Journal of Forensic Dental Sciences
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  Table of Contents  
CASE REPORT
Year : 2015  |  Volume : 7  |  Issue : 2  |  Page : 168-170  

Histological appearance of postmortem pink teeth: Report of two cases


Department of Oral Pathology, Sri Siddhartha Dental College, Tumkur, Karnataka, India

Date of Web Publication4-May-2015

Correspondence Address:
B K Charan Gowda
Department of Oral Pathology, Sri Siddhartha Dental College, Agalkote, Tumkur - 572 107, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0975-1475.156200

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   Abstract 

This article presents images and histological changes in the dentin of two cases involving posmortem pink teeth. Postmortem pink teeth were noted among two deceased male individuals. Pink teeth were noted during autopsy examination after twelve days in one corpse, and eight days following death in the second case. During the examination decomposition and putrefaction of the body was noted. Cause of death was drowning in one case and haemorrhages and shock in another. A central incisor tooth was obtained from each body. Both teeth exhibited a pink appearance and the intensity was more pronounced in the cervical region. Although pink teeth can be noted in death due to asphyxia, carbon monoxide poisoning and so on, it is necessary to study the exact role behind the appearance of pink teeth and try to incorporate the finding medico legally.

Keywords: Drowning, hemoglobin, porphyrins, postmortem pink teeth


How to cite this article:
Charan Gowda B K, Sivapathasundharam B, Chatterji A, Chatterji B L. Histological appearance of postmortem pink teeth: Report of two cases. J Forensic Dent Sci 2015;7:168-70

How to cite this URL:
Charan Gowda B K, Sivapathasundharam B, Chatterji A, Chatterji B L. Histological appearance of postmortem pink teeth: Report of two cases. J Forensic Dent Sci [serial online] 2015 [cited 2019 Jul 21];7:168-70. Available from: http://www.jfds.org/text.asp?2015/7/2/168/156200


   Introduction Top


Identification based on dental information is a highly efficient, reliable, and rapid procedure. [1],[2] Knowledge in rugoscopy, [3],[4] chelioscopy, [5],[6] bite marks, [7],[8] radiographs, [9],[10] tooth DNA analysis [11],[12],[13] and so on, plays an important role in medico legal investigation. However, still many questions in the field of Forensic Odontology remain unanswered. [3],[14] One feature is postmortem pink teeth. Further studies are required to conclude the manner of death by looking into postmortem pink tooth. The appearance of postmortem pink teeth is a common phenomenon that can be noted by the forensic personnel during exhumation. [14] Usually the pink appearance is more pronounced at the region of the cementoenamel junction [3],[14],[15] and more intense among the anterior teeth than the posterior teeth. [3] Bell, in 1829, was the first person to describe pink teeth in a postmortem victim. He noted the appearance of pink teeth in the individuals where the cause of death was drowning. Since then, there have not been many reports published in the literature regarding postmortem pink teeth [14] In 1953, Miles et al., described the appearance of postmortem pink teeth in two individuals where the cause of death was drowning and burns. [15],[16] Van Wyk, [17] in 1989, also observed pink teeth where the cause of death was drowning, fire, and stabbing. Kirkham et al., [18] observed pink teeth during postmortem and mentioned that many cases were associated with decomposition in a moist environment.

Reviewing the literature reveals that the exact cause for the appearance of forensic pink teeth as well as the phenomenon behind its occurrence is still clearly not understood. [14],[16],[17],[19] However, trauma and moist environment may play a role in its appearance. We present two cases of pink teeth in exhumed bodies.

The main aim of our study was to note the changes to pink teeth, histologically.


   Case Reports Top


Case 1

A male individual aged 28 years was found dead. The medical investigator reported that death had occurred 12 days earlier. The cause of death was registered as drowning. One maxillary central incisor [Figure 1] was obtained from the deceased individual's body.
Figure 1: Pink appearance along the cervical region of the tooth

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Case 2

A male individual aged 45 years was found dead. The medical investigator reported that death had occurred eight days earlier. Death was due to hemorrhage and shock. A maxillary central incisor tooth [Figure 2] was obtained from the deceased individual's body.
Figure 2: Pink appearance along the cervical region of the tooth

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Both samples were obtained following oral consent from the medical officer and police investigator.

One tooth was subjected to ground section and the other to decalcification.

The ground section revealed red-brown discoloration of the dentin [Figure 3] and [Figure 4], whereas, the hematoxylin and eosin (H and E)-stained section does not show any notable changes [Figure 5].
Figure 3: Ground section of teeth showing dentin

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Figure 4: Ground section of teeth showing pulp

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Figure 5: H and E-stained section of decalcified tooth

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   Discussion Top


Postmortem pink teeth phenomenon is a condition that may be noted among deceased individuals due to the development of intrapulpal pressure. Various factors including physical trauma and a moist environment play a major role in the development of the pink appearance. [14],[16],[17],[18] In forensic literature, authors who reported cases of pink teeth, note the time delay between death and development of pink appearance. [16],[18] They attribute the cause of discoloration to red blood cells entering the dentin. [18] However, as red blood cells are 7.5 microns in diameter and dentinal tubules are only 3 micrometers in diameter, it is the lysis of erythrocytes and the products of erythrocytes like hemoglobin, porphyrins, and hemosiderins, together with bile and related pigments that are responsible for the pink appearance. The literature mentions the variation in the intensity among different teeth and also the regions of the teeth. The appearance of pink teeth can be noted among incisors, canines, and premolars. Within the tooth, the root exhibits more intense discoloration than in the coronal region. [17],[18]

In our case, we noted a similar variation in the color intensity from region to region. We noted more intense discoloration along the cervical region compared to the incisal region. Van Wyk, in 1989, studied the ground sections of postmortem pink teeth and noted the red-brown discoloration of dentin. Similar to the study by Van Wyk, the ground section of pink teeth in our case showed red -brown discoloration in the dentin but not in enamel and cementum.

We conclude that the pink appearance is due to the derivative products of hemoglobin entering the dentinal tubules.


   Conclusion Top


Pink teeth phenomenon may be noted in dead individuals, where great physical trauma is noted. Moist environment also plays a role as a triggering factor. However, the exact cause of the coloration remains unexplained. Large scale studies are needed to ascertain the exact cause for the appearance of the pink color and the variation in the intensity of the hue.


   Acknowledgment Top


Dr. Rudramurthy, Head, Department of Forensic Medicine and Residential Medical Officer, Government Hospital, Tumkur.



 
   References Top

1.
Kolude B, Adeyemi BF, Taiwo JO, Sigbeku OF, Eze UO. The role of forensic dentist following mass disaster. Ann Ibadan Postgrad Med 2010;8:111-8.  Back to cited text no. 1
    
2.
Valenzuela A, Martin-de lasHeras S, Marques T, Exposito N, Bohoyo JM. The application of dental methods of identification to human burn victims in a mass disaster. Int J Legal Med 2000;113;236-9.  Back to cited text no. 2
    
3.
Borrman H, DuChesne A, Brinkmann B. Medico-legal aspects of postmortem pink teeth. IntJ Legal Med 1994;106:225-31.  Back to cited text no. 3
    
4.
Mohammed RB, Patil RG, Pammi VR, Sandya MP, Kalyan SV, Anitha A. Rugoscopy: Human identification by computer-assisted photographic superimposition technique. J Forensic Dent Sci 2013;5:90-5.  Back to cited text no. 4
[PUBMED]  Medknow Journal  
5.
Barbieri AA, Scoralick RA, Naressi SC, Moraes ME, Daruge E Jr, Daruge E. The evidence of the rugoscopy effectiveness as a human identification method in patients submitted to rapid palatal expansion. J Forensic Sci 2013;58(Suppl 1);S235-8.  Back to cited text no. 5
    
6.
Venkatesh R, David MP. Cheiloscopy: An aid for personal identification. J Forensic Dent Sci 2011;3:67-70.  Back to cited text no. 6
[PUBMED]  Medknow Journal  
7.
Malik R, Goel S. Chelioscopy: A deterministic aid for forensic sex determination. J Indian Acad Oral Med Radiol 2011;23;17-9.  Back to cited text no. 7
    
8.
Wright FD, Dailey JC. Human bite marks in forensic dentistry. Dent Clin North Am 2001;45:365-97.  Back to cited text no. 8
    
9.
Kotb NA, El Attar HS, Soliman AS. Some medicolegal aspects of odontology (case reports). 2013;31(Suppl 1);65.  Back to cited text no. 9
    
10.
Kvall SI, Kolltveit KM, Thomsen IO, Solheim T. Age estimation of adults from dental radiographs. Forensic Sci Int 1995;74:175-85.  Back to cited text no. 10
    
11.
Nomir O, Abdel-Mottaleb M. A system for human identification from X-ray dental radiographs. Pattern Recognit 2005;38:1295-305.  Back to cited text no. 11
    
12.
Ginther C, Issel-Tarver L, King MC. Identifying individuals by sequencing mitochondrial DNA from teeth. Nat Genet 1992;2:135-8.  Back to cited text no. 12
    
13.
Smith BC, Fisher DL, Weedn VW, Warnock GR, Holland MM. A systematic approach to the sampling of dental DNA. J Forensic Sci 1993;38:1194-209.  Back to cited text no. 13
    
14.
Soriano EP, Carvalho MV, Santos FB, Mendoza CC, Araújo MD, Campello RI. The post-mortem pink teeth phenomenon: A case report. Med Oral Patol Oral Cir Bucal 2009;14:E337-9.  Back to cited text no. 14
    
15.
Fish; Glasgow University Dental Hospital and School; Matriculation number: 0105883.  Back to cited text no. 15
    
16.
Dye TJ, Lucy D, Pollard AM. The occurrence and implications of post-mortem 'pink teeth' in forensic and archaeological cases. Int J Osteoarchaeol 1995;5:339-48.  Back to cited text no. 16
    
17.
Van Wyk CW. Postmortem pink teeth: In vitro production. J Oral Pathol 1988;17:568-72.  Back to cited text no. 17
    
18.
Kirkham WR, Andrews EE, Snow CC, Grape PM, Snyder L. Postmortem pink teeth. J Forensic Sci 1977;22:119-31.  Back to cited text no. 18
    
19.
Sainio P, Syrjänen S, Keijälä JP, Parviainen AP. Postmortem pink teeth phenomenon: An experimental study and a survey of the literature. Proc Finn Dent Soc 1990;86:29-35.  Back to cited text no. 19
    


    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5]



 

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