Policy on Child Identification Programs

Purpose

The American Academy of Pediatric Dentistry (AAPD), recognizing the role that dental records play in forensic identification, encourages dental practitioners and administrators of child identification programs to implement simple practices that can aid in identification of unknown infants, children, and adolescents. The AAPD recommends that parents establish a dental home, where clinical data is gathered, stored, and updated routinely and can be made available to assist in identification of missing and abducted persons.

Methods

This document was developed by the Council on Clinical Affairs, adopted in 2003¹, and last revised in 2017². This policy revision included a new literature search of the PubMed®/ MEDLINE electronic database using the terms: child, forensic, dental, and identification; fields: all; limits: within the last 10 years, English. One hundred twelve articles matched these criteria. Papers for review were chosen from this list and from references within selected articles. When information from these articles did not appear sufficient or was inconclusive, policies were based upon expert and/or consensus opinion by experienced researchers and clinicians. 

Background

Nearly 350,000 reports of missing children and approximately 900 unidentified person records were submitted to the Federal Bureau of Investigation’s National Crime Information Center in 2021.3 Since the passage of the Missing Children Act in 1982 and the creation of the National Crime Information Center, the dental profession has provided much of the information used to compare missing persons with unidentified individuals.^4,5 The Manual of Forensic Odontology, produced by the American Society of Forensic Odontology, demonstrates the vital role of dentistry in identification of missing and unknown persons.⁵ Numerous cases have been published in which law enforcement agencies called upon dentistry to provide information that proved vital to the identification process.^6,7 Dental records used for identification purposes have included dental radiographs⁸ , facial photographs, study casts, bite registrations, dental examinations documenting teeth present and distinguishing features of oral structures, and histories documenting appliances (prosthetic and orthodontic) in place, orthodontic treatment, and restored surfaces with materials used.^9-11

Nondental sources of distinguishing information currently include fingerprints, photographs, physical descriptions, and DNA from blood, saliva, and other tissue.¹² Some nondental sources have practical limitations. Few children have fingerprint records. DNA sampling, while being state of the art, can be difficult to access as well as protracted and costly.¹³ While not routinely collected, saliva may be a useful tool in profiling age and gender determination for forensic experts.¹⁴ Dentists may provide many non-invasive tools that help in the identification and tracking of children.¹⁵

Many programs have been developed and sponsored by community groups that use various child identification methods. Examples are:

• Child Identification Program (CHIP), sponsored by the Masons. This program gathers a physical description and features fingerprinting, several still photos of various profiles, a video recording or mannerisms with voice interview, and various DNA samples collected on dental impressions and/or cheek swabs.¹⁶
• New England Kids Identification System (KIDS) sponsored by the Massachusetts Free Masons and the Massachusetts Dental Society, which incorporates dental bite impression and cheek swabs to gather DNA material into the CHIP events.^16-18
• The National Child Identification Program, sponsored by the American Football Coaches Association. They provide an identification kit which includes an inkless fingerprinting card with a DNA collection site.¹⁹
• The Federal Bureau of Investigation (FBI) has a free mobile telephone application (app) “FBI Child ID”20. This application provides an easily accessible means to electronically store photos and vital information about children. Additionally, there is a special tab on the app that allows quick and easily access to e-mail to send information to authorities, if necessary.

Policy statement

The AAPD recognizes the importance of dentistry’s role in the provision of data for identification of missing or deceased children and encourages dental professionals to assist in identifying such individuals through dental records and other mechanisms. The AAPD also encourages community identification programs to include a dental component documenting the child’s dental home²¹ and encouraging consistent dental visits. A dental home should be established for every child by 12 months of age.^21,22 A detailed dental record, updated at recall appointments, economically establishes an excellent database of confidential, state-of-the-art child identification information that can be retrieved easily, stored safely, and updated periodically. The dental record may contain a thorough description of the oral cavity documenting all anomalies, a record of restorative care delivered including materials used, appropriate dental radiographs²³, photographs, study casts, and bite registration.