Dermatoglyphics Of Dental Caries And Periodontal Diseases In Children Of North Karnataka

INTRODUCTION

Have you ever wondered can oral cavity lesions be detected by seeing the hand????

Dental caries and periodontal diseases are infectious diseases caused due to a multifactorial process. This multifactorial etiology comprises of host, micro organism, time and substrate. But genetic susceptibility too plays an important role. We are yet not sure of it and a lot of research work is still required.

For a long time now, the grooves and lines of hands have fascinated all kinds of people, sages, biologists, doctors and layman alike. The modern study of the hand is far removed from the popular image of the soothsaying hand reader uttering mysterious incantations in an arcane language. Rather through decades of scientific research, the hand has come to be recognised as a powerful diagnostic tool in diagnosis of many medical conditions.¹

Cummins and Midlo² coined the term DERMATOGLYPHICS in 1926. Dermatoglyphic means study of ridged skin.

The current status of dermatoglyphics is such that the diagnosis of some diseases can now be done on the basis of dermatoglyphic analysis alone and certain researchers also claim a high degree of accuracy in their prognostic ability.

On this basis, we have designed a study in order to observe the dermatoglyphic peculiarities of dental caries and periodontal diseases in children between an age group of 12– 14 years.

METHOD

The sample size selected for the study was 96 children within the age group of 12-14 years of age in North Karnataka. Medically compromised or handicapped children were excluded from the study. These 96 children were divided in the following groups:

Caries and OHI detection

After taking a consent from the parent/guardian, a relevant case history was obtained from the patient and dental caries was recorded using 'deft' index for primary teeth, 'DMFT' index for permanent teeth, and OHI index for the oral cavity with the help of a right angle probe (no.17), shepherd probe (no. 23), and mouth mirror. The data was recorded in a case history format specially designed for the study. 

Dermatoglyphic pattern recording:

Dermatoglyphic patterns of all 10 palmar digits were recorded using Cummins and Midlo method.3 The finger prints were recorded as follows: At the beginning, hands were scrubbed thoroughly with an antiseptic lotion (Savlon) and allowed to dry. After this, right hand digits were guided by the researcher to the ink stamp pad (Fig 1) and pressed firmly against bond paper (Fig 2) that was placed on a smooth surface board. The impressions were taken 3-4 times and the best one was considered for the study. Same procedure was repeated for the left hand also (Fig.3). In this way, a total of 480 digital prints were obtained from 48 patients.

Dermatoglyphic pattern interpretation:-

These dermatoglyphic patterns were analyzed with the help of a magnifying glass (10x) (Fig 4), with respect to available standards the number of loops and whorls, were recorded with the help of a forensic medicine specialist. The identifying patterns for loops and whorls are shown in (Fig 5 and 6).

RESULTS

The frequency distribution for dermatoglyphic peculiarities data in 48 children for caries assessment is shown in table 1, 2, 3. Table 1 which had children with less caries shows that a high number of subjects showed few whorls (1, 2, 3) and more loops (8, 9, 10). Table 2 which had children with caries between 3-6 shows that more subjects showed whorls and loops between 4 to 7.Table 3 which had children with high caries rate shows that a high number of subjects showed more whorls (8,9, 10) and few loops (1, 2, 3). While applying Anova test, a highly significant difference [Pvalue : <0.005 (loops)] was observed between the three groups of caries with loops and a significant difference [Pvalue : <0.005 (whorls)].

The dermatoglyphic peculiarities of 48 children, for gingival and periodontal assessment, are shown in table 4, 5 and 6. Table 4 that had children with less OHI, showed that a high number of subjects had more of loops (8, 9, 10) while the subjects were equally distributed for number of whorls. Table 5 that had children with OHI between 1.3 to 3, showed that high number of subjects had loops between 4 to 7, while subjects were equally distributed for number of whorls. Table 6 had children with high OHI, showed that a high number of subjects had less number of loops (1, 2, 3), while subjects were equally distributed for number of whorls. While applying Anova test, a significant difference [P value : <0.005(loops)] was observed between the three groups of OHI with loops and a no significant difference [P value : >0.005 (whorls)].

Thus, we could see that as caries increased, there was increase in whorls and decrease in loops and as the calculus and debris increased (more prone to periodontal diseases), there was a decrease in loops and no significant relationship with whorls with increase in OHI.

DISCUSSION

How are these infectious diseases and dermatoglyphics related?

In human, the palate, lip and the enamel start developing by 6 to 7th week of intrauterine life, the dermal ridges developed from volar pads also start developing at the same time. Secondly, the enamel is an ectodermal structure and so is the epithelium of the finger buds. So any hereditary factors affecting the oral cavity will also show effects in the skin of the fingers. This means that genetic message contained in the genome, normal or abnormal, is deciphered during this period and is also reflected by dermatoglyphics.^3,4

The genes responsible for causation of these infectious diseases are Pa+ and Pr22.5

The method of recording and evaluating dermatoglyphics used in the present study is ink-stamp pad method given by Cummins and Midlo.²

There are two basic principles of these finger prints:6

1) The fingerprint is not same for any two individuals, not even for identical twins.

2) This fingerprint once established does not change throughout life. 

Dermatoglyphic patterns are broadly classified into three major types: whorl, loops, and arches, which are present on finger tips/buds, whereas whole of human palm show certain other features such as atd angle, H-loop, IVloop, and t-triradius.^5,7

The children were selected within the age group of 12-14 years as the second window of infectivity would be completed by that age, so the bacterial effect could be relied upon much more confidently.

Thus, we could see that as caries increased, there was increase in whorls and decrease in loops and as the calculus and debris increased (more prone to periodontal diseases), there was a decrease in loops and no significant relationship with whorls with increase in OHI.

Conclusion

There was a significant relationship noticed between dermatoglyphic features and oral diseases like dental caries and periodontal lesions. Dermatoglyphic peculiarities can be used to detect dental caries and periodontal diseases prematurely. The study conducted, is a just a small add on to the existing ocean of research, Still a lot has to be researched and studied upon. May be one day in future, dermatoglyphics will be used as diagnostic tool for infectious diseases of the oral cavity.