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Background: Obtaining thorough documentation of a patient's medical history is important for dental care professionals, as oral health is connected intricately to systemic health. The purpose of this study was to assess the accuracy of parent-reported health history for pediatric patients in a dental setting., Methods: A retrospective chart review was conducted on 863 patients 17 years and younger. Parent-reported health history was compared with subsequent physician-to-dentist consultations. The most common diagnoses were grouped on the basis of International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, categories., Results: The sensitivity of parent report of health conditions was highest for reporting mental and behavioral disorders (75.1%; 95% CI, 69.6% to 80.0%), followed by nervous system diseases (63.0%; 95% CI, 47.5% to 76.8%), respiratory conditions (47.9%; 95% CI, 37.6% to 58.4%), congenital conditions (46.3%; 95% CI, 30.7% to 62.6%), and cardiovascular conditions (25.0%; 95% CI, 11.4% to 43.4%) and was lowest for hematologic conditions (12.2%; 95% CI, 4.1% to 26.2%). Parents of children 6 years and older and those with private insurance had higher sensitivity for reporting mental and behavioral conditions than those with children younger than 6 years or having Medicaid (P < .0001). The specificity of parent-reported health conditions ranged from 96.0% for mental and behavioral disorders to 99.8% for hematologic conditions., Conclusions: Sensitivity varied widely, showing that parents may be unreliable in their report of children's health histories and that dentists cannot rely solely on parents when obtaining health history., Practical Implications: In advocating for patient safety, especially for those with special needs and complex medical conditions, this study supports the use of medical evaluation before dental treatment and for the integration of dental and electronic health records., (Copyright © 2022 American Dental Association. Published by Elsevier Inc. All rights reserved.)

Background: The study objective was to evaluate the workflow of dental providers who use the existing electronic dental record (EDR) system at a large regional health care system to establish a diagnostic-centric culture as part of their dental practice. A further goal focused on identifying when improvements to the workflow and design of the EDR may be indicated., Methods: Dental procedures performed on patients and corresponding International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) diagnoses were retrospectively mined from Marshfield Clinic's enterprise data warehouse. All dental procedures performed were selected and paired with corresponding diagnostic codes documented by dental providers. Frequency of documented diagnosis was further analyzed by characterizing correspondence with their ranking order in the diagnosis column with and without a scroll bar within the EDR user interface (UI). Accuracy of selecting appropriate ICD-9-CM for the corresponding Code on Dental Procedure and Nomenclature (CDT) was checked for 10% (n = 6,187) of the procedure-diagnosis pairs., Results: Of the 61,511 unique procedures documented using 147 CDTs, 11% (6,914 procedures) had a corresponding "not available" option associated under the diagnoses column, whereas 89% (54,597) of dental procedures were associated with a corresponding ICD-9-CM diagnostic code. Overall tendency of dental providers to select the first or last options from the diagnostic list with a scroll bar was noted. Appropriateness of documenting corresponding ICD-9-CM to CDT procedures indicated 98% accuracy., Conclusion: EDR UI design greatly affected documentation process. Redesigning the EDR UI from the results will increase both the quality and utility of clinical documentation., (Copyright © 2018 American Dental Association. Published by Elsevier Inc. All rights reserved.)

Background: The authors conducted a study to determine the frequency and type of adverse events (AEs) associated with dental devices reported to the Food and Drug Administration Manufacturer and User Facility Device Experience (MAUDE) database., Methods: The authors downloaded and reviewed the dental device-related AEs reported to MAUDE from January 1, 1996, through December 31,2011., Results: MAUDE received a total of 1,978,056 reports between January 1, 1996, and December 31, 2011. Among these reports, 28,046 (1.4%) AE reports were associated with dental devices. Within the dental AE reports that had event type information, 17,261 reported injuries, 7,777 reported device malfunctions, and 66 reported deaths. Among the 66 entries classified as death reports, 52 reported a death in the description; the remaining were either misclassified or lacked sufficient information in the report to determine whether a death had occurred. Of the dental device-associated AEs, 53.5% pertained to endosseous implants., Conclusions: A plethora of devices are used in dental care. To achieve Element 1 of Agency for Healthcare Research and Quality's Patient Safety Initiative, clinicians and researchers must be able to monitor the safety of dental devices. Although MAUDE was identified by the authors as essentially the sole source of this valuable information on adverse events, their investigations led them to conclude that MAUDE had substantial limitations that prevent it from being the broad-based patient safety sentinel the profession requires., Practical Implications: As potential contributors to MAUDE, dental care teams play a key role in improving the profession's access to information about the safety of dental devices., (Copyright © 2015 American Dental Association. Published by Elsevier Inc. All rights reserved.)

Background and Overview: Dentists have much invested in their practices. They need to protect their practices from fraud and noncompliance. The author provides practical suggestions for how to significantly reduce the risk of fraud and theft in the practice without disrupting day-to-day operations., Conclusions: By adhering to nonintrusive policy and procedure changes, dental practice owners can reduce inherent risks of fraud and theft, while increasing financial and human resource knowledge regarding their practice., Practical Implications: Practice owners with the appropriate policies and procedures benefit from significantly lower risk of loss from fraud and theft. Furthermore, they have a better understanding of their practice's finances and human resources., (Copyright © 2015 American Dental Association. Published by Elsevier Inc. All rights reserved.)

Background: There is a dearth of knowledge about the type and frequency of adverse events (AEs) in dentistry. Current approaches to obtaining information rely on reviews of randomly selected records, which may not be the most efficient or effective methodology., Methods: Inspired by the Institute for Healthcare Improvement's (IHI) global and outpatient trigger tools, which identifies records with characteristics ("triggers") that are associated with AEs, the authors created the dental clinic trigger tool. The triggers included procedures for incision and drainage, failed implants and selected treatment patterns. The authors ran the trigger tool against six months of electronic health records data and compared its performance with that of a review of 50 randomly selected patient records., Results: In total, 315 records were triggered, 158 (50 percent) of which were positive for one or more AEs; 17 (34 percent) of the 50 randomly selected records were positive for at least one AE. The authors assigned each AE an IHI severity ranking. Most AEs caused temporary harm, but nine were considered to have caused permanent harm according to a modified IHI severity ranking., Conclusions: The study results demonstrate the promise of a directed records review approach, as the dental clinic trigger tool was more effective in identifying AEs than was a review of randomly selected records., Practical Implications: All dental practices should proactively monitor the safety of the care they provide. Use of the trigger tool will help make this process more efficient and effective.

Background: The usability of dental computer-based patient record (CPR) systems has not been studied, despite early evidence that poor usability is a problem for dental CPR system users at multiple levels., Methods: The authors conducted formal usability tests of four dental CPR systems by using a purposive sample of four groups of five novice users. The authors measured task outcomes (correctly completed, incorrectly completed and incomplete) in each CPR system while the participants performed nine clinical documentation tasks, as well as the number of usability problems identified in each CPR system and their potential relationship to task outcomes. The authors reviewed the software application design aspects responsible for these usability problems., Results: The range for correctly completed tasks was 16 to 64 percent, for incorrectly completed tasks 18 to 38 percent and for incomplete tasks 9 to 47 percent. The authors identified 286 usability problems. The main types were three unsuccessful attempts, negative affect and task incorrectly completed. They also identified six problematic interface and interaction designs that led to usability problems., Conclusion: The four dental CPR systems studied have significant usability problems for novice users, resulting in a steep learning curve and potentially reduced system adoption., Clinical Implications: The significant number of data entry errors raises concerns about the quality of documentation in clinical practice.

Background and Overview: The impact of digital imaging on dental practice depends upon the degree of planning conducted before implementation. Digital technologies have the potential to improve diagnosis; facilitate patient treatment procedures; and streamline storage, transfer and retrieval. These technologies also provide for secure backup of patients' image data, critical to re-establishing the practice should fire, flood or earthquake occur., Conclusions: The decision to invest in digital radiographic equipment should be a simple one for dental practitioners. Although digital x-ray sensors have long equaled analog film for diagnostic tasks, they have several advantages over film radiography, including immediate image production with solid-state devices; interactive display on a monitor with the ability to enhance image features and make direct measurements; integrated storage with access to images through practice management software systems; security of available backup and off-site archiving; perfect radiographic duplicates to accompany referrals; security mechanisms to identify original images and differentiate them from altered images; the ability to tag information such as a patient identifier, date of exposure and other relevant details; and interoperability of the Digital Imaging and Communications in Medicine file format., Clinical Implications: Most clinicians should contemplate integrating, at a minimum, intraoral digital x-ray sensors and a digital panoramic system into their practices.

Background: Most current paper- and computer-based formats for patient documentation use a two-dimensional dental chart, a design that originated almost 150 years ago in the United States. No studies have investigated the inclusion of a three-dimensional (3-D) charting interface in a general dental record., Methods: A multidisciplinary research team with expertise in human-computer interaction, dental informatics and computer science conducted a 14-week project to develop and evaluate a proof of concept for a 3-D dental record. Through several iterations of paper- and computer-based prototypes, the project produced a high-fidelity (hi-fi) prototype that was evaluated by two dentists and two dental students., Results: The project implemented a prototypical patient record built around a 3-D model of a patient's maxillofacial structures. Novel features include automatic retrieval of images and radiographs; a flexible view of teeth, soft tissue and bone; access to historical patient data through a timeline; and the ability to focus on a single tooth., Conclusions: Users tests demonstrated acceptance for the basic design of the prototype, but also identified several challenges in developing intuitive, easy-to-use navigation methods and hi-fi representations in a 3-D record., Clinical Implications: Test participants in this project accepted the preliminary design of a 3-D dental record. Significant further research must be conducted before the concept can be applied and evaluated in clinical practice.

Carefully following procedures in their practices will help dentists avoid legal pitfalls and go a long way toward providing a positive clinical service to their patients.

Digital photography almost has overtaken the conventional photographic film industry. Most professional photographers are using either digital photography alone or a combination of digital and conventional film photography. The trend toward digital photography is not likely to change. Using digital photography in the dental office is fast, easy and highly useful for documenting treatment, carrying out patient education and accomplishing clinical research. Supervision and use of this new technology can be delegated to staff members, and it will provide many benefits to dentists and patients.

Background: This article discusses how to integrate clinical and administrative workstations into your dental practice from the planning phase to the implementation phase. The author discusses the costs that are associated with integrating technology, as well as the hardware components and configuration. He then discusses in greater detail the core clinical technologies and how they tie in together to facilitate building a cohesive digital patient record., Conclusions: There are no shortcuts to successfully integrating technology into a dental practice. A significant commitment of time, energy and money is a prerequisite to building a secure and reliable computer network that incorporates all clinical and administrative applications., Practice Implications: Technology is reinventing the world, and dentists need to keep pace with the people they serve. These new and not-so-new technologies will enhance dental services and productivity, which ultimately will raise the bar for the standard of care in dentistry.

Background: Dental practitioners are faced with a myriad of high-technology tools. Many purchase these tools without fully understanding how to use them. It is necessary to look at the simple operations of a dental office and see where these products can be of value., Conclusions and Practice Implications: Patient care and communication can be enhanced substantially by using several new technologies. The practitioner can use these tools to improve--not necessarily change--his or her methods. The result should be a more efficient and productive dental practice.

Background: The purpose of this study was to evaluate the impact of a brief, interactive multimedia tutorial designed to prepare dentists to recognize and respond to domestic violence., Methods: The authors randomly assigned dentists and dental students to one of three groups: a control group or one of two experimental groups in a modified Solomon four-group design., Results: One hundred sixty-one dental students and 13 dentists completed the multimedia tutorial. At the posttest, subjects in both experimental groups demonstrated significantly better scores than did subjects in the control group on most items. The two experimental groups (pretest and posttest, posttest only) did not differ significantly from each other., Conclusion: An engaging, interactive tutorial presenting a simplified model for ways in which dental professionals can recognize and respond to domestic violence significantly improved dental students' knowledge of, and attitudes toward, the topic., Clinical Implications: Clinicians may improve the care they provide to patients by accessing this brief tutorial and following the lessons contained in it.

Background: The authors used a custom-built electronic record system to investigate endodontic diagnostic and treatment outcome data in patients with and without diabetes., Methods: The medical histories and endodontic treatment data for nonsurgical endodontic patients treated in predoctoral and postgraduate specialty clinics were entered into an electronic record system. A total of 5,494 cases (including 284 cases in patients with diabetes) were treated, and 540 cases (including 73 cases in patients with diabetes) had follow-up data two years or more postoperatively. The authors performed univariate and multivariate analyses to determine important factors affecting endodontic diagnosis and treatment outcome., Results: Patients with diabetes had increased periodontal disease of teeth with endodontic involvment compared with patients who did not have diabetes. There was a trend toward increased symptomatic periradicular disease in patients with diabetes who received insulin, as well as flareups in all patients with diabetes. Two years or longer postoperatively, 68 percent of cases followed were successful. Older age, the absence of preoperative lesions, the presence of permanent restorations and longer postoperative evaluation periods all were associated with a successful outcome. A multivariate analysis showed that in cases with preoperative periradicular lesions, a history of diabetes was associated with a significantly reduced successful outcome., Conclusions: Patients with diabetes have increased periodontal disease in teeth involved endodontically and have a reduced likelihood of success of endodontic treatment in cases with preoperative periradicular lesions., Clinical Implications: Patients with diabetes who are treated endodontically should be assessed carefully and be treated with effective antimicrobial root canal regimens, particularly in cases with preoperative lesions.

Background: Dental identification of skeletal remains frequently is accomplished via comparison of antemortem and postmortem radiographs. When dental radiographs are unavailable or of poor quality, the dentist may have to rely on other evidence such as study models, head and neck radiographs and anthropological examination results. The authors present a case report in which all of these modalities were used to identify skeletal remains., Case Description: The skeletal remains of a female adolescent found in a retention sewer were identified as those of a 14-year-old girl who had disappeared from her home one year earlier. The identification was based on anthropological findings, a comparison of antemortem and postmortem study models, and a comparison of antemortem and postmortem radiographs. CLINICAL IMPLICATIONS; Dentists who are called on by local authorities to assist with the identification of skeletal remains must be familiar with ways in which dental comparisons can be made when periapical radiographs, bitewing radiographs or both are unavailable.

Background: Risk management in dentistry has been developed over the years by concentrating on recording treatment in dental records and informing patients of the proposed treatment before treating them. This article advances the concept of risk management through higher involvement of the entire office staff by increasing communication with patients., Conclusions: By integrating practice management concepts with risk management techniques, dentists can reduce risk management exposure and improve patients' awareness, understanding and follow-through on the treatment of their dental needs., Practice Implications: Practice enhancement through risk management not only improves patient care and reduces risk exposure, but it also brings the dental team together in an effort to improve patient care. In this way, the office will have improved patient acceptance of proposed dental care and an increase in office growth.

Background: The authors compare patterns of oral health care reported by the Washington Dental Service, or WDS, Seattle, in 1993 and 1999 to assess changes in patient populations, practice characteristics, procedures and treatment costs in the state., Methods: Data were obtained from dental benefits claims from a population of about 1.25 million people. Variables of interest included patient age and other demographic information, character of dental practice, dental procedures and treatment costs that combined WDS payment and patient copayment., Results: The results showed high agreement (97 percent) between the database and randomly surveyed patient records. For both 1993 and 1999, general dental offices were responsible for more than 80 percent of patient care. Single crowns (21 percent), restorative services (15 percent) and dental prophylaxis (13 percent) made up about half of the costs of dental care. Broad categories of service were similar in 1993 and 1999, and anticipated major declines in restorative procedures related to caries were not apparent. The mix of services varied considerably by patient age and between generalists and specialists in both years., Conclusions: Patterns of oral health care among this insured patient population largely remained unchanged from 1993 to 1999, with some shifts in specific procedures and specialty care. During this period, dentists saw more patients and performed fewer treatments per patient, while total treatment costs per patient increased., Clinical Implications: Patterns of oral health care in the United States are projected to undergo major changes linked to improved oral health, declining trends in caries and periodontal diseases, scientific advances in treatment approaches and a patient population that is living longer. Changes in care patterns during this six-year period may reflect patient and provider preferences, as well as the influence of reimbursement policies. Dental benefits databases can serve as a critical resource for monitoring such changes.

Background: The pediatrics community has promoted the concept of a medical home to improve families' care utilization. The authors describe the medical home and propose a dental home concept to improve families' access to dental care., Description: The dental home is a locus for preventive oral health supervision and emergency care. It can be a repository for records and the focus for making specialty referrals. When culture and ethnicity are barriers to care, the dental home offers a site adapted to care delivery and is sensitive to family values., Clinical Implications: The dental home can provide access to preventive and emergency services for children. Establishment of the home early in the child's life can expose a child to prevention and early intervention before problems occur, reduce anxiety and facilitate referral.

Background: Dental informatics is a relatively new field that has significant potential for supporting clinical care. Most dentists are unaware of what dental informatics is, what its goals are, what it has achieved and how they can get involved in it., Methods: The authors conducted a literature review and several round-table discussions with dental informatics experts to discuss the preceding issues surrounding dental informatics., Results: Dental informatics is the application of computer and information sciences to improve dental practice, research, education and management. Numerous applications that support clinical care, education and research have been developed. Dental informatics is beginning to exhibit the characteristics of a discipline: core literature, trained specialists and educational programs., Conclusions: Dental informatics presents possible solutions to many long-standing problems in dentistry, but it also faces significant obstacles and challenges. Its maturation will depend as much on the efforts of people as on the collective efforts of the profession., Practice Implications: Dental informatics will produce an increasing number of applications and tools for clinical practice. Dentists must keep up with these developments to make informed choices.

Background: Health care is being changed dramatically by the marriage of computers and telecommunications. Implications for hospitals and physicians already have received extensive media attention, but comparatively little has been said about the impact of information technology on dentistry. This article illustrates how the digital transformation will likely affect dentists and their patients., Conclusions: Based on recent experiences of hospitals and medical practices, dentists can expect to encounter revolutionary changes as a result of the digital transformation. The Internet, the World Wide Web and other developments of the information revolution will redefine patient care, referral relationships, practice management, quality, professional organizations and competition., Practice Implications: To respond proactively to the digital transformation of oral health care, dentists must become familiar with its technologies and concepts. They must learn what new information technology can do for them and their patients and then develop creative applications that promote the profession and their approaches to care.

Background: Computer technology has revolutionized the way the world does business, allowing us to work faster, smarter and more efficiently than ever before. Computers first made their way into the dental office in the late 1960s as an accounts receivable device. Today, we can digitize anything and recall it in the operatory with the patient., Clinical Implications: This article discusses new trends in the digital patient record and the benefits this technology provides to the dental team in terms of improved data collection and recording. It also discusses the benefits a digital patient record provides to patients, as well as how to communicate patients' oral health needs using these electronic tools.

Background: The authors conducted a study to investigate the feasibility of having patients enter their health histories, or HHs, directly into a computer so the HHs then can be transferred into computer-based patient records. The authors examined a patient-completed, pen-based computerized HH questionnaire to determine if it is acceptable to patients, if patients answer sensitive questions on the HH questionnaire more forthrightly using a computer than a pen and paper, and if the availability of explanations and examples provided for each question on the computer questionnaire results in more accurate responses than on the paper version., Methods: Fifty subjects completed two almost identical versions of a 78-item HH questionnaire, completing either the pen-based, computerized version first or the paper version first. After the subjects finished the questionnaires, they completed an opinion survey about using the computer to provide their HHs., Results: Subjects responded favorably to the use of a pen-based computer questionnaire to provide their HH; 73 percent indicated that they would prefer to use it in the future rather than complete a paper questionnaire. The authors found that the overall reliability of answers was 93 percent with an average of 5.4 inconsistent answers between the two HH questionnaires., Conclusions: HHs can be collected efficiently and reliably from patients using a computer. It is important, however, that oral health care professionals review the data provided on HHs with their patients regardless of method used to collect them., Clinical Implications: Practices can expand the use of computers into more areas of patient care by having patients complete a computerized HH questionnaire. Computerized data capture is more legible, complete and efficient than a paper HH and can be imported directly into clinical data systems, thus avoiding data entry.

Background and Overview: Computers are becoming an integral part of the practice of dentistry. Smaller, smarter and more ergonomic computing devices will support an increasing proportion of dental practice activities. Technology will make practice management more efficient, mainly by reducing transactional overhead. Educational software and intelligent assistants will increasingly support the needs for decision making in clinical practice. Research will benefit from automated tools for data acquisition, management and analysis., Conclusions: Dentistry must actively shape the application of technology. It can do this by developing a cadre of experts in dental informatics, relying on sound research principles, effectively disseminating best practices and developing strategic objectives for the implementation of technology., Clinical Implications: Computer technology is an essential ingredient for state-of-the-art patient care. Dentists must stay current with this rapidly developing field to make appropriate choices in their use of technology.

Background: Mercury, or Hg, is a neurotoxin that has been speculated to play a role in the pathogenesis of Alzheimer's disease, or AD. Dental amalgam releases low levels of Hg vapor and is a potential source of Hg for a large segment of the adult population., Methods: The authors studied 68 subjects with AD and 33 control subjects without AD to determine Hg levels in multiple brain regions at autopsy and to ascertain the subjects' dental amalgam status and history. The subjects were from central Kentucky and Elm Grove, Wis. The authors conducted dental amalgam assessments during the lives of the majority of subjects and in some subjects at the time of autopsy only. The authors also determined three dental amalgam index scores--Event (placement, repair or removal of amalgam), Location and Time In Mouth--in addition to the numbers of and surface area of occlusal amalgam restorations. The authors determined Hg levels in multiple brain regions and performed full neuropathologic evaluations to confirm the normal status of the brain or the presence of AD., Results: The authors found no significant association of AD with the number, surface area or history of having dental amalgam restorations. They also found no statistically significant differences in brain Hg level between subjects with AD and control subjects., Conclusions: Hg in dental amalgam restorations does not appear to be a neurotoxic factor in the pathogenesis of AD. The authors found that brain Hg levels are not associated with dental amalgam, either from existing amalgam restorations or according to subjects' dental amalgam restoration history., Clinical Implications: Dental amalgam restorations, regardless of number, occlusal surface area or time, do not relate to brain Hg levels.

No comprehensive national study has ever been completed on the oral health status of people with disabilities, their patterns of use of oral health services and access-to-care barriers. The authors describe the Special Olympics, Special Smiles program, conducted as part of the New Jersey Summer Special Olympics Games, and assess a pilot-tested model for collecting epidemiologic data. The results of this initial data collection are also compared with the goals of the U.S. Public Health Service, as outlined in the Healthy People 2000 publication.

The use of computers in dentistry has expanded considerably in the last 15 years. Computer software can facilitate practice activities ranging from patient data management and financial management to treatment planning and electronic scheduling. This article addresses strategies for using technology to simplify and improve practice management.

A complete guide provides direction to the forensic dentist for greater accuracy in body identification. Methods used by a majority of forensic investigators are described in detail.

Patients scheduled to receive radiation therapy that involves the mandible, maxilla or salivary glands should be referred for dental consultation, assessment and clearance before therapy begins. A form that aids the radiation oncologist and the dentist in patient referrals is presented.

Two basic areas of risk management are recordkeeping and informed consent. Most dental offices can improve both to make the patient a more aware participant in care and make an unfounded allegation of negligence easier to disprove.

Questions have been raised about the safety of dental amalgam. The main point of contention is whether the mercury contained in dental restorations is released in sufficient quantities to pose a public health hazard. Most scientists agree that current evidence is not sufficient to show that amalgam restorations pose a general health threat. But researchers on both sides of this debate agree that much remains to be learned about any potential toxicity of dental amalgam--an issue serious enough to merit additional research.

Providers' periodontal diagnostic and treatment behaviors were assessed in 34 practices in two North Carolina counties. Regularly attending patients had a low prevalence of gingival pocketing on index teeth, moderate attachment loss, and fairly prevalent bleeding and calculus. Treatment frequency and patient knowledge were generally adequate, but the notation of periodontal status in the patient record was insufficient. A continuing education intervention resulted in substantial and significant improvement in notation rates. Changes in rates with which services were provided, and changes in patient periodontal status were smaller and mixed. The study shows that continuing education can be effective in helping some but not all providers adopt needed, appropriate behaviors.

This paper presents a case report describing the forensic dental investigation that enabled the identification of a decomposed dead body. The body was discovered under such circumstances that there were no known missing persons to account for its occurrence and no clues as to a possible identify. Through teamwork, fragments of nonspecific information were pieced together to point to a possible victim who had disappeared a year earlier and 1,400 miles away. Subtle dental and anthropologic peculiarities were detected and identified on antemortem medical radiographs made 3 years earlier, thus allowing a successful match. The extent of our nation's missing persons and unidentified dead problem is discussed. In a country where almost 40,000 cases of unsolved missing persons are recorded and 2,000 to 10,000 unidentified dead bodies remain anonymous, cooperation among jurisdictions and the use of dental evidence in a computerized form are the likely means of approaching this problem.