underwater earthquake is a natural phenomenon
that can create a tidal wave called a
tsunami. Tsunamis can be initiated by
the movement of the earth’s tectonic
plates that registers greater than 7.0
on the Richter scale. The wave may cause
major destruction to any coastal areas
within the tidal wave’s reach. Usually,
the deceased are identified and a sample
of DNA can be analyzed soon after death.
However as decomposition occurs, the identification
becomes more difficult. Forensic dentistry
is a valuable tool in this situation.
Sunday, December 26th, 2004 at 9:50 AM,
the southwest coast of Thailand was crushed
by an enormous tidal wave from an underwater
earthquake near the Sumatra Island of
Indonesia. The tsunami caused horrific
destruction and brought out unimaginable
remorse and shock from the coastal communities
of the Indian Ocean.
Wednesday, December 29th, The Dean of
University Faculty of Dentistry, Dr.
Theeralaksna Suddhasthira, called an emergency
meeting of our Faculty Board and arranged
the relief force of our school to reach
out to the Southern Coast affected by
the disaster. The most damaged of the
affected six Thai provinces affected,
Phang-Nga at Takaul-Pa District, was the
focus of the MU Team. It was reported
that the beach areas of Phuket, Pathong,
Kamala, Kata, Karon, and Niyang were in
Since there were thousands of unidentified
bodies recovered from the ocean debris,
it became the burden for forensic specialists
to perform basic identification of the
corpses. Dean Suddhasthira strongly encouraged
MUFD staff to volunteer for this task.
That Wednesday afternoon, more than four
hundred volunteers showed up revealing
the compassionate spirit of our institution.
The 60 volunteers of the first task force
were transported the following day at
6 AM by Royal Thai Air Force from Bangkok
to Phuket Province. Our team comprised
instructors, dentists, dental students,
dental assistants, dental technicians
and other staff. A meeting of the representatives
from different institutions was conducted
to sort out a job description for each
team in Phuket. Another team had to survey
affected sites to manage situations in
areas of Phuket and Phang-Nga. It was
decided that MUFD would assist the forensic
medicine team in Phang-Nga, where identification
was the most needed. To identify the more
than three thousand bodies, each team
was instructed to perform basic identification
and provide any necessary assistance to
the primary forensic medical teams in
Yan-Yaow and Bang-Moung Temples.
Khunying Porntip Rojanasunund, the Vice
Director of the Thai National Forensic
Institute, was in charge of the disaster
response and was working tirelessly in
the field. Needless to say, the bodies’
were horribly decomposed and the odor
was unbearable. However, with inspiring
fortitude the volunteers continued to
open body bags to establish general and
specific descriptions of the bodies.
Our dean inspired us to perform our best
although some of the bodies were decayed
to the point that race or nationality
was indistinguishable. At the time, DNA
examination also was required for positive
identification. Some of our team members
also performed tooth extractions and radiographic
records to be used in conjunction with
the DNA identification process. It was
not easy extracting teeth or take radiographs
since the drowning victims’ jaws
were tightly closed. It took many resections
of the muscles to remove the mandible
for further examination.
More than three months after the disaster,
volunteers from our faculty continued
to take turns with the mission to identify
victims. Nearly a year later, the institution
still supports activities such as HRH
Princess Maha Chakri Sirindhorn’s
dental mobile services that offer dental
treatment, oral health and hygiene recommendations,
and providing consultation to the Ministry
of Public Health among others. To date,
more than 600 volunteers from MUFD have
participated in the relief and recovery
Method of Dental Analysis
of the oral examination is an invaluable
process in identification of the
extensively decomposed bodies. The
criteria are listed below.
1. General dental examination of
the remaining dentition
2. Radiographic examination
3. Extraction of a tooth for DNA
Process of Identification
1. Dental charting: collection
of data from oral examination.
2. Radiographic Examination: six
periapical films (three maxillary
and three mandibular).
3. Tooth extraction for DNA analysis
with Siriraj and Ramathibodhi hospitals.
4. All data is recorded digitally
for further cross matching of victims.
dental examination by nature is a difficult
process and can be easily complicated
by many factors. In this case, since there
was a vast number (3,000) of bodies in
the field that were decaying, dental examination
was exceedingly difficult. Another specific
problem was that there were inadequate
personnel to perform this time-consuming
task. It was not difficult to feel overwhelmed
in a situation as this. Also, the accommodations
for the volunteers were a long three hour
journey from the site. This is not to
detract at all from the generous hospitality
of the Hilton Phuket Acadia that waived
Mahidol’s expenses without hesitation.
Suggestions for improvement are below.
1. Additional teams need to be sent to
perform the unremitting identification
2. Panoramic examination should be used
instead of periapical radiographs.
3. Accommodations should be closer to