ROLE OF FINGER DERMATOGLYPHICS IN PREDICTING SUSCEPTIBILITY TO DENTAL CARIES

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.