Substance-induced dental damage

Dental hard tissues have a unique property to retain traces in susceptible conditions, making them valuable for forensic investigation due to their resistance to physical, chemical, and biological degradation. This three-fold study explored the potential of analysing dental tissues for the detection of substances and trace elements, including a scoping review on PubMed, Scopus, and Web of Science; a global JISC e-survey sent to relevant professionals; and the development of 3D digital models. Three-quarters of the scientific publications that met the criteria were experimental and used molars and premolars. Studies focused mainly on drug detection using gas or liquid chromatography, combined with mass spectrometry. Experiments using acids were more popularly studied, followed by morphine, codeine, and cocaine, but only half included visual representation. A total of 160 respondents from 37 countries shared information on substance-related dental alterations; only 35.6% had formal education on substance-related dental changes, 14.4% felt confident handling such cases, and 8.1% correctly identified all five conditions in image-based survey questions. Images of generalised fluorosis and tobacco stains were more correctly identified than methamphetamine. Three 3D models (licit drugs, illicit drugs, chemicals/elements) were developed using Blender 3D, ZBrush, and Adobe Substance Painter and are accessible via the Sketchfab 3D viewer and a dedicated website for education and consultancy. These findings highlight limited familiarity and training among professionals in recognising substance-induced dental changes, alongside poor access to visual and educational resources, particularly on illicit drugs. The 3D digital models have been created to address this gap, enhance awareness and support forensic practitioners in interpreting substance-related dental evidence in casework.