Abstract
Background
Dental caries, a major public health concern, is impacting millions of people worldwide. Its etiology being complex, nevertheless, a possibility of true genetic dental decay has puzzled dental researchers for years, as anatomical structures, namely, lips, thumb, and tooth enamel, are derivatives of an embryonic germ layer, the ectoderm.
Aims and objectives
The study aims to know the association between lip print and tooth decay and to determine the type of lip print that is most susceptible to tooth decay. To determine this relationship, the lip print samples (lip prints) were extracted from the subjects and segregated according to their types and the presence of dental caries.
Methodology
A descriptive, cross-sectional study was conducted among 110 children aged 6–9 years by cheiloscopy and examination of dental caries using decayed, missing, and filled teeth (DMFT)/decayed, extracted, and filled teeth (DEFT) index. The recording of lip prints was done on bond paper and analyzed using Suzuki and Tsuchihashi's classification.
Result
In our research, lip prints with branched pattern (type II) were seen in majority of the samples with a higher incidence of caries.
Conclusion
The study aided us in correlating certain patterns that may be related to specific incidences of dental caries and their association. Type II (branching) pattern was predominant among the cheiloscopic patterns recorded in our study.
How to cite this article
Kashani RN, Kaul B, Rajput S, et al. Cheiloscopy—Your Identity, Our Indicator: A Cross-sectional Study to Evaluate the Relationship between Lip Prints and Dental Caries in Children of Jammu Province. Int J Clin Pediatr Dent 2025;18(8):992–996.
Keywords: Cheiloscopy, Dental caries, Lip prints
Introduction
Cheiloscopy, a scientific study of lip print pattern, was first documented by anthropologist R. Fischer in 1902, marking the earliest recognition of the forensic significance of lip morphology.1 It is defined as a method of identifying a person based on the characteristic arrangement of lines appearing on the red part of the lips.2
It holds importance because, like fingerprints, lip prints too are permanent, unchanging, and unique to each person except for identical twins, identifiable from the sixth week of intrauterine life.3 They have been proven to recover from changes, such as trauma, inflammation, and disease. Their distribution and shape of grooves are immune to changes in environmental factors.4
It is a well-known fact that parts of the facial skeleton, especially lips, commence to take shape during the sixth to seventh week of intrauterine life.3 Interestingly, teeth too develop simultaneously during similar term. Thus, our study aimed to determine the predominant lip pattern for caries predilection, using cheiloscopy as a noninvasive tool.
Aim
The study aims to access the relationship between lip prints and dental caries among children aged 6–9 years of Jammu province.
Methodology
Sampling
The study was conducted at Indira Gandhi Government Dental College (IGGDC), Department of Pediatric and Preventive Dentistry, Jammu. A total of 110 eligible children were randomly selected. Age eligibility required subjects to fall within the appropriate age-group of 6–9 years at the time of sampling.
Planning
The study took place between October and December 2022.
Cheiloscopy
Lip prints were recorded by applying petroleum jelly around the lips using a swab, later lipstick evenly, on the upper and lower lips in one motion.
The cellophane tape was cut into rectangular sections using scissors and glued to the lips. The tape was then carefully pulled out from one end to the other to prevent smearing of the lip prints obtained, and was mounted on office paper, as a record kept for each child.5
The Suzuki & Tsuchihashi classification was used to determine the lip pattern type.
Classification by Suzuki and Tsuchihashi4
Type I: Vertically running clear grooves across the lip.
Type I′: Type I partial length groove.
Type II: Branched groove.
Type III: Intersecting groove.
Type IV: Reticular pattern.
Type V: Other designs.
Dental Examination
American Dental Association (ADA)-specified type III dental examination was carried out according to the World Health Organization (WHO) 1997 recommendation, with mouth mirror, probe, tweezer, and adequate illumination.
All the teeth were examined for DMFT/DEFT index.
DMFT/DEFT ≥ 3—carious.
DMFT/DEFT < 3—control.
Inclusion Criteria
All participants were in the age range of 6–9 years.
All participants were life residents of Jammu province.
Exclusion Criteria
Individuals having inflammation, trauma, surgical scars, congenital anomalies, or active lesions of the lips or finger.
Statistical Analysis
The statistical analysis was executed using IBM SP SS21 software, with data being compared using Chi-square test.
Results
The study was conducted among 110 children, in the department of Pediatric and Preventive Dentistry, IGGDC, Jammu. The study was done to assess the relationship between various cheiloscopic patterns with dental caries Tables 1 to 3.
Table 1:
Cheiloscopy types
| Type—cheiloscopy | Frequency | Percentage (%) |
|---|---|---|
| I | 32 | 29.09 |
| II | 44 | 40 |
| III | 16 | 14.55 |
| IV | 08 | 7.27 |
| V | 10 | 9.09 |
| Total | 110 | 100 |
Table 3:
Association between cheiloscopic pattern and DMFT/DEFT
| Type—cheiloscopy | DMFT | p-value | |
|---|---|---|---|
| <3 (%) | ≥3 (%) | ||
| I | 24 (42.11) | 8 (14.04) | 0.001* |
| II | 7 (12.28) | 37 (64.91) | |
| III | 10 (17.54) | 6 (10.53) | |
| IV | 6 (10.53) | 2 (3.51) | |
| V | 10 (17.54) | 0 (0) | |
| Total | 57 | 53 | 110 |
*p-value is statistically significant
Table 2:
DMFT/DEFT
| DMFT | Frequency | Percentage (%) |
|---|---|---|
| <3 | 57 | 51.82 |
| ≥3 | 53 | 48.18 |
| Total | 110 | 100 |
The findings revealed that branched pattern of lip print (type II) was the most prevalent in the study group with 40% of the total study sample, followed by type I with 29.09%, type III with 14.55%, type V with 9.09%, and type IV with 7.27%.
Among the Total Sample
A total of 51.82% had DMFT/DEFT score < 3.
A total of 48.18% had DMFT/DEFT score ≥ 3.
Association of Lip Print and DMFT/DEFT
Type II pattern had the highest DMFT/DEFT index among the groups with p-value = 0.001, that is statistically significant.
A 64.91% of type II pattern showed DMFT/DEFT index score ≥ 3 (carious) followed by type I with 14.04%.
Discussion
Dental caries in present times is one of the most common bacterial diseases in humans.6 Dental caries is an irreversible microbial disease of the calcified tissues of the teeth. Similar to various medical and oral diseases, the incidence of dental caries is influenced by a complex interplay between genetic predisposition and environmental factors. Environmental factors include diet, oral hygiene practices, fluoride exposure, composition of microbiota, as well as host-related factors, such as salivary flow rate, buffering capacity, tooth position, depth of occlusal pits and fissures, and properties of enamel surface.7 It is not uncommon to observe individuals who exhibit a heightened susceptibility to dental caries while others demonstrate remarkable resistance, despite the presence of multiple environmental risk factors. Investigating their genetic constitution may provide insight into currently unexplained variations in individual susceptibility to certain diseases. Research has demonstrated that genetic factors may modulate the expression of dental caries, which are often initiated by common environmental influences. Twin studies involving individuals reared together—while controlling for age and gender—have estimated the heritability of dental caries to range between 45 and 65%.8 But extracting genetic information from chromosomes is both invasive and expensive.9 Thus, a more accessible genetic marker for dental caries prediction can be utilized to bridge the gap between technology and clinicians (Figs 1 to 7).
Fig. 1:
Materials used
Fig. 7:
Bar diagram for the association between cheiloscopic pattern and DMFT/DEFT
Figs 2A to F:
Recording lip prints. (A and B) Application of petroleum jelly using an applicator tip; (C to E) Application of lipstick using an applicator tip; (F) Application of cellophane tape for recording lip prints
Figs 3A to E:
(A) Type I—vertical; (B) Type II—branched; (C) Type III—intersected; (D) Type IV—reticular; (E) Type V—undifferentiated
Fig. 4:
Dental examination for recording DMFT/DEFT index
Fig. 5:
Pie chart for distribution of cheiloscopic patterns
Fig. 6:
Pie chart for distribution of DMFT/DEFT pattern
Various orofacial structures, such as the lip, alveolus, teeth, and palate, originate from the same embryonic tissue and develop concurrently during sixth to seventh week of gestation.3 The lip print patterns are considered unique biometric markers that remain consistent throughout an individual's lifetime and demonstrate the capacity to revert to their original form following distortion or injury.10 The uniqueness of lip print patterns to each individual suggests that the anatomical characteristics of the lips may serve as valuable indicators in the identification and diagnosis of congenital diseases and anomalies, similar to the diagnostic utility of epidermal ridge patterns on the fingers and palms. Since the epithelium of the fingers and the enamel of the teeth both originate from the ectoderm, and given that the enamel organ plays a critical role in the development of the periodontal apparatus, any disturbance in the ectodermal layer may be reflected in abnormalities of both dermal ridge pattern and tooth structure.11
Cheiloscopy has the potential to serve as a noninvasive, cost-effective, and reliable tool for dental caries prediction in developing countries, such as India. Given that cheiloscopy remains an inexact science, further comprehensive research and analysis are essential to determine and assess the significance of variations in cheiloscopic features among patients with dental caries.
In the present study, branched pattern of lip print (type II) was observed to be the most prevalent among the study participants with 40% of the total study sample, followed by type I with 29.09%, type III with 14.55%, type V with 9.09% and type IV with 7.27%. The type II pattern had highest DMFT/DEFT index among the groups with 64.91% of type II pattern showing DMFT/DEFT index score ≥ 3 (carious) followed by type I with 14.04%. Thus, type II (branched) is the most predominated among the cheiloscopic patterns. Similar prevalence in subjects with permanent dentition was obtained with the study conducted by Raghav et al. and Madhusudan et al.3,12,13 Sumathy et al. conducted a study that too showed type II branched pattern the with highest caries prevalence.11
Conclusion
It was evident in our research that the branched pattern of lip print (type II) was the most prevalent among the study group with the highest caries prevalence. Thus, cheiloscopy can be used as a noninvasive and inexpensive modality to predict caries susceptibility in children.
Orcid
Syed Gulbar Shah https://orcid.org/0009-0002-1892-6138
Footnotes
Source of support: Nil
Conflict of interest: None
References
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