A SHORT HISTORY OF FORENSIC ODONTOSTOMATOLOGY and FORENSIC MEDICINE
A Survey by Klaus Rötzscher, Speyer.
The different terms of dentistry, dental medicine, odontology and stomatology imply different practical and scientific-theoretical functions. Modern stomatology stands, according to our requirements, for the normal development, conservation or rehabilitation of the orofacial system.
The orofacial system includes the functional system of teeth, masticatory apparatus, jaws and temporomandibular joints, masseter and facial muscles, glands, soft tissues, membranes and their support by blood, lymph and nerves.
A stomatologist is therefore not just a dentist (odontologist), but has to think and treat in terms of odontology and orthodontics. Forensic Odonto-Stomatology as a special modification of stomatology is an independent scientific branch within the forensic sciences which deliberately put their research and methods into the service of the administration of justice.
Forensic odontostomatology is supposed to collect all the results of odontological research to serve criminal prosecution and legal procedure. It is therefore regarded as an independend branch of science, originating from the requirement of a civilized nation to its system of law and its administration of justice.
Some aspects of forensic odontostomatology are as follows:
1. Assessing scientific disputes forensically
2. Establishing certain principles which, being generally approved correct, are supposed to serve as a standard for the correct odontological practice
3. Identification of unknown bodies (dead or alive) in certain cases
4. Supporting investigation and prosecution of crimes
5. Imparting certain juridical knowledge solely leading to an effective cooperation between stomatologists and the administration of justice.
It is often believed that only those few odontostomatologists who serve as expert witnesses need to have some knowledge in this field. But one must not forget, that every dentist is obliged by the code of criminal procedure to be an expert witness should the situation arise. In addition to that, it is advisable to know something about it to avoid possible compensation claims.
Early History, part 1
The forensic odontostomatology still lacks a systematology in teaching as well as in research and even in its practical performance. With the help of a historical survey, this text wants to point out the necessity to build up structures for a forensic odontostomatology all over the world. At the same time the forensic odontostomatologist, the forensic pathologist, the police and the public prosecutor should be given an understanding of this scientific branch. The evolution of the forensic odontostomatology undisputedly depends on the development of medicine, odontology and jurisprudence. It is a part of the cultural history of mankind. In the primitive society of prehistoric time affliction, the urge to help, and the community feeling of the kinship group marked the beginning of the art of healing. In spite of their artistic work in Western Europe 20,000 and more years ago, cavemen and bone engravers did not record anything relating to odontology.
The hieroglyphs and pictographs of the smaller or larger slave holding states of the Old Orient (Middle East) show, through the use of mouth and teeth in their writing system, how much importance was given to these. The most important evidence from Old Egypt is the EDWIN-SMITH-PAPYRUS from the 17th century BC. In this document a dislocation of the jaw and its correct reposition are depicted. Findings of dental prostheses and tooth support are attributed to the marvels of antique metal technology and not to human medicine. There was no knowledge about forensic medicine.
Little do we know about oral hygiene in Mesopotamia. There is more information on the importance of good teeth in the CODEX HAMMURABI which was written shortly after 2,000 BC for Babylonia and Assyria:
§ 200: "If anyone knocks out anyone's teeth, then his teeth shall be knocked out likewise."
§ 201: "If he has knocked out the teeth of a freed man, then he shall pay 1/2 mine of silver." At least after the publication of the CODEX HAMMURABI no surgery could be performed in Mesopotamia.
Early History, part 2
China had a culture as noteworthy as Egypt's or Mesopotamia's, which, in its turn, influenced India and Arabia. It is true that there have been books on odontology, but they have not been published. From the books on history, law, religious cults and devotional writing in ancient Israel, one cannot expect anything serious concerning medicine or odontology in particular. And if a man smite the eye of his servant, or the eye of his maid, that it perish, he shall let him go free for his eye's sake.
“And if he smite out his manservant's tooth or his maidservant's tooth, he shall let him go free for his tooth sake.” (Exodus 21, 26-27) Jewish law, as well as Babylonian law ranked the value of the tooth straight after the eye (“Eye for eye, tooth for tooth, hand for hand, foot for foot (Exodus 21, 24 and Talmud 5th century AC). The “replaced tooth" in Talmud is treated as a cosmetic intervention under “female ornaments". The artificial tooth was made by a craftsman and had therefore nothing to do with medicine. The first denture was found in a tomb near Saida in Phoenicia, two right incisors tied together with a gold threat and fixed to the dental neck of the neighbouring teeth by means of a loop of gold wire. Even for ancient Greece, where there was no subdivision into the different branches of medicine, it can be proved that there were no “medics" specialising in odontology.
The therapies of Hippocrates, Archigenes, Celsus and Galenus were most remarkable. The first Roman laws, written down ca 450 BC, mention gold threads to tie teeth together. The law of the Twelve Slabs (302 ab urbe condita) stated: “Do not throw any gold onto the stakes where dead bodies are burnt, but you may burn the deceased with the gold that keeps his teeth together without violating the law."
The ancient Roman medicine was part of religion and magic. The first medics were slaves, people set free or adventurers. Aeneas had soldiers and officers skilled in the art of healing, which they performed only occasionally, because they were mainly trained to fight. Roman law subsumed injuries of the teeth to injuries in general. In ancient Greece and Rome, there are no traces of expert witnesses, although in both societies the law developed in a rather complicated way and both societies had a high standard of medical knowledge. The fall of the Greek and Roman empires led to decline in culture and affected a step backwards in medicine and at the same time in odontology.
Until the beginning of the Christian calendar there had been no odontology on its own. In theory and practice it had always been part of general medicine, which was preferable performed by priests or medical men who had come from the priest's caste.
The Teutonic tribes of the Franks, Alemanns, Goths, Vandals etc., who were looked down upon as barbarians, were the first to “legally” introduce medical experts. This was done to stop the custom of blood feuds, and thus they assigned a certain responsibility to the community. But in medicine they did not yet have the these days necessary qualifications to come up to the expectations. We do not know anything of dental treatment in the Celto-Germanic history.
The codification of their laws was done at the same time when these tribes entered Roman territory: First the Visigoths under Eurich (466-456), then the BurgLindians under Gundobad (474-516), who was the most important legal expert among the Germanic princes. In the 6th century these tribes were followed by the different tribes of the Franks.
In the first half of the 7th century, a «law» of the Langobards and the Alemanns, the so-called Pactus Alamannorum, came into existence, which was, a hundred years later, rewritten as the Lex Alamannorum. Both allow an insight into how medical expertise was treated in these days. In the 8th century, the Langobards and the Franks rewrote some “laws”. At the same time, the Bavarians, the Saxons, Thuringians, and Frisians recorded their own laws. Whereas the 8th century basically meant the completion of legal recordings, the Anglo-Saxons did not finish recording laws until the 11th century, only succeeded by the Northern Germanic tribes (11th-13th century).
The Nordic laws of the Icelandic and Scandinavian peoples, although latest in their recording, have retained a certain naturalness. The recordings of the Germanic tribes fell into oblivion; they are hardly known on the continent in the 10th century. There were very rarely new recordings of laws.