T
he MH17 tragedy that unfolded on July 17, 2014, where Malaysia Airlines flight 17 was shot down over Ukraine, strengthened Dr Rabi’ah Al-Dawiyah Rahmat’s resolve to pursue her career in forensic dentistry.
This was despite the fact that cases that forensic odontologists (dentists) help to investigate are often violent, gruesome, and disturbing. Entering into the practice is certainly not for the faint of heart and, in fact, it can be quite emotionally disturbing.
“Not everyone has the courage to get close to burnt skeletal remains, charred bodies of fire victims or fractured skulls, but having worked for nearly 10 years in this field, all these have become a norm,” Dr Rabi’ah told Bernama.
As one of 15 forensic odontology specialists in the country, Dr Rabi’ah, 37, said the MH17 tragedy was an wake-up call for her then, a dental officer, on the importance of this field, especially in identifying victims who perished in tragic circumstances including criminal cases.
“Just imagine if the victim was found dead with the head smashed....With our expertise, we will be able to identify (the victim) based on the teeth.
“While this profession is perceived as downright scary, I am grateful that the services provided can help the authorities such as the police in their investigation and also family members,” she said, adding that to date, she has handled hundreds of such cases.
INSPIRED
Dr Rabi’ah who holds a PhD in forensic dentistry from University of Adelaide, Australia, said she gained exposure in forensic odontology under the guidance of the first forensic odontology specialist in Malaysia, Prof Dr Phrabhakaran Nambiar at the Faculty of Dentistry, Universiti Malaya (UM).
“After graduating with a Bachelor of Dental Surgery from Vinayaka Missions University, India in 2011, I returned to Malaysia and was placed at the Ministry of Health as a dental officer. After two years there, in 2013, I was transferred to the Dental Faculty, UM.
Dr. Rabi'ah has never regretted serving in the field of dental forensics to continue helping the community.
“When the MH17 tragedy took place, Dr Phrabhakaran gave me an opportunity to be involved in identifying the victims,” she recalled.
‘MH17 is my first experience with a closed disaster...this lesser known medical field, was an eye opener for me,” she said, adding that she later pursued her studies at University of Adelaide.
Sharing her experience in the challenging mission to identify MH17 victims, Dr Rafi’ah said she, together with other experts from various nations, were assigned to the Disaster Victim Identification (DVI) team which played a pivotal role in conducting ante-mortem inspection, that is, analysing the victims’ dental records.
For the record, on July 17, 2014, Malaysia Airlines flight MH17 en route from Amsterdam to Kuala Lumpur, crashed after being hit by a missile over eastern Ukraine. All 298 people on board including 15 crew members and 283 passengers from 17 countries, died in the crash. Thirty of them were Malaysians.
According to Dr Rabi’ah, among the main challenges faced by the DVI team included collecting the various data and dental records on the victims.
“(However, in this case), we were grateful the process was made easier with the assistance from a dental clinic which kept records of the victims. In other words, our task was merely to match the victims’ dental records with the data provided by the investigators.
“Our DVI Malaysia team succeeded in analysing the identity of nearly all of the victims assigned to us,” she said, adding that the data was sent to the International Police for further action.
RUMMAGING THROUGH GARBAGE BIN
Dr Rabi’ah said her experience has also helped the authorities in Adelaide to identify the identity of a dead victim who was murdered while studying there, noting that the case has left an indelible mark on her career.
“A dead body was found in a garbage bin, believed to be killed. Police then took the body for post-mortem and we assisted by conducting forensic dentistry inspection on the dead body. During the inspection, we found the victim’s tooth had fallen out from the mouth after death and we believe the lost tooth can help us identify the victim.
Experts have to dare to turn over burnt skeletons, or crushed skulls to identify the cause of death and the victim's identity.
“After sharing the findings, the police brought the waste disposal bin for us to carry out our task. Just imagine, we had to rummage through the stinky garbage before we finally found the tooth.
“From one tooth, we managed to identify the victim and confirmed that the victim was murdered,” she said, adding that her involvement in the case was part of the requirements for her studies at the university.
According to Dr Rabi’ah, dental evidence in forensic identification can bring about the fastest results and the highest rate of success compared to other procedures adopted by other forensic experts.
She said besides dental records, identification can also be undertaken through Deoxyribonucleic acid (DNA) that can be found in an individual’s teeth.
Teeth is one of the best sources of DNA available for identification of degraded or fragmented human remains compared to other organs such as skin, flesh or body fluid such as blood as the teeth structure can endure high pressure and besides, it is not easily broken or damaged,” she said.
At the same time, forensic dentistry is also aided by high technology such as Cone Beam Computed Tomography (CBCT) scan, a type of x-ray that produces 3D images of the teeth, jaws and the surrounding structures in the patient’s mouth.
"Through the CBCT, we can estimate age, determine the race and gender, which is almost accurate in addition to dental trauma, which is caused by fractures,” she said.
With a single tooth, CBCT can produce almost accurate data compared to previous procedures which required a set of teeth of at least seven to get the data on the victim’s identity.
SHORTAGE OF EXPERTS
Meanwhile, Dr Rabi’ah said the number of professionals in forensic dentistry is still low despite the growing demand for its expertise especially in identifying dead victims.
In this regard, she said that the situation is probably due to the stigma attached to the profession itself which demands the forensic dentist to be “surrounded” with dead bodies, often in bizarre or scary condition.
“It appears that forensic dentistry is rather ‘sidelined’ when compared to other fields in forensic science. In fact, the eligibility criteria for a scholarship (for forensic dentistry studies) is very strict, which among others, requires that students can only pursue their studies at any of the Top 50 World University Rankings.
CBCT is capable of providing 3D images to help estimate age through teeth and determine the victim's race or gender almost exactly.
“However, the courses offered at this university are only for three years and are not sufficient for you to build your expertise in this field,” she said, adding that, becoming an expert is no mean feat, noting that it is a continuous pursuit of knowledge, experience and growth.
“In Malaysia, before becoming a practitioner, one needs recognition from the Malaysian Dental Council, whereby he or she must possess at least a dental degree and postgraduate degree in forensic dentistry,” said Dr Rabi’ah, who is now attached to the Dental Faculty of UM as a lecturer and forensic dentistry expert.
In this respect, she urged stakeholders to give more focus on the forensic field, especially in dentistry, to meet future demand for such services.
The field of dental forensics is quite unique and 'rare' considering that Malaysia only has around 15 experts so far.
She believes that the government’s focus on the importance of this field would help change public mindset, hence encouraging more youths to choose forensic as their career, especially women given the shortage of forensic experts among women.
“Alhamdulillah (Praise to Allah), my family is fully supportive of my career. I personally have a one-year old daughter, and I will encourage her to follow in my footsteps (as a forensic dentistry expert),” she added.
Translated by Salbiah Said
