Working in forensic dentistry – experiences from a dental nurse
Katherine Pearce talks about her role and experiences in forensic dentistry.
Odontology, otherwise known as forensic dentistry, can be used in legal investigations which involve the identification of human remains, bite marks and age estimation. Historically, this was undertaken by a forensically trained dentist. However, in recent years more forensic dentists have been making use of DCPs to assist. So where do we fit in to a forensic investigation?
I spent 12 years working for the military as a civilian dental nurse. My interest in forensics was initially inspired by lectures at study days by two experienced forensic dentists (odonts). A good proportion of my military nursing was spent working with a dentist studying for her MSc in forensic dentistry and a member of the Military Dental Identification Team (DIT). Therefore, I approached her with my interest.
She nurtured my interest by arranging a training pathway to ensure I knew what I was getting into! I was ‘initiated’ with a trip to the mortuary at The John Radcliffe Hospital. Under guidance of my fellow experienced odont assistant, I got the feel of the mortuary set up, the staff, the day-to-day activity and the (attractive) white suits and wellingtons. Once acclimatised, I observed the identification of a bomb blast victim, and assisted with setting up and packing away the kit, infection control procedures, charting and dental X-rays.
At the end of the day, I was TRIM assessed (Trauma Risk Management). This is where we sat down and talked through the whole experience. I then had a further assessment 48 hours later. The team were incredibly supportive during any further work that I was given. They provided guidance and advice at the end of a long day. And they made sure I was developing the skills I needed both hands-on and mentally.
I surprised myself in terms of dealing with the mortuary environment. Having fainted as a teenager whilst having my ears pierced – twice! – I wasn’t sure it was going to be for me, or my stomach. But I think the open-minded, no pressure approach, made it, dare I say, easy. As it was always a subject that I had found fascinating since childhood, it was easy to get lost in the amazement of the human body during the post-mortems, and how much it actually did look like the anatomy textbooks!
My attachment with the DIT and making contacts through attending the British Association for Forensic Odonotology (BAFO) conferences, led me to involvement with the UK Disaster Victim Identification (UKDVI) team. The training days and exercises provided by the UKDVI has been invaluable since I joined. They enable all elements of the DVI teams to come together and find out where they fit into the process.
Odontologists, pathologists, anthropologists, fingerprints experts, police, counter terrorism, trauma risk assessors, health and safety experts, emergency services, DNA experts, firearm specialists, explosives specialists, catering, logistics, accommodation, subsistence, travel, and of course DCPs, can all have a role. The list really is endless.
Mass disaster training
UKDVI is an arm of the police service which responds to mass fatality incidents in the UK and abroad. It co-ordinates all the specialties mentioned to ensure the safe recovery and identification of the victims in a mass disaster scenario. Therefore, training plays a huge part in the preparation for such events. One of the most memorable training sessions took place over a chilly few days at a disused power station in Dartford.
‘Exercise Unified Response’ was the largest ever exercise to be staged in Europe. It involved the mock-up of a building collapse on a tube train in Waterloo station during rush hour. It was led by London Fire Brigade however, it involved upwards of seventy specialist agencies from across Europe. Each had a pivotal role in disaster victim recovery and identification.
The set up was extremely realistic. We had tunnels that are found on the underground and even ‘live’ dead bodies! Actors gave up their time to play the wounded, seriously injured and deceased. Additionally, we worked out of a ‘pop up’ mortuary, a temporary structure literally put together in quick time to accommodate all the required specialties. The training attracted huge interest from the world’s press. It highlighted the importance of each speciality, where it would fit into a mass disaster situation and gave us an idea on how it might be ‘for real’.
Working on the Grenfell Tower fire
Sadly, mass disaster scenarios hit the UK hard in 2017. I was involved in the Manchester Arena bombing, the first London Bridge attacks and the Grenfell Tower fire. Each incident was different in terms of mortuary set up, length of investigation, information gathering, recovery of evidence, and state of remains.
The Grenfell Tower fire really was an investigation – the extent of which the country had never seen. The recovery and identification process alone took six months involving a multi-disciplinary team approach. Odontology was at the forefront of the identification process and over 30 members of the UKDVI odont team were used. It was the first time DCPs had been used en-masse. As a collective, we certainly proved a valuable addition to the team.
It was incredibly challenging to be involved in, with lots of lessons learnt. However seeing the way all teams integrated, with everyone’s role being an important one, and using collective expertise to get the result we were all there for, was actually one of the most inspiring elements to working in this environment
Remembering those lost
Much reflection, learning and development was taken after these events. It was decided that the UKDVI Odont team currently had enough staff to cope with the countries biggest mass disasters. However, I would strongly encourage attending the BAFO conference once yearly for fascinating lectures and networking opportunities from every angle of forensic dentistry and beyond. For further information visit www.bafo.org.uk
I would like to take this opportunity to remember all those we have identified and their loved ones. When the unthinkable happens, the very least we can do is reliably identify the victims so their families can go through the process of laying their loved ones to rest. This is in the forefront of everyone’s minds every time we get the call out. It is the main reason we do what we do.
Katherine Pearce has been a dental nurse for 23 years and been involved on a voluntary basis in forensic odontology for over 12 years. She began her career whilst working as a civilian dental nurse in the military and then continued as part of the UKDVI. Her latest deployments have included the Manchester Arena bombing and Grenfell Tower fire.