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REVIEW ARTICLE
Year : 2021 | Volume
: 10
| Issue : 2 | Page : 95-107
Can dermatoglyphics predict dental caries? A review
Shreyasi Roy, Jaydip Sen
Department of Anthropology, University of North Bengal, Darjeeling, West Bengal, India
Correspondence Address:
Dr. Shreyasi Roy
Department of Anthropology, University of North Bengal, NBU Campus, Raja Rammohunpur, Darjeeling - 734 013, West Bengal
India
Source of Support: None, Conflict of Interest: None
CheckDOI: 10.4103/ijhas.IJHAS_173_20
Dermatoglyphics is the study of epidermal ridges present on the palm, sole, fingers, and toes. Apart from judicial and legal investigations, it has also proved to be valuable in the diagnosis of many diseases, especially of genetic origin. The etiology of dental caries proves to be multifactorial. Although it is thought to be of microbial origin, several researches have proved it to have genetic predisposition. This has urged many researchers to use dermatoglyphics as a tool for screening dental caries. However, there exist a limited number of studies that have attempted to evaluate the association of dermatoglyphics with dental caries. The aim of the present review is to systematically identify, review and appraise available literature that evaluated an association of different dermatoglyphic variables with dental caries. In-depth screening of the titles, abstracts, and full papers yielded 48 studies pertaining to this issue. From the selected studies, we inferred that the presence of higher number of whorls and lesser number of loop patterns can predict the susceptibility of dental caries among the participants.
Keywords: Association, dental caries, dermatoglyphics, loops, whorls
“Dermatoglyphics”…. a term introduced by Cummins in a presentation at the 42nd annual meeting of the American Association of Anatomists in 1962. It would be worth mentioning here that before Cummins, dermatoglyphics began scientifically with the publication of Purkinje's thesis[1] and Galton's classic book “Fingerprints.”[2] Etymologically “dermatoglyphics” is a harmonious blend of two words “Derma” which means skin and “Glyphe” meaning carve, which gives an impression that something has been carved out of skin.[3] In other words, it reflects the study of epidermal ridges and their patterns they make on the fingers, palms, and soles.[4] It has wide application in the field of criminology. In addition, it acts as a powerful tool in the diagnosis of psychosocial, medical, and genetic conditions through many decades. It has been used as a tool in finding any association with various diseases in terms of etiology and pathogenesis ever since Cummins[5],[6] demonstrated abnormalities in the dermatoglyphics of the palms and fingers of Mongols.
Dental caries are one of the most common oral health diseases. It is the scientific term for “tooth decay or cavities.” It is defined as a microbial disease of the calcified tissues of the teeth, characterized by demineralization of the inorganic portion and destruction of the organic substance of the tooth.[7] According to World Oral Health Report of 2003, it is stated as one of the pandemic diseases affecting all population irrespective of gender, age, or socioeconomic status.[8] To quantify dental health status, an index named decayed, missing, and filled teeth (DMFT) or decayed-missing-filled surfaces (DMFS) is used. DMFT or DMFS is the sum of the number of decayed, missing due to caries, and filled teeth/teeth surfaces in the permanent set of teeth. Another similar index named 'def' is also used which is equivalent to DMF index and is generally used for measuring dental caries in primary dentition. These indices are one of the simplest and most commonly used indices in the epidemiological surveys of dental caries.[9] However, there exist several other better methods to quantify oral health. The sole reason for mentioning this index in the present review is that all studies [mentioned in [Table 1] had utilized this index while assessing dental caries among the participants.
The basis of using dermatoglyphics as a tool for screening dental caries is solely reliable on two factors. First, the genesis of dermal ridges occurs during the 12th week of the intrauterine life and is completed by the 24th week of intrauterine life. During this time, tooth formation also occurs in intrauterine life.[56] Consequently, this conveys that the genetic meaning contained in the genome, normal or abnormal, is decoded during this stage and could also be replicated by dermatoglyphics.[58] Second, epithelium of primary palate as well as finger buds develops from the same site and both are of ectodermal origin.[59] Thus, it could be conjectured that with genetic susceptibility and added environmental factors the proneness for dental caries due to abnormality in the tooth structures may be reflected in the dermatoglyphic variables, namely whorls, loops, and arch patterns.[51]
Dental caries is a major oral health problem, especially among children. There are a limited number of studies that studied the association of dermatoglyphic variables with dental caries. Hence, at the outset, the present study has tried to conduct a review to find the association of dermatoglyphic variables with dental caries. The review will aid in contextualize the findings of studies related to this issue.
Materials and MethodsThe present study was conducted during the period of June 2020–October 31, 2020. This review is reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. Circumstantial information on the studies of association of dermatoglyphics with the occurrence of dental caries was acquired from various peer-reviewed indexed journals abstracted in various databases such as PubMed® (Medline), POPLINE, Cochrane Library, and Trip Database. In addition, the search was also done through various gray literature sources, namely OpenGrey, Google Scholar, and Google. The search string (”dermatoglyphics” [MeSH Terms] OR “dermatoglyphics” [All Fields]) AND (”dental caries” [MeSH Terms] OR (”dental” [All Fields] AND “caries” [All Fields]) OR “dental caries” [All Fields]) was employed. Available full text articles and abstracts were screened based on the following inclusion and exclusion criteria.
Inclusion criteria
Peer-reviewed journal articles that studied the association of dermatoglyphic variables with dental cariesOnly original articles and brief reports or communicationStudies that had assessed dermatoglyphic features on all fingers of both hands.Exclusion criteria
Studies available in non-English languageStudies whose abstracts were not availableStudies that had taken only thumbprintsStudies that included other factors such as twin-zygosity, dexterity, impacted tooth, gingivitis, and bruxism.The search retrieved 66 publications till October 2020 [Figure 1]. Out of 66 publications retrieved, seven publications (including abstract and full papers) were discarded as they included duplicated references. As a result, a total of 59 publications (abstracts and full papers) persisted for further analysis. Out of these 59 publications, 11 articles were excluded based on the various inclusion and exclusion criteria mentioned above. Ultimately, 48 publications (seven abstracts and 41 full papers) were included for the present review.
Results and DiscussionFrom each and every included study, details such as sample size, age, place of study, findings of the study were extracted, and accordingly, the characteristics of the included studies were framed [Table 2]. Almost all the studies were conducted on the basis of comparison of case and control groups. The case group mainly consisted of individuals with dental caries (with high DMFT) whereas the control group is devoid of dental caries (with less or no DMFT). In addition, studies were conducted only with finger prints and palm prints. The use of plantar region or sole prints is not seen in any of the studies.
Characteristics of the study populations
Out of 48 selected publications, 11 of them have not mentioned their place of study[10],[12],[16],[20],[24],[39],[43],[4]5,[46],[55],[57] It would be misleading if we guess the place of study through the information furnished in the “authors” information section' as several researchers sometimes work at a different location away from their respective working institute. Therefore, 37 studies were analyzed while counting the number of studies based on location. Fourteen studies were conducted on the southern part of India, i.e., 1 in Telangana region,[26] 2 in Tamil Nadu,[41],[51] 3 in Andhra Pradesh,[22],[27],[33] and 8 in Karnataka.[17],[18],[37],[44],[47],[52],[53],[54] Remaining studies include eight studies in Uttar Pradesh,[15],[23],[25],[35],[36],[40],[50],[56] 4 studies in Gujarat,[19],[31],[34],[42] 2 studies in Punjab,[14],[38] 1 study in Assam,[13] 1 study in Bihar,[11] 1 study in Maharashtra,[28] 1 study in Madhya Pradesh,[30] 1 study in Himachal Pradesh,[48] and 1 study in West Bengal.[49] Three studies were from outside India.[21],[29],[32] Higher number of studies was seen comparatively in the southern states of India. This could be due to the prevalence of more dental caries in the southern part of India, as illustrated in a review by Mehta.[60] The ethnicity of the participants was not vividly mentioned in the selected studies. Aiming toward the years at which those 48 selected studies were conducted, year from 2010 to 2020 (till October 2020) yielded higher studies (i.e., 46 in number) than the period before 2010 which have just two studies.[56],[57] Focusing our view on the age group that had been chosen as participants in those 48 selected publications, it can be inferred that four studies did not mentioned the age groups of the participants,[14],[46],[55],[57] 13 studies had preschool children,[11],[12],[17],[21],[24],[32],[36],[40],[43],[44],[50],[54],[56] 28 studies had nonpreschool and adolescent children as their participants of study,[10],[13],[15],[18],[19],[20],[22],[23],[25],[26],[27],[28],[29],[31],[33],[34],[35],[37],[38],[39],[42],[45],[47],[48],[49],[51],[52],[53] and three studies with adult group as their participants.[16],[30],[41] Higher number of studies on this issue has been conducted on children as dermatoglyphics proved to be an effective tool in screening early childhood dental caries.
The sample size is also an important parameter to be discussed. Out of 48 studies, 2 had not mentioned about their sample size.[46],[57] Henceforth, on the basis of sample size, we will classify the remaining 46 studies into four groups: Very small (≤100),[10],[11],[13],[17],[19],[20],[21],[23].[24],[25],[27],[30],[33],[37],[38],[39],[40],[41],[45],[50],[53],[55],[56] small (101–500),[12],[14],[15],[16],[26],[28],[29],[31],[32],[34],[35],[42],[43],[44],[47],[48],[49],[52],[54] medium (501–1000),[18], [22], [36] and large (>1000).[51]
Findings of the selected studies
It could be inferred that the selected studies vary greatly in their sample sizes which could create hindrances to compare them thoroughly. In addition, the sex and age of the individuals and the location of the study field were inconclusive in many studies. Furthermore, the case and control groups were classified on the basis of DFMT/DFMS/def score which too varies widely in their numerical values. Despite these limitations, we had framed a short summary of the findings of the 48 selected studies [Table 1]. Nearly 36 out of 48 selected studies have claimed that the dental caries susceptibility of an individual increases with an increase in the incidence of whorl pattern and it decreases with an increase in the incidence of loop pattern (especially ulnar loops). Out of the remaining 12 studies, seven studies claimed just the opposite.[10],[17],[31],[39],[40],[44],[47] The findings of the remaining 5 studies were inconclusive.[12],[29],[33],[37],[49]
Out of 48 studies, only 14 studies had showed association of total finger ridge count (TFRC) with dental caries.[11],[16],[18],[19],[21],[24],[26],[35],[41],[43],[47],[49],[54],[55] Out of them, nine studies have claimed that higher TFRC could be found in caries-free participants or participants with less caries.[11],[21],[24],[26],[35],[41],[43],[47],[54] On the other hand, the remaining five studies have claimed just the opposite. Out of the total studies, only 8 studies have included atd angle in their studies.[11],[19],[21],[27],[32],[40],[43],[55] 2 out of these 8 studies had found insignificant correlation between atd angle and dental caries.[19],[27] On the other hand, remaining six studies[11],[21],[32],[40],[43],[55] claimed mean atd angle to be higher in caries-free/control group. Owing to such meagre amount of studies, the association is inconclusive.
It could also be found that several of the selected studies mentioned in [Table 1] had compared their dermatoglyphics findings on each of the digit of the participants. Few of them have compared dermatoglyphic findings of both the hands. Some have also made sex-wise comparison. These findings though could not be compared in the present study due to immense differences in sample sizes, data interpretations, and statistical findings.
ConclusionThe present review found insufficient data to support any strong dermatoglyphic relationship with dental caries, in general. The study inferred that participants with dental caries have shown a higher prevalence of whorls compared to caries-free participants and/or participants with minimal dental caries. On the other hand, caries-free participants (or participants with least dental caries) bear higher prevalence of loops in their digits. In addition, higher TFRC could be found in participants with no or minimal dental caries. However, several factors limit such interpretations such as limited sample size, limited number of studies on such theme, inconsistency among case and control groups, neglecting the diet history during analysis, etc., More studies with better protocol, greater sample size, and vivid comparison among the dermatoglyphic variables can yield better interpretation. More advanced studies with larger sample group and with environmental and bacterial factors as coordinates are required.
Limitations
As with the majority of studies, the design of the present study is subjected to few limitations, such as (i) majority of the findings were statistically insignificant and (ii) all sorts of dermatoglyphics properties could not be compared due to the lack of data and clear interpretations in some papers.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
References
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