Dr. Marianne Schaefer
Forensic dentist Dr. Marianne Schaefer is very much like a detective who searches for clues in dental work.
(Photo courtesy of Mary Jane Photography)

She finds truth hidden in the tooth

Like a detective, Dr. Marianne Schaefer helps identify unidentified bodies by looking at their teeth. She is a forensic dentist who is a member of the Cook County Medical Examiners Disaster Response Team. She is called in when circumstances require.

Schaefer began her career as a regular dentist. In fact, she also continues her 20-year-old private practice. But during her dental training, she had the opportunity to work with one of her professors on the John Gacy case. The professor helped identify bodies Gacy had buried in his basement.

We invited you to ask Dr. Marianne Schaefer any questions you might have about her job and her experiences as a forensic dentist.

She answers them here.

What does a dead person’s mouth smell like?
—Jason Kehoe

I suppose it depends on the state of the decomposition of the person.

Can you tell if a person is male or female just from their teeth?
—Cyndi Kehoe

Yes and no. There are many “female” or “male” characteristics of teeth but sex determination is frequently made by reviewing differences in the skull and skeletal remains.

What if the person wore dentures? Is there any way you are able to identify them from the wear and tear on their jaw line?
—Lauren DeBarsh

A law exists that requires dental laboratories to inscribe names into dentures. And although the identification of an edentulous mouth might be harder to do, the availability of bone patterns in antemortem and postmortem x-rays makes the identification of toothless individuals possible.

Do teeth burn?

Yes, teeth will be destroyed by heat if the temperatures are high enough. This occurs rarely, however since the temperature around the teeth must exceed 1000F.

The teeth are protected by the soft tissue of cheeks, lips and tongue. Materials used for dental restoration are also resistant to destruction. Materials used for dental restoration are also resistant to destruction. Fillings generally can withstand high temperatures exceeding 1600F.

I always watch those Forensic Detective shows on cable. I’ve always wondered…with something like the Gacy case where it was a mass murder and you had a number of skulls, how do you figure out which teeth go to who?
—J.E.R.

In that particular case, the forensic odontologist found it particularly difficult to work because the bodies were stacked one on top of another, leading to co-mingling remains.

Dentists and anthropologists worked long and hard hours to bring closure for the families. In most cases, the teeth remained positioned in the jaw, which made the portion of the identification easier then working on mass disasters in which not only are the remains co-mingled, bat jaws can be fractured and teeth avulsed.

How fast do teeth decompose? Do they ever decompose?
—burt w. in P.A.

As evidenced by exhumed, mummified bodies, bones and teeth are extremely resistant to decomposition. This is why they are used in forensics and anthropology. The environment determines the amount of decomposition.

Why do you think people are so scared of going to the dentist?
—Debbie

People are fully conscious during dental procedures and must allow another person, who is a stranger to invade their personal space, doing a procedure that has the potential to be painful.

It has been my experience that this “giving over of power” is what patients fear the most.

Does each mouth have a distinct
‘fingerprint’ or can siblings or a parent and child have nearly the same teeth?
—sam i am

There are subtle differences that can distinguish the teeth between even highly similar family members. However, at a time in which orthodontics is readily available and decay is less prevalent, some forensicists feel that identification may become more difficult.

My teenager son has two yellow front teeth. How safe is bleaching? How long will it last?
—Melona

There are many types of bleaching procedures. If you are seeking to change the color of only two teeth, you may want to ask your dentist about the chair side bleaching procedure that is commonly done with the combined use of a re-agent and a heat source or laser.

Some sensitivity might occur, and color change could also occur depending on dietary habits and other oral habits the person engages in.

I could use a good dentist in the Joliet area. Could you help me find one? Also, I would like a dentist that does their own root canal.
—Rushatu@aol.com

It is sometimes difficult to find a dentist with whom you feel completely comfortable. It is important that the doctor and patient establish a good rapport for thorough communication. There are many good practitioners waiting to meet you with great anticipation.

Perhaps you would consider asking for a referral from a trusted physician.

Do you analyze bite marks for comparison in criminal investigations? (I have had occasion to utilize the services of a forensic odentologist in the past.)
—Don

Yes, this is some of the work that I have been trained to do, and cases are presented to forensic odontologists by a variety of sources.

In Cook County, the homicide cases are presented to the Office of the Medical Examiner and handled by the Office of Forensic Odontology, headed by Dr. Sandford Block.

Forensic dentists are free to accept cases presented to us, but most of us feel that shared knowledge and teamwork are a more professional approach to case involvement.

Hello,
If a tooth had a root canal can DNA id be possible? Can replacement tooth materials be traced to their origin?
—Mike maxplz@aol.com

I don’t quite know how to answer the second part of your question because I don’t understand it.

What I can tell you is that most forensicists would not choose to use a tooth that has been root canalled for the purpose of the extraction of DNA, since, generally the most DNA rich site would have been the dental pulp enclosed by the coronal chamber.

Some DNA may be removed from the dentin or cementum, but for the purposes of specific identification by DNA, if a tooth is not intact, then the sectioning of fragmented teeth is attempted.

How long can my cavity go without needing a root canal? The cavity is on my molar and is black and canyon-like? I have no money to fix it RIGHT NOW.
—classcgrl1

May I suggest that a succinct answer to your question would be impossible without examining you and taking an x-ray of the tooth.

If you can not afford to see a dentist at the moment, would you consider seeking emergency care at one of our two remaining dental schools.

If they don’t work, how does the FTC allow toothpaste manufacturers to sell products that supposedly will whiten teeth? Was that you at the Hyde Park Baroque concert recently? Who was the handsome guy with you?

Toothpaste manufacturers are held to the same truth in advertising statutes that govern most other consumer issues. The whiteness of teeth is a highly subjective observation. My taste in music tends to be a bit more eclectic. Look for me at the next Metallica concert.

I saw a show on the Learning Channel recently. The police THOUGHT the woman was dead, but could not prove it. When they found ONE tooth, they said they had all the evidence they needed to identify her. How is it possible to conclude an identity from only one tooth?
—Trevor

There is a discrepancy in forensics that many of us are faced with on a regular basis. The discrepancy frequently surrounds the willingness of an individual or group of individuals to “positively identify” an individual or a bite mark using limited evidence.

Most of us who would find a single tooth would be hard pressed to positively identify it as missing remains, (no matter how unusual the morphology) unless DNA analyses were used. The DNA can be extracted from within the tooth.

What kind of work will need to be done out at the Amtrak crash site?
—David Stedler

Investigators will evaluate the scene of the accident. The victims’ bodies will be transferred to a temporary morgue facility for identification.

Jurisdiction of identification will be decided, and a team of forensic specialists will attend to the remains.

Based on the travel manifest, antemortem records will be requested from the families’ dentist for each individual suspected to have lost his/her life.

Can a DNA sample large enough to test be drawn from teeth? If so, how long after death can this be done?
—Tim Lasby

A sample of DNA is normally extracted from the dental pulp chamber. If the tooth is broken, DNA can be extracted from crushed portion, however, a better sample is retrieved from an intact pulp chamber.

Does your business get REALLY gory?
—Jessica

Gory is such a subjective term. If working with human remains in various states of decomposition, would seem unpleasant to you, then yes, it can be gory.

However, a forensic dentist rarely visits a crime scene. In my opinion, crime scenes might be more upsetting for the majority of people.

I’ve always been interested in the solving of mysteries. Are there any jobs in the field of forensic dentistry that don’t require a degree in dentistry. If so, what are they?
—egmain

The field of forensic science is comprised of a tremendous number of occupational fields. For example, there are forensic psychologists, psychiatrists, anthropologists and nurses. There are even forensic engineers whose structural investigations encompass the reasons for failures leading to human injury and death.

Some people who enjoy working as a team member in crime solving situations pursue a career as crime scene investigators.

Why is the word “forensic” involved with both speech teams and your line of work?
—Laura

I’m sorry, but I’m not familiar with the word “forensic” used in association with speech teams. Stedman’s Medical Dictionary’s definition of the word is as follows: "Pertaining to, as used in, legal proceedings.’

Have you ever worked with Dr. E. Steven Smith on a forensic case?

I feel privileged to have known Dr. E. Smith as both a professor and a colleague.

Dr. Smith has been the mentor for many forensic dentists and will continue to share his knowledge and expertise with dentists in his new location.

With the closing of Northwestern Dental School, we have lost many talented people as local authorities.

Does the enamel of one’s tooth have a “finger print” similar to that on one’s finger?

No, that is the wrong concept. The shape of the tooth, the morphology of the crown and the type of filling that might exist “marks” the tooth in a unique fashion.

I still can’t understand how anyone can be identified by the dental work.
—sarah lopez

There are 32 teeth in the average adult mouth and five surfaces per tooth.

There are a variety of materials used to restore teeth. Comparisons of x-rays before death (antemortem) with x-rays of the remains (postmortem) can reveal unique patterns.

I work for Dr. Edward Pavlik. Do you know him? He worked with the Gacy case also. He also did the plane crash in 1979, and Christopher Meyer.
Please respond.
—Kris LoBue Krisie1223

Most every forensic dentist knows of Dr. Pavlik and his fine work. His careful, detailed work has helped to set many of the standards for forensic dentists currently. You are fortunate to work for such a talented individual.

Does this include artificial teeth? Are they all different also, or all the same?
—Mike Lamonica

Artificial teeth can aid in identification, but forensic dentists rely heavily on bone patterns of the jaws in toothless individuals.

What was the most gruesome case of forensic dentistry that you can recall from personal memory? What was the most difficult/ challenging case?
—Lothar Sanchez-Speer

I think most forensic dentists would agree that the Florida Everglades’ air crash was a most difficult identification scenario.

The remains were not only fragmented and co-mingled, but scattered or eliminated by the presence of scavenging animals.

In terms of gruesome, I am sure Dr. Pavlik would agree that the Gacy case upset even some of the stronger individuals involved.

What’s the worst thing about your job? Is there one?
—Tony

For me, the most difficult situations are those that deal with child abuse.

Is it likely that you’ll find skeletons with the full jaw and all the teeth? Or is it more common just to find a couple of teeth and have to take it from there?
—S.P.R.

In accidents and mass fatalities, you are more likely to have fragmented remains. In homicides, you may more frequently find teeth in jaws and jaws intact, unless the perpetrator intentionally tries to mask the identity of the victim.

Is there anything that still amazes you about your line of work?
—Michael V.

Yes, the inventiveness and resourcefulness of the various forensics specialists who must frequently face unusual circumstances in identification used in unusual environments.

For instance, a forensic dentist and forensic entomologist combined forces to determine that the remains of a deceased had been moved from the original site of the murder based upon the type of maggots found in the oral cavity.

How much do forensic dentists make? Is a great paying job?

Forensic dentists can be paid by Federal, State, or County agencies. The preparation of work necessary to formulate an expert opinion can be compensated by either defense or prosecution.

Most forensic dentists maintain their private practices because may perform this service as an expression for their love for the science.

You said that this is a “job that few women hold”.How come?
—Evelyn McMullen

I don’t know but I would welcome more women entering this field.

What kind of education would you recommend if someone was interested in forensics?
—Jeffrey Samuels

I would recommend a background in basic sciences and perhaps some course work in criminal justice or corrections.

I imagine that you come in touch with a great deal of tragedy in your line of work – how do you deal with that?
—Kim

Personally, I rely on the love, support and humor of my friends and family. I find cases involving child abuse too “charged” and might defer them to another dentist more able to handle them in an impartial manner.

Can you still find clues if the person never had any dental work? Like no cavities or anything?
—Nathan

Yes, shapes of teeth, shapes of roots of teeth and bone patterns, as well as sinus structure can lend themselves to identification by forensic odontologists.

Since the jaw is one of the strongest muscles and rig sets here first…how do you get the mouth open? Then how do you close it?
—blb176

If remains are considered “unviewable” by the mortician involved, the jaws may be excised for view. If the jaws are to remain intact, forensic dentists will use anything from manufactured wedging instruments to wooden levers.