PhD from Saveetha Dental College of Saveetha University.
This eight year old descriptive
study on the role of dermatoglyphics in dental caries had been completed
through various Community Outreach
Programs, in 15,000 subjects from all the prominent parts of South India
and the dental status has been assessed and published in General Dentistry
Journal September/October 2014 – Volume 62, Number 5. An Australian crew from
Australian broadcasting corporation and Smithsonian network USA visited the
department to shoot the research done on “Role of Dermatoglyphics in Dental caries” for their documentary
series which was subsequently telecasted in April 2014. Next phase has been
initiated with the development of software for the benefit of the entire
society.
PRINCIPAL RESEARCHER:
Dr.Pratibha Ramani PhD, Deparment of Oral Pathology, Saveetha Dental
College
PROJECT DESCRIPTION:
“Think
globally - act locally”
WHO Oral Health Programme
Health promotion deals with the broader
determinants of health and aims at reducing risks through sensitive policies
and actions. Promotion of health in the settings where people live, work, learn
and play is clearly the most creative and cost-effective way of improving oral
health and, in turn, the quality of life.
In accordance with WHO overall
priorities, the Global Oral Health Programme has adopted the following
priorities and strategic orientations.
The threat of non-communicable diseases
and the need to provide urgent and effective public health responses led to the
formulation of a global strategy for prevention and control of these diseases,
endorsed in 2000 by the Fifty-third World Health Assembly (resolution WHA
53.17). Priority is given to diseases linked by common, preventable and
lifestyle related risk factors (e.g. unhealthy diet, tobacco use), including
oral health.
A thorough knowledge and understanding
of the pathological conditions affecting teeth is an essential pre-requisite to
plan and execute treatment logically. There are four main conditions that
result in defective tooth structure – dental caries, tooth wear, trauma and
developmental defects. By far, dental caries is the most common chronic disease
in the world.
Dental decay
has an important role in the manifestation of tooth pain and loss, and has been
associated with problems in school and absenteeism in the workplace, leading to
a decrease in quality of life. Moreover, oral health presents a close
association with the individual’s general health, and may be a risk factor for
several diseases
The major advancement in genetics has
enabled a greater understanding of the human genome. In the near future, the
DNA blue print could foretell the lifespan, character traits, physical
attributes and the disease susceptibility of a new born. This knowledge will be
a boon in propagating the philosophy of ‘prevention is better than cure’ that
has always remained the impetus of the ancient Indian wisdom to the true realm.
Over the past 150 years, Dermatoglyphics has been a useful tool in
understanding basic questions in biology, medicine, genetics and evolution, in
addition to being the best and most widely used method for personal
identification. In many respects, it has
been used as an adjunct to other disciplines, serving as a vehicle to resolve
broader biomedical problems. Thus in biology, anthropology, genetics and
medicine, dermatoglyphics serves as a tool to describe, compare and contrast,
and predict occurrences and risks for biomedical events studied by these major
disciplinary areas.
Because research should span both
qualititative and quantitative methodologies, it brings the ability to describe
events in greater or less depth as needed, organise information in meaningful
ways and ultimately draw reasonable conclusions. In a developing country like
India, it might prove to be a non-invasive, inexpensive and effective tool for
screening. Moreover, this tool can be
utilised in any part of the world so as to suit for the individual country’s
scenario. Studying this correlation in a broad spectrum of population between 5
– 45 years which are indicator age groups as per the WHO (Poul Erik Peterson,
Denis Bourgeosis, Douglas Bratthall , Hiroshi Ogawa) – towards measuring
progress in oral health promotion and disease prevention program. Our study
will therefore encompass 3 phases, first phase as case control study comprising
of 800 subjects in the age group of 5-15 years, second phase as descriptive
cross sectional study among 10,250 subjects. The third phase was also done as
descriptive study but comprised of 5 clusters classified according to the age
groups 5-7 years, 12-14 years, 15-17 years, 25 -28 years and 35 – 45 years with
equal distribution of gender and 315 subjects per group. The above phases will
give candid picture on carious prevalence, dermatoglyphic pattern distribution
and the reliability of the patterns in predicting the susceptibility to dental
caries. We restricted the age group to 45 years, as beyond 45 years the
prevalence of missing teeth is more and the subject may not be aware as for the
reason for extraction as the incidence of periodontitis increases with age. We
have included children from 5 years as most of the subjects will be available
for the follow up for future studies. For the fieldwork, the principal
investigator selected and formed field teams consisting of three dentists to
assess the dental status and 2 volunteers to record the finger prints. The
study is designed as a double blinded assessment to increase the validity of
results and done by forensic fingerprint experts, retired from CB-CID,
Tamilnadu Police. The finger prints are subsequently studied on the basis of
their shapes and presence of triradii for qualitative parameters namely whorls,
loops and arches and Analysis of associations was done using SPSS software.
The findings of the study can be used
to develop a software that will be a milestone in the field of dentistry and
society as this will be a valuable tool to predict the susceptibility to dental
caries in every day practice as this
software can be incorporated into any dental chair like the RVG but will be
more cost effective and affordable. It is recommended that these be expanded
and extended in all rural and urban areas in such a away as these are
affordable, accessible and acceptable for the all communities .This will pave
way for us to achieve the overall goal for service provision as oral health
care must be to increase the proportion of children and adults with caries-free teeth.All
this is valid especially in developing countries like India having enormous
population and relatively less health budgets.
This recommendation can be further
investigated with varied demographic samples, different races and specific DNA
analysis. Future studies have to be advocated in this rewarding field to
establish dermatoglyphic markers for susceptibility to dental caries with prospective
studies.
Dental caries susceptibility of an
individual increases with an increase in the incidence of whorl pattern. There
is a significant association of loops and no caries. All the variables show
statistically significant value, with a degree of divergence of specific
dermatoglyphic patterns in all the phases of the study. There is increased
frequency of whorls in association with dental caries in left hand in both
males and females.The association of
dental caries and individual fingers in males is frequently seen in left little
finger followed by right little finger
right middle finger ,and left middle finger. In females it is frequently
seen in right middle finger followed by
left middle finger , right little finger and in left index finger.
Our observations have revealed the
susceptibility to dental caries through its convincing association with the
heritable dermatoglyphic traits as a valid marker. The software will be an
easier and cost effective method for identification of subjects to assess the
susceptibility to dental caries.
Study outline:
DERMATOGLYPHICS:
Dermatoglyphics may be an effective mechanism to study
the genetic basis of dental
caries. In a developing country like India it might be a non invasive,
inexpensive, effective tool for screening.
PHASES: The entire study of dermatoglyphics and dental
caries was carried out in 3 phases
The first study group had
800 subjects .[CASE CONTROL]
The second study group had
10,500 subjects. [DESCRIPTIVE STUDY]
The third study group had
1575 subjects.[CLUSTER SAMPLING]
RESULTS:
1)Dental caries susceptibility of an individual increases with an increase in
the whorl
Pattern.
2)All variables shows a statistically
significant value with a degree of divergence of specific dermatoglyphic
pattern among the study group and control group.
3)The dermatoglyphic pattern are efficient
and can predict in assessing the risk of
susceptibility to dental caries in the study group.
CONCLUSION
: Dental caries susceptibility of the individuals increases with
increase in the increase in the incidence of the whorl pattern and showed a
significant correlation with the cut off point for caries and whorl pattern on
the ROC curve plotted as ≥4 for the number of whorls that had an association
with the caries.
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