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BITEMARK
EVIDENCE
A Color Atlas and Text
Second Edition
BITEMARK
EVIDENCE
A Color Atlas and Text
Second Edition
Edited by Robert B. J. Dorion
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v
Table of Contents
Foreword to the Second Edition xi
Foreword to the First Edition xiii
Preface xv
Acknowledgments xix
Contributors xxi
ISection 
A HiSToriCAl PErSPECTivE
 1 History of Bitemark Evidence 3
DaviD R. Senn
ISection I
BiTEmArk rECogniTion
 2 The role of Health Professionals in Diagnosing Patterned injuries 
from Birth to Death 25
John D. McDowell
 3 role of the medical Examiner, Coroner, and Pathologist 33
JoSeph h. DaviS
 4 The Team Approach in Bitemark investigation 43
veRonique F. DelattRe
IISection I
DESCriPTion oF THE BiTEmArk
 5 The nature of Bitemarks 53
MaRk l. BeRnStein
 6 reconstructive Bitemark Analysis 67
MaRk l. BeRnStein
vi table of contents
ISection V
CollECTion oF BiTEmArk EviDEnCE
A: noninvASivE AnAlySES
 7 Photography 73
GReGoRy S. GolDen anD FRanklin D. wRiGht
 8 Practical Tips in Forensic Bitemark Photography 103
luc GaGnon
 9 image Processing and Analysis for Evidentiary Purposes 111
williaM R. oliveR
 10 Bitemarks as Biological Evidence 131
DaviD Sweet o.c.
 11 Bitemark impressions 145
RoBeRt B. J. DoRion
 12 microscopy Techniques 153
peteR J. BuSh
 13 nonperishables and Perishables 159
RoBeRt B. J. DoRion
ISection V
CollECTion oF BiTEmArk EviDEnCE
B: invASivE AnAlySES
 14 Tissue Specimens 167
RoBeRt B. J. DoRion
 15 Histology and Timing of injury 195
JoSeph h. DaviS
VSection 
BiTEmArk vAriABlES AnD CASES
 16 Animal Bites 209
RichaRD R. SouviRon
 17 Carnivore Bitemarks 217
RoBeRt B. J. DoRion
table of contents vii
 18 Human Bitemarks 241
RoBeRt B. J. DoRion
 19 Patterns, lesions, and Trauma-mimicking Bitemarks 283
RoBeRt B. J. DoRion anD RichaRD R. SouviRon
VSection I
rESEArCH
 20 Current Context of Bitemark Analysis and research 303
MaRy a. BuSh anD peteR J. BuSh
 21 research, Emerging Technologies, and recent Developments 317
RoBeRt B. J. DoRion
 22 Experimental Bitemarks and Histology 433
Michelle houDe
 23 genotypic Comparison of Bacterial DnA recovered from Bitemarks 
and Teeth 453
GeoFFRey R. toMpkinS
VISection I
CollECTion oF EviDEnCE From THE SuSPECT
 24 The Suspect 463
l. thoMaS JohnSon
VIISection I
mETHoDS oF ComPAriSon
 25 methods of Comparison 469
Jon cuRtiS Dailey
ISection X
THE rEPorTS
 26 Bitemark report 493
MaRk l. BeRnStein
viii table of contents
XSection 
PrEvEnTion AnD ConTAminATion
 27 Precautionary measures 499
paul G. StiMSon
XSection I
lEgAl ConSiDErATionS AnD THE CourTroom
 28 Science and the law 507
RichaRD a. MinceR anD haRRy h. MinceR
 29 Case law 517
RoBeRt e. BaRSley
 30 Contracting with the Expert Witness 543
RoGeR D. MetcalF
 31 Courtroom Aids in Bitemark Evidence 561
John p. kenney
 32 legal liability of an Expert Witness 569
haSkell M. pitluck
 33 Wrongful Convictions and Erroneous Bitemark opinions 577
iain a. pRetty anD c. Michael BoweRS
XISection I
ConTEnTiouS iSSuES
 34 reliability of Bitemark Analysis 587
iain a. pRetty
 35 resolving issues in Bitemark Analysis 601
iain a. pRetty
XIISection I
APPEnDiCES
Appendix 1: ABFo Bitemark Analysis Guidelines—outline 617
Appendix 2: ABFo guidelines for investigative and Final Bitemark reports 619
table of contents ix
Appendix 3: Bitemark Checklist—Bitemark recipient 621
Appendix 4: Bitemark Checklist—Suspected Biter 625
Appendix 5: Sample Consent Form 629
Appendix 6: Dental nomenclature 631
index 633
xi
The analysis of bitemark evidence is clearly the most 
challenging and arguably the most intriguing aspect 
of forensic dentistry. And the stakes involved are high, 
because the bitemark evidence in a case may well be 
the key factor in determining whether a human being 
will be exonerated or sentenced to death. The Arizona 
case of State v. Krone and the Florida case of Bundy 
v. State, discussed in Chapter 1, are just two of many 
cases in point.
In 2003, Dr. Robert B. J. Dorion decided that there 
was a need to assemble the best in-depth knowledge 
available regarding bitemark evidence and create a high-
quality text that would be a valuable and unprecedented 
tool for case work, research, teaching, and any other 
activity involving bitemarks. He developed a team of 21 
exceptionally well-qualified contributors and worked 
industriously to assist them. The result was the 2005 
publication of the first comprehensive text anywhere on 
the subject of bitemark evidence. As such, it is a land-
mark in the field of forensic science.
The outstanding reception received by the first edi-
tion validated Dr. Dorion’s foresight and is a tribute to 
all who contributed to that monumental work. That 
edition also provided a solid foundation for enhance-
ments, and the book you are now reading is a major step 
forward from the excellent first edition. The editor has 
maintained his insistence on quality and has added new 
topics, new contributors, and new chapters. Some chap-
ters, such as Chapter 1, have been extensively rewritten 
and expanded. Others have been updated. The book is 
larger, even more comprehensive, and has far more color 
photographs than the first edition.
Recent years have seen challenges to the legitimacy 
of various types of pattern analysis and this has certainly 
included bitemark analysis. These issues are addressed 
in depth in this text, starting at the end of the opening 
chapter. Much additional material presenting both the 
challenges and the responses are found in Chapters 20, 
21, 28, and 33–35.
I salute Dr. Dorion and the many top-flight indi-
viduals involved in this effort for bringing together an 
awesome amount of information on an important sub-
ject in an organized fashion. The text BitemarkEvidence 
remains unchallenged in its field. Most importantly, 
I believe that both the novice and the weathered veteran 
in forensic dentistry who seriously utilize the contents 
of this book will feel richly rewarded for having done so. 
I wish the reader well in the adventures that lie ahead.
Gerald L. Vale, DDS, MDS, MPH, JD, D-ABFO
Past president, American Board of Forensic Odontology; 
distinguished fellow, American Academy 
of Forensic Sciences
Foreword to the Second Edition
xiii
This book, Bitemark Evidence, is a clear and welcome 
reflection of the maturing of forensic odontology as a 
science. It is a sign that the field is evolving past its ori-
gins in a Frye-era “consensus of experts” and moving into 
an era of true scientific standards. It is also a signpost, 
pointing in directions still to be pursued. Those of us 
who have been in the field for some time can remember 
when we were hard pressed to find any reference text-
books whatsoever on the subject of forensic odontology, 
let alone bitemark evidence. This volume was conceived 
by its editor, Dr. Robert Dorion, to advance current 
knowledge and techniques in bitemark analysis in the 
cause of justice. In any branch of science, the questions 
to be asked must be tempered by the availability of the 
means to answer them.
Dr. Dorion has assembled a team of eminent forensic 
scientists from the disciplines of forensic odontology, DNA, 
pathology, and jurisprudence to present their views in the 
13 parts of this much needed and long overdue book. The 
forensic community will surely appreciate the authors for 
the scope and depth of their knowledge of this fascinating 
subject. Professionals involved in the administration of 
justice will find this text to be an indispensable reference 
in any situation that confronts them with a question on 
the validity of bitemark evidence. The book will take the 
reader from the early history of bitemark investigation to 
the most sophisticated techniques in current use.
For years, the Frye rule was the standard for admis-
sion of bitemark evidence. The Daubert decision in 
1993 radically changed the terms of admission and set 
the stage for objective and repeatable scientific stan-
dards. The decade since Daubert has been characterized 
by unprecedented growth in all the forensic sciences. 
Odontology is no exception. We have seen the emergence 
and development of novel methods of analysis that would 
have seemed like pure science fiction to the founders of 
this field. These techniques have had a very real and 
positive impact in courtrooms throughout the world. 
The evolution of bitemark investigation in the post-
Daubert era is well documented in the chapters of this 
book. Dr. Dorion has performed an invaluable service in 
presenting the most up-to-date techniques of bitemark 
analysis in an intelligent and easily referenced manner. 
He has wisely chosen his contributors, whose aggregate 
knowledge and experience represent the very backbone 
of this field.
It is my privilege to have known Dr. Dorion since he 
was a young dental student. I have watched him grow 
into a leader in his field, and I hold him in the highest 
esteem. Likewise, I count the other contributors to this 
volume as valued colleagues and friends. Their work, as 
presented in these pages, will be an important and last-
ing contribution to the science of forensic odontology 
for years to come.
Arthur D. Goldman, DMD, FAGD, D-ABFO
Past president, American Board of Forensic Odontology; 
past president, American Academy of Forensic Sciences
Foreword to the First Edition
xv
The second edition of Bitemark Evidence, an atlas text-
book, contains over 1,500 photographs, of which more 
than 1,300 are in color. It covers everything from the his-
tory of bitemark evidence to diagnosis and on through 
courtroom testimony.
The book will interest first responders, emergency 
room personnel, physicians, pediatricians, dentists, nurses, 
crime scene investigators, police identification and pho-
tography personnel, medical examiners, coroners, path-
ologists, law enforcement, forensic and social service 
personnel, lawyers, and judges. The faculties of medicine, 
nursing, dentistry, and law will find this atlas textbook an 
invaluable reference in the respective disciplines.
The reader will appreciate the complexity, difficul-
ties, and problems encountered by the expert in the field 
of bitemark evidence and its legal implications. This text 
is a collective work and as such reflects the knowledge, 
training, experience, opinions, and research of 27 authors 
from around the world.
The protocols for photography, collection, preserva-
tion, and analysis of bitemarks as well as the current and 
upcoming research are detailed and the legal implica-
tions and ramifications discussed. In the realm of death 
investigation, the coroner, medical examiner, or patholo-
gist is the primary diagnostician, controller of informa-
tion, and provider of access to material. The emphasis 
of the textbook is on diagnosis, communications, and 
cooperation among the different experts.
The atlas unravels the mystery of bitemarks in 13 
sections. The first section is a new chapter on the histori-
cal perspective fittingly described by Senn. His treatment 
begins with the earliest known bitemark references from 
the Bible and the Kama Sutra, through old English law, 
to early cases from around the world. The era of growth 
and development of bitemark analysis is accentuated by 
significant cases from Great Britain, Germany, Russia, 
Norway, Scotland, Canada, Australia, Africa, and the 
United States. The development of forensic organizations 
throughout the world is outlined. Lastly, the challenges to 
the legitimacy of bitemark evidence are described, with 
particular reference to the 2009 report of the National 
Academy of Sciences.
Section II, on bitemark recognition, is divided into 
three chapters dealing with the roles of health profes-
sionals and personnel from various fields. The teamwork 
approach in bitemark recognition, diagnosis, and investi-
gation is emphasized. In Chapter 2, McDowell treats bit-
ing associated with domestic violence and child, intimate 
partner, and elder abuse in the living. Davis (Chapter 3) 
relates the role of the medical examiner, coroner, and 
pathologist in bitemark detection and underlines pattern 
variables. Delattre expresses the rationale and benefits of 
the teamwork approach in Chapter 4. The importance 
of developing a teamwork protocol is emphasized as well 
as the role of each team member.
In Section III, Bernstein (Chapter 5) describes the 
nature of bitemarks from class and individual character-
istics to anatomy, variations, and pathology. In Chapter 6, 
he deals with reconstructive bitemark analysis: quality of 
the bitemark, profiling the biter and its limitations, and 
maintaining perspective.
Sections IV(A) and IV(B), on the collection of bite-
mark evidence, are divided into noninvasive and invasive 
analyses, respectively. The former is made up of seven 
chapters dealing with digital photography and practi-
cal tips, image processing and analysis for evidentiary 
purposes, bitemarks as biological evidence, bitemark 
impressions, microscopy, and the handling of perish-
ables and nonperishables.
Golden and Wright discuss digital photography in 
Chapter 7, beginning with the principles of reflection, 
absorption, fluorescence, and diffusion. The digital arma-
mentaria of cameras, lenses, and flash units are further 
analyzed. The different uses and types of photography, 
including infrared (IR), ultraviolet (UV), and alternate 
light imaging (ALI), are discussed with case presenta-
tion. The application of photographic techniques for 
purposes other than the recording of bitemarks rounds 
off the chapter.
A new chapter by Gagnon (Chapter 8) offers prac-
tical tips in forensic bitemark photography. Image pro-
cessing and analysis for evidentiary purposes is aptly 
described byOliver’s new contribution in Chapter 9. He 
discusses image processing, digital work flow, and soft-
ware resources.
Sweet discusses salivary swabbing and DNA analysis 
in Chapter 10. The discussion of salivary flow, physiology, 
cellular content, stability, recovery, storage, and transpor-
tation of saliva as well as case examples more than ade-
quately covers the theme.
Preface
xvi preface
In Chapter 11, Dorion’s discussion of bitemark 
impressions includes a description of materials and 
new inclusions on techniques for hair removal and 
impression taking. A new contribution by Peter Bush 
(Chapter 12) explores the rationale, use, materials, and 
methods employed for confocal laser microscopy (CLM) 
and the scanning electron microscope (SEM) and pro-
vides examples.
The last of the noninvasive techniques is addressed 
by Dorion in Chapter 13. It describes the materials and 
methods employed in the handling, preservation, stor-
age, and transportation of perishables and nonperish-
ables as well as outlining the factors affecting bitemarks 
in perishables.
The invasive analysis component to the collection of 
bitemark evidence is composed of two chapters on tissue 
specimens and histology. In Chapter 14, Dorion discusses 
skin wetness and dehydration, the ring technique for 
tissue excision, fixation, storage, postfixation and stor-
age, transportation, and transillumination. Practical 
examples are demonstrated using the microscope and 
transilluminated tissue. The examples serve to illustrate 
the significance of transillumination.
Davis eloquently introduces histology and the “tim-
ing” of bitemarks in Chapter 15. He points out text-
book discordance in estimating the timing of bruises 
while discussing the differences between abrasion, con-
tusion/bruise, laceration, and postmortem bruising. 
Histopathology, histochemistry and biochemistry, and 
critique of the literature reviews help the reader under-
stand the complexities of this evidence. Reliance on color 
determination for aging bitemarks is called into question.
Section V explores bitemark variables while pre-
senting case material in four chapters. In Chapter 16, 
Souviron deals with animal bites in general, incorporat-
ing aquatic and carnivore bites, both fatal and nonfatal, 
as well as postmortem animal bites while suggesting an 
animal bite protocol.
In Chapter 17, Dorion deals with nonfatal and fatal 
carnivore bites, including mountain lion, bear, and dog 
cases. Section 17.3, Forensic Nightmare: Misdiagnosis, 
exposes how a simple dog bite case evolved into a homi-
cide charge and, 4 years later, resulted in civil litigation 
against the police, the pathologist, and the odontologist. 
There is discussion of the significance of pattern dis-
tribution, wound patterning, clothing, “blood wiping,” 
tissue avulsion, and transillumination in case evaluation. 
Autopsy failures and forensic lessons learned conclude 
the chapter.
Factors affecting bitemark dynamics introduce 
Chapter 18 on human bitemarks. Of the 100-odd fac-
tors involved in bitemark dynamics, Dorion specifically 
deals with case presentations, cross-referencing several 
in other chapters. Hair, orifices, amputation/avulsion, 
pigmentation, healing, clothing, self-inflicted bitemarks, 
erectile tissue, and the presence of other trauma are 
among the subjects discussed.
Dorion and Souviron team up in Chapter 19 to 
resolve issues of patterns, lesions, and trauma- mimicking 
bitemarks. They discuss healing and healed lesions as 
well as patterned injuries on the deceased. The reader is 
warned of the potential for misinterpreting emergency 
medical treatment or autopsy trauma as bitemarks. The 
chapter also addresses the issue of unspecified marks 
and lesions.
Section VI on research is one of the major reasons for 
revising this edition. It incorporates four new chapters. 
The first, Chapter 20, is “Current Context of Bitemark 
Analysis and Research,” written by Mary and Peter Bush 
to include an overview of the National Academy of 
Sciences report and its implications in bitemark analysis. 
They discuss the uniqueness of the dentition and skin as 
an impression material.
Chapter 21 by Dorion discusses research, emerging 
technologies, and recent developments. It contains over 
430 color, UV, IR, and ALI photographs of “gold stan-
dard” experimental bitemarks from infliction to 9 months 
postmortem in some cases. It discusses, among others, 
the topics of the influence of the presence of hair, cloth-
ing, extracellular fluid, overlapping bitemarks, lingual 
markings, muscle perforation, lividity, and freezing.
Chapter 22 is another new chapter dealing with 
experimental bitemarks and histology by Houde, a foren-
sic pathologist and former coroner. She describes the 
normal porcine skin histology, the microscopic exami-
nation of bitemarks on fresh and frozen piglet skin, and 
the microscopic examination of human bitemarks.
Lastly, this section contains an update to Tompkins’s 
work on genotypic comparison of oral bacteria isolated 
from bitemarks and teeth in Chapter 23.
Section VII comprises the collection of evidence from 
the suspect. In Chapter 24, Johnson explains questions of 
court order versus informed consent as well as the means 
and methods of obtaining the suspect’s dental history, 
intra- and extraoral photographs, and impressions.
Section VIII, on methods of bitemark comparison 
by Dailey, introduces the concept of test and static bites. 
Bite exemplars in wax, Styrofoam, animal and human 
skin, and the dynamic test bites on volunteers, as well 
as standard dental impression materials, are evaluated. 
Methods of direct comparison and the avoidance of tech-
nical problems regarding dental nomenclature and dental 
cast inversions in comparison techniques are addressed. 
The issues of simple versus computer-generated overlays 
and the respective problems of metric and digital analysis 
are effectively conveyed. Other comparison techniques, 
preface xvii
three-dimensional pattern analysis, ink immersion, the 
dental line-up, and other methods of computer-aided 
visualization are discussed. Pattern recognition ability 
concludes Chapter 25.
In Section IX, Bernstein (Chapter 26) discusses report 
writing: its goals, objectives, basic qualities, preparation, 
content, perspective, and security. He suggests measures 
for maintaining objectivity and addresses the issue of the 
components for a standard bitemark report. A new con-
tribution includes the topics of disposition of evidence, 
investigator information, perspective, and security.
Stimson points to issues of prevention and contami-
nation in Section X. Various subjects are addressed in 
Chapter 27, from personnel to autopsy protocol, instru-
ments, and equipment, to bitemark and dental impres-
sions and casts.
Section XI deals with legal considerations and the 
courtroom. The six chapters cover science and the law, 
case law, courtroom aids in bitemark evidence, and the 
legal liability of the expert witness. There are two new 
contributions on contracting with the expert witness, 
and wrongful convictions.
Chapter 28 introduces the reader to the legal system 
by explaining science and the law, justice versus truth, 
the adversarial system, and evidentiary restrictions. 
Mincer and Mincer further discuss the principles of 
differentiating good from junk science, the importance 
of objectivity, the interplay and tension between science 
and advocacy, and how to approach serving as an expert 
witness in a bitemark case.
Barsley discusses the foundation of case law in 
Chapter 29, the qualification of the expert, and the con-
cept of “degree of certainty.” He delves into the battling 
experts, qualifying to testify, the expert’s testimony in 
opinion, and “linkage.”
A new chapter by Metcalf (Chapter 30) introduces 
the notion of contracting with the expert witness. It 
explains the notion of a valid contract, oral versus writ-
ten contracts, the offer, the acceptance, and theconsider-
ation. A sample contract is included.
In Chapter 31, Kenney introduces the topic of 
courtroom aids in bitemark evidence by emphasizing 
the need for simplicity, clarity, and conciseness on the 
part of the testifying expert witness. In the early 1970s, 
the analysis of bitemark evidence consisted of analyzing 
black-and-white photographs of dubious quality and 
producing hand-drawn overlays of the suspect denti-
tion for comparison. Kenney itemizes different methods 
and materials that, historically, have been used in court-
room presentations by forensic dental experts in bite-
mark cases.
The eye-opening Chapter 32 describes the legal liabil-
ity of the expert witness with specific reference to foren-
sic dentists. Pitluck emphasizes the reasoning behind 
absolute immunity and the changing concepts regarding 
that immunity and what to expect in the future. Chapter 
33, the other new chapter in this section, written by 
Pretty and Bowers, discusses wrongful convictions and 
erroneous bitemark opinions. It describes the anatomy 
of a wrongful conviction including examples.
Section XII, on contentious issues, is divided into 
two chapters concerning the reliability of bitemark evi-
dence and resolving issues in bitemark analysis. Chapter 
34 introduces concepts of reliability, validity, accuracy, 
sensitivity and specificity, receiver operator character-
istics, and positive and negative predictive values. The 
effects of Daubert and other judicial rulings and the vari-
ous research projects in bitemark evidence and their effect 
on statistics are alluded to. Chapter 35, also by Pretty, dis-
cusses the human skin as a bitemark registration mate-
rial and methods of analysis—both physical comparison 
and molecular biological techniques. Further discussion 
on the levels of conclusion and uniqueness of human 
dentition conclude the chapter.
Lastly, Section XIII is composed of six appendices 
that will undoubtedly benefit the reader with their brev-
ity, conciseness, and checklist approach.
The views and opinions expressed by one contrib-
utor in this edition may or may not coincide with or 
reflect the views and opinions of the other contributors. 
An attempt has been made, however, to reflect the con-
temporary scientific view of the subject matter.
Robert B. J. Dorion, editor
xix
I would like to thank all those who have contributed 
directly and indirectly to this project and in particular 
to the 27 contributing authors, without whom this book 
could not have been realized.
To Dr. Jean Paul Valcourt (in memoriam) and 
Dr. André Lauzon, former directors of pathology at 
the Laboratoire de Sciences Judiciaires et de Médecine 
Légale, for their professionalism, cooperation, and 
encouragement over the years—and, above all, for hav-
ing fostered the development of forensic dentistry in 
Quebec, thank you.
Thank you to Drs. Serge Turmel and Louise Nolet, 
former and current chief coroners for the province of 
Quebec, for their cooperation.
To my dental collaborators at the Laboratoire de 
Sciences Judiciaires et de Médecine Légale, Drs. Sylvain 
Desranleau, Sylvain Laforte, Marie-Josée Perron, and 
André Ruest, thank you for your assistance.
Thank you to the forensic photographers in the 
identification section of the Quebec Provincial Police 
for their professional attitude and product and, in 
particular, Sgt. Luc Gagnon and Agt. Robert Fortin. 
Other photographs were taken by various police agen-
cies, including the identification section of the Service 
de Police de la Ville de Montréal (SPVM), the Royal 
Canadian Mounted Police, the Ottawa-Carleton Police, 
the Winnipeg Police, and the Bermuda Police.
To Dr. Linda J. Wykes, associate professor and 
William Dawson scholar, School of Dietetics and Human 
Nutrition, McGill University, thank you for your pre-
cious collaboration.
Thank you to the Office of the Chief Medical 
Examiner of the Commonwealth of Kentucky and 
to the Office of the Commonwealth Attorney of the 
Commonwealth of Kentucky for their cooperation.
Special recognition goes to Louise Reynolds, Felicity 
Hawthorn, and Terry Maxwell for their cooperation 
and assistance.
Lastly, I thank the various local, national, and inter-
national friends and colleagues for the encouragement 
expressed and the cooperation received in the writing 
of this edition.
Acknowledgments
xxi
Robert B. J. Dorion (editor), BSc, DDS, FACD, D-ABFO; 
director of forensic dentistry, Laboratoire de Sciences 
Judiciaires et de Médecine Légale, Ministry of Public 
Security for the Province of Quebec, Montreal, Quebec, 
Canada; assistant professor, faculty of dentistry, McGill 
University; adjunct research assistant professor, Dept. of 
Oral Diagnostic Sciences, School of Dental Medicine, 
SUNY at Buffalo; past president, American Board of 
Forensic Odontology; past president, Canadian Society 
of Forensic Science; distinguished fellow, American 
Academy of Forensic Sciences; fellow, Canadian Society 
of Forensic Science; member of the board of directors of 
the American Academy of Forensic Sciences.
Robert E. Barsley, DDS, JD, D-ABFO; forensic den-
tal consultant to the Orleans Parish Coroner’s Office 
and the Jefferson Parish Coroner’s Office, New Orleans, 
Louisiana; professor of comprehensive dentistry, and 
director, dental oral resources, LSUHSC School of 
Dentistry, New Orleans; past president, American Society 
of Forensic Odontology; secretary, American Academy of 
Forensic Sciences; fellow, American Academy of Forensic 
Sciences.
Mark L. Bernstein, DDS, D-ABOMP, D-ABFO; pro-
fessor of oral and maxillofacial pathology, University 
of Louisville School of Dentistry, Louisville, Kentucky; 
forensic dental consultant to Chief Medical Examiner’s 
Office, Commonwealth of Kentucky; fellow, American 
Academy of Forensic Sciences.
C. Michael Bowers, DDS, JD, D-ABFO; deputy medical 
examiner, Ventura, California; associate clinical profes-
sor, the Herman Ostrow School of Dentistry, University 
of Southern California, Los Angeles.
Mary A. Bush, DMD; director, the Laboratory for 
Forensic Odontology Research, School of Dental 
Medicine, University at Buffalo, State University of New 
York at Buffalo, New York.
Peter J. Bush, BS; director, South Campus Instrument 
Center; codirector, Laboratory for Forensic Odontology 
Research, School of Dental Medicine, University at Buffalo, 
State University of New York at Buffalo; adjunct professor, 
art conservation, Buffalo State College, Buffalo, New York.
Jon Curtis Dailey, DDS, D-ABFO; part-time private 
practice in prosthodontics; forensic odontology consul-
tant, State of Massachusetts Medical Examiner’s Office; 
adjunct faculty, Armed Forces Institute of Pathology; past 
president, American Society of Forensic Odontology; 
fellow, American Academy of Forensic Sciences.
Joseph H. Davis, MD; retired chief medical examiner, 
Miami-Dade County, Florida; professor of pathology 
emeritus, University of Miami; certified by the American 
Board of Pathology in pathologic anatomy and foren-
sic pathology; past president, American Academy of 
Forensic Sciences; past president, National Association of 
Medical Examiners; distinguished fellow and Gradwohl 
laureate, American Academy of Forensic Sciences.
Veronique F. Delattre, BSc, DDS, FAGD, D-ABFO; 
director of quality assurance and risk management, and 
professor, University of Texas Dental Branch at Houston, 
Texas; forensic dental consultant, Harris County Institute 
of Forensic Sciences, Houston, Texas; fellow, American 
Academy of Forensic Sciences; fellow, Academy of General 
Dentistry; charter member, FBI-CJIS National Dental 
Image Repository Review Panel; recipient, 2008 FBI assis-
tant director’s award for exceptional public service.
Luc Gagnon, section head, Crime Scene Module Western 
Section, Forensic Identity Division, Criminalistics 
Service, Sûreté du Québec, Montreal, Quebec, Canada.
Gregory S. Golden, DDS, D-ABFO; chief odontologist/
deputy coroner, County of SanBernardino, California; 
assistant professor, School of Dentistry, Loma Linda 
University, Loma Linda, California; fellow, American 
Academy of Forensic Sciences.
Michelle Houde, MD; retired forensic pathologist and 
coroner for the Province of Quebec, Canada.
L. Thomas Johnson, DDS, D-ABFO, CSCSA; associ-
ate medical examiner, Milwaukee County Medical 
Examiner’s Office, Milwaukee, Wisconsin; professor, 
dental science, forensic dentistry and public health, 
Marquette University School of Dentistry, Milwaukee, 
Wisconsin; past president, American Board of Forensic 
Odontology; consultant, Wisconsin Department of 
Contributors
xxii contributors
Justice, Crime Laboratory Bureau; fellow, American 
Academy of Forensic Sciences; certified senior crime 
scene analyst, International Association for Identifica-
tion, Crime Scene Certification Board; certified law 
enforcement instructor, Illinois Bureau of Law Enforce-
ment Standards and Training.
John P. Kenney, DDS, MS, D-ABFO, SCSA; deputy 
coroner and director of identification services, Du Page 
County, Illinois, Coroner’s Office; associate clinical profes-
sor of surgery, Northwestern University Medical School; 
consultant, Joint POW-MIA Accounting Command, 
Hickam AFB, Hawaii; secretary and trustee, the 
Forensic Sciences Foundation; past president, American 
Board of Forensic Odontology; editorial board, Journal 
of Forensic Sciences, Journal of Forensic Identification; 
fellow, American Academy of Forensic Sciences; fellow, 
American Academy of Pediatric Dentistry.
John D. McDowell, DDS, MS, D-ABFO; director, oral 
medicine and forensic sciences, University of Colorado 
School of Dentistry; chairman, oral diagnosis, oral 
medicine and oral radiology, University of Colorado 
School of Dentistry; past president, American Academy 
of Forensic Sciences; past president, American Society 
of Forensic Odontology; fellow, American Academy of 
Forensic Sciences.
Roger D. Metcalf, DDS, JD, D-ABFO; director of the 
Human Identification Laboratory, Tarrant County Medical 
Examiner’s District, Fort Worth, Texas; distinguished vis-
iting clinical professor, Texas Wesleyan University, Fort 
Worth; fellow, American Academy of Forensic Sciences; 
fellow, American College of Legal Medicine.
Harry H. Mincer, DDS, PhD, D-ABFO; dental consultant 
to the medical examiner, Shelby County, Tennessee; pro-
fessor and director of oral and maxillofacial diagnostic 
services, University of Tennessee College of Den tistry; past 
president American Board of Forensic Odontology; fel-
low, American Academy of Forensic Sciences.
Richard A. Mincer, JD; Hirst Applegate, LLP, 
Cheyenne, Wyoming; managing editor, University of 
Memphis Law Review; past president, Defense Lawyers 
Association of Wyoming.
William R. Oliver, MD, MS (computer science), MPA 
(justice administration); professor and director of ana-
tomic and forensic services, Department of Pathology 
and Laboratory Medicine, Brody School of Medicine at 
East Carolina University, Greenville, North Carolina; 
network administrator, Scientific Computing Network, 
Armed Forces Institute of Pathology; former regional 
medical examiner, Georgia Bureau of Investigation; 
former deputy medical examiner, Office of the Armed 
Forces Institute of Pathology; board certified in ana-
tomic, clinical, and forensic pathology; fellow, College of 
American Pathologists, American Academy of Forensic 
Sciences, National Association of Medical Examiners; 
selected as one of Federal Computer Week’s 100 most 
influential information technology professionals, 1997; 
finalist, Berry Prize in Military Medicine, 1998; execu-
tive committee, Scientific Working Group on Imaging 
Technology, Applied Imagery Pattern Recognition 
Workshop; chair, SWGIT Image Analysis Subcommittee.
Haskell M. Pitluck, JD; retired circuit court judge 
(Illinois); past president, American Academy of Forensic 
Sciences; fellow, American Academy of Forensic Sciences.
Iain A. Pretty, BDS (Hons), MSc, MPH, PhD, MFDSRCS 
(Ed); forensic dentist to the North West Coroner’s 
Services; forensic consultant to Merseyside and Cheshire 
Police Forces; senior lecturer in dental public health, 
School of Dentistry, University of Manchester.
David R. Senn, DDS, D-ABFO; clinical assistant profes-
sor, dental diagnostic science, University of Texas Health 
Science Center at San Antonio; director, Center for 
Education and Research in Forensics; chief forensic odon-
tologist, Bexar County Medical Examiner, San Antonio, 
Texas; fellow, American Academy of Forensic Sciences.
Richard R. Souviron, DDS, D-ABFO; chief forensic 
odontologist, Miami-Dade County Medical Examiner’s 
Office, Florida; adjunct professor, pathology, University 
of Miami School of Medicine; past president and found-
ing member, American Board of Forensic Odontology; 
fellow, American Academy of Forensic Sciences; found-
ing member of the Odontology Section of the American 
Academy of Forensic Sciences.
Paul G. Stimson, DDS, MS, D-ABFO, D-ABOMP (emeri-
tus); senior forensic consultant, Harris County Forensic 
Center, Office of the Medical Examiner, Houston, Texas; 
professor emeritus, University of Texas Dental Branch 
at Houston, University of Texas Health Science Center 
at Houston; past president, American Board of Forensic 
Odontology; past president and member emeritus, 
American Society of Forensic Odontology; fellow, Ameri can 
Academy of Forensic Sciences; DMORT team member.
contributors xxiii
David Sweet O.C., DMD, PhD, D-ABFO; director, 
Bur eau of Legal Dentistry Laboratory, University of 
British Columbia, Vancouver, Canada; professor, facul-
ties of dentistry and medicine, the University of British 
Columbia, Vancouver, Canada; consultant forensic odon-
tologist, Office of the Chief Coroner, British Columbia 
Coroners’ Service, Burnaby, Canada; consultant forensic 
odontologist, Royal Canadian Mounted Police Forensic 
Laboratory Services Directorate, Ottawa, Canada; fellow, 
American Academy of Forensic Sciences.
Geoffrey R. Tompkins, PhD; senior lecturer, Department 
of Oral Sciences, and director, Oral Microbiology and 
Dental Health Research Theme, University of Otago, 
Dunedin, New Zealand; past president, Georgia Chapter, 
American Association for Dental Research.
Franklin D. Wright, DMD, D-ABFO; forensic dental con-
sultant, Hamilton County Coroner’s Office, Cincinnati, 
Ohio; fellow, American Academy of Forensic Sciences.
iA Historical Perspective
3
1History of Bitemark EvidenceDaviD R. Senn
Contents
1.1 Introduction 4
1.2 Early History of Bitemarks 4
1.2.1 From the Beginning through the Middle Ages 4
1.2.1.1 The Garden of Eden 4
1.2.1.2 The Kama Sutra 5
1.2.1.3 The Orkneyinga Saga 5
1.2.1.4 William the Conqueror (William I of England; William II, Duke of Normandy) 5
1.2.2 1600 to 1950 7
1.2.2.1 Mayhem and the Ancient Law of England, Seventeenth Century 7
1.2.2.2 Indentured Servitude, Seventeenth Century 7
1.2.2.3 Salem Witch Trials, 1692 7
1.2.3 Other Nineteenth and Early Twentieth Century Cases 7
1.2.3.1 The Coram Street Affair, London, 1872 7
1.2.3.2 The Woods of Chantilly 7
1.2.3.3 The Gangs of New York, Late Nineteenth Century 8
1.2.3.4 Transparent Overlays in Bitemark Analysis, Germany, 1924 8
1.2.3.5 Ohio v. Robinson, Ohio, United States, 1870 8
1.2.4 Additional Cases 9
1.2.4.1 Teeth Marks in Cigar Holders, Russia 9
1.2.4.2 Bitemark in Cheese, Germany, 1905 9
1.2.4.3 Bitemark in Cheese, England, 1906 9
1.2.4.4 The Heath Case, England, 1946 9
1.2.4.5 The Gorringe Case, England, 1948 9
1.2.4.6 Tunbridge Wells, England, 1949 9
1.2.5 Cases in Canada 10
1.2.5.1 Nova Scotia, 1924 10
1.2.5.2 Quebec, 1930 10
1.3 Bitemark Evidence in the Modern Era (1950–2010): Cases Leading to the Acceptance of Bitemark 
Evidence in Courts of Law 10
1.3.1 Doyle v. State, 1954 (Texas) 10
1.3.2 Wayne Clifford Boden, 1968–1971 (Canada) 10
1.3.3 People v. Johnson, 1972 (Illinois) 11
1.3.4 People v. Marx, 1974 (California) 11
1.3.5 State v. Bundy, 1979, 1980; Bundy v. State, 1984 (Florida)12
1.3.6 Other Significant Cases 12
1.3.6.1 State v. Milone, 1973 (Illinois) 12
1.3.6.2 Wilhoit v. State, 1991 (Oklahoma) 13
1.3.6.3 People v. Moldowan and Cristini, 1991; People v. Moldowan, 2002; People v. Cristini, 
2004 (Michigan) 14
1.3.6.4 State v. Krone, 1992, 1995 (Arizona) 14
1.3.6.5 State v. Brewer, 1995; Brewer v. State, 1998, 1999 (Mississippi) 14
1.3.7 Cases in Modern Europe and the United Kingdom 15
1.3.7.1 Fredrik Fasting Torgersen, Oslo, Norway, 1957 15
1.3.7.2 Gordon Hay, Biggar, Scotland, 1967 16
4 Bitemark evidence: a color atlas and text, 2nd edition
1.1 introduction
When human teeth contact objects or surfaces or, alter-
nately, those objects or surfaces contact the teeth, a mark 
or marks may be left. Human teeth are capable of mark-
ing almost any material that is softer than the enamel 
that covers their crowns. Not all of these marks should 
be called bitemarks. Those marks that occur as a result 
of objects or surfaces striking the teeth are more accu-
rately called teeth marks. Bitemarks are created by the 
dynamic actions of the mouth and jaw complex of a per-
son or animal. In human interactions, biting is known 
to occur in situations ranging from play to lovemaking 
and, more malevolently, in violent interchanges, such as 
fights and frays, and criminal activities from assaults to 
homicides. Bitemarks and teeth marks can be danger-
ous to the health of their recipients. Closed-fist teeth 
mark injuries of the type seen in fistfights may result in 
serious infections, amputations, and even death [1]. In 
those instances that result in bitemarks, the biter may be 
a willing participant, an assailant, or a person assailed 
acting in self-defense. Bitemarks occur more frequently 
during these activities than most imagine.
Some earlier societies have considered the teeth to 
be weapons necessary for defense in battle. Practitioners 
of forensic odontology confirm that the teeth are used 
as both defensive and offensive weapons. Teeth marks 
and bitemarks that have legal repercussions have been 
recorded in food such as cheese, sandwiches, fruit [2,3], 
food containers, and expanded polystyrene cups [4], as 
well as on other objects ranging from cigar holders [5,6] 
to duct tape bitten while immobilizing a victim [7,8] to 
a truck window trim strip bitten by a victim during sex-
ual assault [9]. The resulting teeth marks and bitemarks 
often become important physical evidence in legal cases 
that deal with the disorder, havoc, injury, and mayhem 
of which humans are capable.
1.2 Early History of Bitemarks
1.2.1 From the Beginning through 
the middle Ages
1.2.1.1 The Garden of Eden
In the first edition of Bitemark Evidence, Vale discussed 
the roles of Eve, Adam, and the serpent in the allegorical 
biting of the forbidden fruit [10]. This may be consid-
ered by some the first case to include bitemark evidence. 
If that were true, it could also be considered the least 
controversial bitemark case; there were no lawyers, no 
dental experts, no jury, and only one judge. Both sus-
pects confessed their joint culpability. One could argue, 
1.3.8 Cases in Modern Africa 16
1.3.8.1 State v. Shabangu, 1998 16
1.3.8.2 State v. Nxele, 1999 16
1.3.8.3 Vierfontein, Free State, 2002 17
1.3.9 Cases in Modern Australia 17
1.3.9.1 Ipswich, Queensland, 1973 17
1.3.9.2 Darwin, Northern Territory, 1986 17
1.4 Forensic Odontology Organizations 18
1.4.1 International Organization for Forensic Odontostomatology (IOFOS) 18
1.4.2 The Odontology Section of the American Academy of Forensic Sciences (AAFS) 18
1.4.3 The American Society of Forensic Odontology (ASFO) 18
1.4.4 Canadian Society of Forensic Science (CSFS), Odontology Section 18
1.4.5 American Board of Forensic Odontology 18
1.5 History of Bitemark Education in North America 19
1.5.1 Armed Forces Institute of Pathology (AFIP) 19
1.5.2 McGill University and the Laboratoire de Sciences Judiciaires et de Médecine Légale (LSJML) 19
1.5.3 University of Texas Health Science Center at San Antonio Dental School 19
1.5.4 Bureau of Legal Dentistry (BOLD) 20
1.5.5 Other Courses 20
1.6 Challenges to the Legitimacy of Bitemark Evidence 20
1.6.1 Bitemark Evidence Controversies 20
1.6.2 National Academy of Sciences 2009 Report 20
1.7 Perspective on the Relationship between the Past and Future of Bitemark Evidence 21
Acknowledgments 21
References 21
history of Bitemark evidence 5
perhaps, that groundwork was laid for future cases 
involving bitemarks in food, including apples.
1.2.1.2 The kama Sutra
The ancient Sanskrit compendium text first published in 
its current form in the second century CE includes a list 
of various types of bites and describes their roles in love-
making and beyond. Although certainly not forensic in 
nature, these descriptions can be considered the earliest 
known classification system for bitemarks. The types of 
bites listed are the hidden bite, the swollen bite, the point, 
the line of points, the coral and the jewel, the line of jew-
els, the broken cloud, and the biting of a boar. The Kama 
Sutra [11] further describes each of the bite types:
The biting, which is shown only by the excessive red-
ness of the skin that is bitten, is called the “hidden 
bite.” When the skin is pressed down on both sides, it 
is called the “swollen bite.” When a small portion of 
the skin is bitten with two teeth only, it is called the 
“point.” When such small portions of the skin are bit-
ten with all the teeth, it is called the “line of points.” 
The biting, which is done by bringing together the teeth 
and the lips, is called the “coral and the jewel.” The lip is 
the coral, and the teeth the jewel. When biting is done 
with all the teeth, it is called the “line of jewels.” The 
biting, which consists of unequal risings in a circle, and 
which comes from the space between the teeth, is called 
the “broken cloud.” This is impressed on the breasts. 
The biting, which consists of many broad rows of marks 
near to one another, and with red intervals, is called the 
“biting of a boar.” This is impressed on the breasts and 
the shoulders; and these two last modes of biting are 
peculiar to persons of intense passion. Both the “line 
of points” and the “line of jewels” are to be impressed 
on the throat, the arm pit, and the joints of the thighs; 
but the “line of points” alone is to be impressed on the 
forehead and the thighs.
The Kama Sutra [11] also offers advice on personal 
behavior following being bitten:
When a man bites a woman forcibly, she should angrily 
do the same to him with double force. Thus a “point” 
should be returned with a “line of points,” and a “line 
of points” with a “broken cloud,” and if she be exces-
sively chafed, she should at once begin a love quarrel 
with him.
The love quarrel, then as now, was apparently much 
dreaded.
1.2.1.3 The Orkneyinga Saga
This history of the Orkney Islands of Scotland includes 
an account of fatal teeth marks. In the year 892, a 
Norwegian earl, Sigurd (the Mighty), arranged a meeting 
with a rival Scottish earl, Maelbrigte (the Bucktoothed), 
ostensibly to discuss and peacefully settle differences. 
Sigurd arrived at the meeting with double the agreed force 
by placing two men on each horse. Although Maelbrigte 
recognized the treachery in advance, noting two legs on 
each side of every horse, he and his men engaged the 
Norwegians. They fought bravely but were overwhelmed 
and killed by the superior force. Sigurd ordered the 
beheading of the defeated Scots. Their severed heads 
were tied to the saddles of Sigurd and his men to make a 
show of the victory. As Sigurd spurred his horse for the 
triumphant ride home, he struck his bare calf against 
the protruding teeth of Maelbrigte’s head slung from his 
saddle. The resulting injury led to infection, swelling, 
fever, and, ultimately, to the death of Sigurd the Mighty. 
He is buried on the bank of the Oykel River near the 
present-day Scottish town of Dornach [12].
1.2.1.4 William the Conqueror 
(WilliamI of England; 
William II, Duke of Normandy)
It has been previously reported that William, the 
Norman conqueror of Britain at the 1066 Battle of 
Hastings, would sometimes seal official documents by 
biting his teeth into the wax seals affixed [13]. In The 
Curiosities of Heraldry, Mark Antony Lower reported 
that William gave an estate near Leeds in York to a fam-
ily named Roydon. There are two separate but similar 
accounts of the wording of the deed. Only one refers 
to the biting of wax and that document is questionable 
and no longer exists. The elusive title deed, which would 
have been created around 1069 CE, was “formerly in the 
possession of the family” [14] (Figure 1.1).
A similarly worded version omits the biting of the 
wax [14]:
I, William King, give to thee, Powlen Rowdon, my hop 
and my hoplands, with all the bounds up and downe, 
from Heaven to Earth, from Earth to Hell, for thee and 
Figure 1.1 title deed transferring land from king william 
to the Roydon family.
6 Bitemark evidence: a color atlas and text, 2nd edition
thine to dwell, from me & mine to thee & thine, for a 
Bowe and a broad Arrow, when I come to hunt upon 
Yarrow; in witnesse Magge, Maude, and Margery, & my 
third Son Henery.
That the teeth were used in ancient times to mark 
sealing wax, however, is clearly seen in one of two beau-
tifully illustrated books privately published in 1847, 
Sigilla Antiqua, 2nd Series [15]. The volume contains 
high-quality engraved images of ancient wax seals. The 
first image of plate 1 in volume 2 depicts an engraving of 
a wax seal containing the imprints of anterior teeth. The 
exact date of the transfer is unknown, but the postscript 
indicates that the transfer occurred during the reign of 
Edward II (1284–1327) (Figures 1.2 and 1.3).
As a postscript to the second series, Sir Thomas Hare, 
baronet of Stowe-Bardolph and sponsor of the series, 
added, “It has been said that before the use of Seals was 
in England, divers writing had the wax of them bitten 
with wang tooth of him that passed them.” Taylor notes 
that they sometimes include the inscription shown in 
Figure 1.4. He adds, “What amount of truth there may 
be in this assertion I pretend not to say: we have here, 
however, at a later period, an example in which, for lack 
of Seal, the fair Agnes has sharply impressed the form of 
her teeth upon the wax” [15]. Though the teeth shown 
in the figure are clearly anterior teeth, the term “wang” 
tooth usually refers to a “cheek” or “jaw” tooth, gener-
ally understood to mean a molar [16].
Figure 1.2 “no. 1. the impression of teeth on wax, in place of Seal, of agnes the daughter of agnes, daughter of willim 
Fiz of Fyneham, to a Deed by which she enfeoffs adam de Fyneham, in one acre and three roods of land there. S.D. temp. 
edw. 2.” (taylor and hare. 1847. Sigilla Antiqua. Engravings from Ancient Seals Attached to Deeds and Charters in the 
Muniment Room of Sir Thomas Hare. Stowe-Bardolph. priv. print. 1 p.l., 14 l 15.)
Figure 1.3 numbers 1 through 3 of the engravings of ancient wax seals as seen in Sigilla Antiqua. (taylor and hare. 
1847. Sigilla Antiqua. Engravings from Ancient Seals Attached to Deeds and Charters in the Muniment Room of Sir 
Thomas Hare. Stowe-Bardolph. priv. print. 1 p.l., 14 l 15.)
Figure 1.4 according to taylor, inscriptions such as this sometimes accompanied bitemarks in wax.
history of Bitemark evidence 7
1.2.2 1600 to 1950
1.2.2.1 Mayhem and the Ancient Law of 
England, Seventeenth Century
In seventeenth century England, the act of humans bit-
ing humans during violent interchanges was well known. 
According to the Lawes of England, the loss of the teeth 
at the hands of another was considered to be the crime 
of mayhem, depriving one of “a member proper for 
his defense in fight.” During that period in England, 
mayhem was punishable by death [17]. This interest-
ing ancient law clearly illustrates a fact well known to 
modern forensic odontologists but perhaps not as widely 
known generally: People often bite other people, espe-
cially during violent interaction.
1.2.2.2 Indentured Servitude, 
Seventeenth Century
Debtors and others desiring passage to the New World 
would often enter into agreements with entrepreneurs 
who financed their passage. They agreed either to work 
for a specified period of time or to repay the agreed 
amount. Some would verify the agreement by biting into 
the document seals in lieu of or in addition to signatures. 
They were referred to as indentured servants [18]. An 
alternate explanation of the term refers to the practice 
of drawing up the agreement in duplicate, then cutting 
or tearing between them in a zigzag manner so that the 
two halves of the document could be fitted together to 
assure authenticity [19].
1.2.2.3 Salem Witch Trials, 1692
In her deposition, 17-year-old Mary Walcott testified 
that “Mr. George Burroughs or his Apperance came to 
me whom I formerly well knew and he did immediately 
most greviously torment me by biting pinching and 
almost choacking me urging me to writ in his book” 
[20]. Similar depositions and testimony against the lay 
minister led to his being tried as a male witch or wizard. 
The indictments cited those depositions and listed [20]
Sundrey other Acts of witchcrafts by Said George 
Burroughs upon the bodies of Mary Walcot, Marcy 
Lewis, Abigail Williams, Ann Putnam and Eliz. 
Hubbard and Susan Sheldon Upon Som: or all of them, 
of Salem Village or farm[es] whereby great hurt and 
dammage benne donn[e] to the Bodys of s’d persons 
above named therefore Craved Justice.
Burroughs protested his innocence and stated that 
he was incarcerated at the time of most of the accused 
occurrences. The alibi was circumvented by claims 
that Burroughs’s specter, the previously mentioned 
“Apperance,” did the actual biting. His mouth was pried 
open in court and it was declared that he was the biter. 
Burroughs was convicted.
Mr. Burroughs was carried, through the streets of 
Salem to Execution; when he was upon the Ladder, 
he made a Speech for the clearing of his Innocency, 
with such Solemn and Serious Expressions, as were 
to the Admiration of all present; his Prayer (which he 
concluded by repeating the Lord’s Prayer) was so well 
worded, and uttered with such composedness, and such 
(at least seeming) fervency of Spirit, as was very affect-
ing, and drew Tears from many (so that it seemed to 
some that the Spectators would hinder the Execution). 
(Calef [21])
It was widely believed that witches could not recite 
the Lord’s Prayer. Unfortunately, Burroughs had a reli-
gious rival, Rev. Cotton Mather, who believed him to be, 
unforgivably, both a witch and a Baptist!
Mr. Cotton Mather, being mounted upon a Horse, 
addressed himself to the People, partly to declare, that 
he [George Burroughs] was no ordained minister, and 
partly to possess the People of his guilt; saying, That the 
Devil has often been transformed into an Angel of Light. 
In doing this he reassured the crowd of Burroughs’ guilt 
and the execution proceeded. (Calef [21])
George Burroughs was executed on August 19, 1692. 
As Vale prophetically stated in the first edition, “Thus, 
the Salem Witch Trials provide a thought-provoking 
backdrop for the introduction of bitemark evidence into 
the American judicial system” [10].
1.2.3 other nineteenth and Early 
Twentieth Century Cases
1.2.3.1 The Coram Street Affair, 
London, 1872
In his 1937 book, The Criminals We Deserve, Henry T. F. 
Rhodes cites cases involving bitemark evidence. In the 
Bloomsbury district of London, the Coram Street affair of 
1872 concerned the murder of a prostitute. A German pas-
tor was accused and part of the evidence was a bitemark in 
an apple. The evidence was poorly managed and the pas-
tor had strong political influence. He was acquitted [22].
1.2.3.2 The Woods of Chantilly
Rhodes also cites the successful prosecution of a man 
for attempted rape in the woods of Chantilly. During 
the attack, thevictim bit the attacker and escaped. The 
suspect claimed the injury to his right hand was not a 
result of a bite. “But under the skilled examination of an 
expert in identification they were proved to correspond 
8 Bitemark evidence: a color atlas and text, 2nd edition
at ten points with the marks made by the girl’s teeth. The 
man was convicted” [22].
1.2.3.3 The Gangs of New York, 
Late Nineteenth Century
In the last 20 years of the nineteenth century, tough guys 
and professional thugs in the gangs of New York could 
be hired to maim and murder. Rhodes published a tariff 
found on one of those thugs, Piker Ryan, when he was 
arrested [22]. The tariff included the following disturb-
ing price list:
Punching 2 dollars
Both eyes blacked 4 dollars
Nose and jaw broke 10 dollars
“Jacked” out 15 dollars
Ear chawed off 15 dollars
Leg or arm broke 19 dollars
Shot in leg 25 dollars
Stab 25 dollars
Doing the big job 100 dollars and up
Avulsive bitemarks of ears are not uncommon in violent 
interchanges today. The bizarre antics of Mike Tyson in 
his boxing match with Evander Holyfield form a well-
known example.
1.2.3.4 Transparent Overlays in Bitemark 
Analysis, Germany, 1924
Ferdinand Strom, among others, noted that the German 
forensic odontologist A. Sorup was an early investiga-
tor of bitemarks. In a 1924 case Sorup reported the use 
of transparent paper representations of suspects’ denti-
tions compared to life-sized images of bitemarks [23,24]. 
These may be considered as precursors to the more mod-
ern transparent overlays.
In a notably comprehensive chapter on bitemarks 
in his still impressive 1976 book, Dental Identification 
and Forensic Odontology, Harvey referred to cases with 
bitemark evidence occurring prior to 1950 in North 
America (1925, 1944), the United Kingdom (1937), and 
Germany (1929, 1932, 1938) [3].
1.2.3.5 ohio v. robinson, Ohio, 
United States, 1870
In 1990, Pierce, Strickland, and Smith published an arti-
cle describing an 1870 case involving bitemark evidence 
[25]. This is very likely the first case in North America 
that included the testimony of a dentist in a bitemark case. 
Records of the trial are sparse and most of the informa-
tion about it comes from newspaper accounts. Ansil L. 
Robinson was charged with the murder of his mistress, 
Mary Lunsford. Prosecutors introduced evidence that 
alleged Robinson had left bitemarks on the victim’s arms. 
“A further examination revealed a large cut in her abdo-
men and her arm showed five bites, the print of teeth 
being plainly visible” [26]. Three dentists, Dr. C. R. Taft 
and Drs. DeCamp and Watt, testified at trial for the pros-
ecution. All three agreed upon these points:
The marks on Mrs. Lunsford’s arm were of teeth 
made by biting.
The marks were plain and easily observed.
There was also a distinct area of ecchymosis asso-
ciated with the injury.
The teeth of each individual are unique.
The marks made by a set of teeth can be distinguished 
from marks made by another set of teeth.
The teeth do not imprint well into the tissue of 
the arm.
The marks could be evaluated.
There were five distinct teeth marks demonstrated 
in the bite.
The models of Robinson’s teeth fit well into the 
marks.
Robinson’s teeth had made the marks.
For the defense, a physician testified and described 
his unusual examination technique. At the scene, shortly 
after the body had been discovered, a Dr. Whitney bit the 
victim’s arm “with his own teeth” to compare his teeth 
marks with those already present. The article reports that 
he also later asked Robinson to bite his (Dr. Whitney’s) 
arm, in order to compare the mark with those on the 
body of Lunsford. Three other physicians testified for 
the defense. The judge summarized the case presenta-
tions in his instructions to the jury [26]:
It is claimed that the deceased when first discovered, 
had marks on the arm of a bite of the human mouth—
that they must have been inflicted at the time of the kill-
ing—that a model or copy of the defendant’s mouth was 
then obtained: and when tested and applied directly to 
the arm and marks, it corresponded and agreed accu-
rately in every particular. It is further claimed by the 
State that the model is an accurate copy of the defen-
dant’s mouth, and the mode of taking it is reliable—that 
the human teeth, by a bite will be distinctly and accu-
rately imprinted on the human arm: that the diversity 
of human mouths is almost infinite and endless: that 
the diversity is so great that no two exactly alike can 
be found: that the distinctive peculiarities of the defen-
dant’s mouth are even greater than is ordinarily found.
For the defendant, it is claimed that the mode of 
taking the model of his mouth is unreliable and conse-
quently the models are inaccurate: that the human teeth 
will not be accurately imprinted on the human arm by 
history of Bitemark evidence 9
a bite and that an accurate, or reliable test cannot he 
made by the application of a model of a mouth to the 
marks of a bite on the arm: that there is such a general 
uniformity of human mouths that the means employed 
by the State to ascertain and identify the mouth that 
inflicted the bites cannot be relied on in the case.
The jury deliberated for 6 hours and found Robinson 
not guilty. The procedures used, testimony given, and 
legal points cited are all remarkably similar to those of 
many cases that followed.
1.2.4 Additional Cases
1.2.4.1 Teeth Marks in Cigar Holders, Russia
In Teeth That Told, Keiser-Nielsen offers an account 
of a Russian case reported in a doctoral thesis at the 
University of Lyon in France. An expensive amber cigar 
holder found at a murder scene contained clearly visible 
depressions presumably caused by the irregular teeth of 
the owner. The depressions did not fit the victim, so the 
investigators theorized that the holder may have belonged 
to the killer. During the inquest, the judge asked a cousin 
of the victim during his testimony to try the holder in 
his mouth. The cousin “went pale and refused.” He was 
immediately arrested and his teeth “fitted exactly” into 
the depressions in the cigar holder [4,6].
1.2.4.2 Bitemark in Cheese, Germany, 1905
During a robbery in Germany in 1905, the culprit took a 
“goodly bite” out of a piece of Swiss cheese and left it on 
a windowsill. Police had a plaster cast made of the cheese. 
The resulting model showed an abrasion on the left side 
that was interpreted as a “pipe hole,” implicating one of 
several suspects [2].
1.2.4.3 Bitemark in Cheese, England, 1906
In a 1906 burglary case in County Cumberland in north-
ern England, a piece of cheese allegedly bitten by one of 
two accused burglars was brought into evidence. Dental 
impressions were made and resulting models compared 
to the cheese. The teeth of one of the two accused men 
were judged to fit the bitemark in the cheese, leading to 
the conviction of that man [3].
In a 1925 murder trial in Boston, the prosecutors 
claimed that marks on the left forearm of a murdered 
policeman were teeth marks and that the defendant’s 
lower anterior teeth, as shown in plaster of Paris mod-
els, “fitted these marks.” As a single arch “bitemark,” 
the prosecution theorized that the dead policeman’s 
rubber coat sleeve may have blocked the upper teeth. 
Over 1,000 mouths were inspected in an attempt to find 
teeth resembling the alignment seen in the bitemark 
and the defendant’s teeth. Impressions of more than 
a dozen of the most similar mouths failed to produce 
models that corresponded as well to the indentations in 
the skin as the defendant’s. The mark had been excised 
and stored in formalin. The changes in the excised skin 
compromised the accuracy of the prosecution’s case. 
The sketches of the indentations in the skin made at 
autopsy and 13 days later showed changes that did 
not correspond with meas ure ments of the defendant’s 
teeth, weakening the prosecution’s case [27].
1.2.4.4 The Heath Case, England, 1946The well-known forensic pathologist, Professor Keith 
Simpson, was involved in a famous murder case with 
bitemarks. Neville Heath, by all accounts, was an attrac-
tive and charming young man, but a habitual liar with 
unsavory habits. On June 20, 1946, he took Margery 
Gardner to London’s Pembridge Court Hotel after 
drinking at a local club. The next morning the maid 
found Gardner’s badly beaten and lifeless body tied on 
the bed. The nipples of both breasts were almost bitten 
off. Heath fled London to Bournemouth, changing his 
name to Group Captain Rupert Brooke. There he met 
and murdered Doreen Marshall. Her body was not 
found until after Heath had been arrested and returned 
to London under suspicion for the Gardner murder. Two 
deep knife wounds to the throat had killed Marshall. 
One nipple had been completely bitten off. Simpson was 
unable to link Heath definitively to the Gardner breast 
bitemarks due to the severity of the injuries. Heath was 
tried in September 1947 and found guilty. He was hanged 
October 16, 1946, at Pentonville Prison [28].
1.2.4.5 The Gorringe Case, England, 1948
Professor Simpson utilized bitemark analysis in another 
case. His testimony contributed to the evidence that led 
to the conviction of Robert Gorringe for the murder of 
his wife, Phyllis. Simpson’s opinion to the court that the 
bitemarks on Mrs. Gorringe’s body were made by her 
husband was one of the first recorded instances of foren-
sic odontology evidence in an English court being used 
to relate the teeth of a biter to bitemarks on skin [29].
1.2.4.6 Tunbridge Wells, England, 1949
Professor Simpson was also involved with the investiga-
tion of a New Year’s Day, 1949, murder in Kent. A girl 
had been killed in the back of a lorry, behind the police 
station in Tunbridge Wells. Her head had been battered 
in, she had been sexually assaulted, and there was a bite-
mark on her right breast. Unable to locate a dentist in 
the early hours of the morning after the crime, Professor 
Simpson himself took the dental impressions of the 
suspect. The unfortunate girl’s husband was arrested, 
10 Bitemark evidence: a color atlas and text, 2nd edition
charged, and convicted. Again, no dentist was involved 
in the prosecution of this case, but dental evidence 
played an important role [30].
1.2.5 Cases in Canada
1.2.5.1 Nova Scotia, 1924
The first known bitemark case in Canada occurred in 
Sheet Harbor, Nova Scotia, in 1924. Two local dentists, 
Drs. Bagnall and Faulkner, identified the bitemarks in 
an apple left at the scene of a burglarized clothing store 
as belonging to the teeth of the suspect, William Steele. 
He was convicted of burglary [31].
1.2.5.2 Quebec, 1930
In a 1930 Quebec case, a murdered infant was found 
with multiple bitemarks (Figure 1.5). This may be the 
first North American case of human bitemarks on skin 
that is documented by archival photography [10].
1.3 Bitemark Evidence in the modern 
Era (1950–2010): Cases leading 
to the Acceptance of Bitemark 
Evidence in Courts of law
1.3.1 Doyle v. State, 1954 (Texas)
The first reported case in the United States involving 
bitemarks was an appellate case. In the original case, 
Doyle had been accused of burglary and he allegedly left 
his bitemark in cheese at the scene (Figure 1.6). This first 
reported U.S. case is significant for establishing admis-
sibility in a court of law of bitemarks in food. A firearms 
examiner, with supporting testimony from a dentist, 
gave the testimony concerning the pattern evidence. At 
issue in the appeal was the manner in which the evi-
dence from the alleged biter was collected. Mr. Doyle 
was asked to bite into another piece of cheese, which he 
did voluntarily.
This evidence was introduced at trial and compared 
with the cheese from the crime scene, establishing a 
link between Mr. Doyle and the burglary. Doyle was 
convicted and the conviction was appealed later that 
same year on the grounds that Doyle’s constitutional 
rights were violated. The appellant claimed that a court 
order had not been issued for the gathering of evidence 
in violation of the Fourth Amendment, protection from 
illegal search and seizure, and the Fifth Amendment, the 
right to protection from self-incrimination. The appeals 
court denied Doyle relief on both issues [32].
1.3.2 Wayne Clifford Boden, 
1968–1971 (Canada)
Boden was a Canadian serial killer also known as the 
“vampire rapist” because he left bitemarks on the breasts 
of several of his victims. This was the first known case 
in the Canadian courts in which bitemarks in human 
skin were used to identify a perpetrator. Dr. Gordon 
C. Swann, a Calgary orthodontist, compared casts of 
Boden’s teeth to the bitemarks on the breast and neck of 
a 1971 murder victim, Elizabeth Ann Porteous. Using a 
system of direct geometric progression modified from 
a method described by Furness [33], he identified 29 
points of similarity leading him to conclude that “the 
bitemarks on the body of Porteous were indeed inflicted 
by the teeth of the accused Wayne Clifford Boden.”
Dr. Swann also reviewed evidence in three earlier 
murders in Montreal with similar features. He was 
unable to associate Boden with two of those cases but 
found 17 points of similarity to a bitemark on the breast 
of the October 1969 victim, Shirley Audette. Boden was 
transferred to Montreal, where forensic odontologist 
Figure 1.5 the earliest known archival photographs of multiple human bitemarks in an infanticide/homicide case from 
quebec, canada, 1930. (photos courtesy of Dr. Robert Dorion.)
Figure 1.6 Model of a bitemark in cheese in Doyle v. State.
history of Bitemark evidence 11
Dr. Araceli Ortiz, assisted by a fourth-year dental 
student, Robert Dorion, took dental impressions of 
Boden at the maximum-security Saint Vincent de Paul 
Penitentiary. Boden eventually confessed to the three 
Montreal murders and received four life sentences.
In a bizarre turn of events, Boden was able, while 
in prison, to apply for and receive an American Express 
credit card. In the fifth year of his life sentence, during 
an escorted day-pass excursion from prison, he escaped 
through the bathroom window of the Montreal Sheraton 
Hotel’s Kon Tiki restaurant. Using the credit card, he 
enjoyed 36 hours of freedom until he was recaptured at 
a nearby bar—the same one where he had met some of 
his victims 15 years earlier. Boden died of skin cancer in 
a prison hospital in 2006 [34].
1.3.3 People v. Johnson, 1972 (illinois)
In the first recorded case in the United States involv-
ing a bitemark in human skin, Johnson was accused of 
rape and aggravated battery. There was a bitemark on 
the breast of the victim. An Illinois dentist, Dr. Paul 
Green, testified that Johnson’s teeth were similar to the 
bite pattern on the breast of the victim. “Finally an oral 
pathologist in comparing a cast of defendant’s teeth 
with a photograph of the teeth marks on complainant’s 
breasts expressed the opinion that it was highly probable 
the teeth marks on the breasts were made by Johnson’s 
teeth.” Johnson was convicted of rape and aggravated 
battery and his conviction was upheld at the appellate 
level [35].
1.3.4 People v. Marx, 1974 (California)
This was the first case in the state of California involv-
ing bitemark evidence. Walter Marx was charged with 
the murder of Lovey Benovsky. An alleged bitemark 
was the only physical evidence offered by the pros-
ecution. The elderly female victim had been sexually 
assaulted and strangled. In February of 1974, Marx was 
jailed for contempt of court for refusing to provide den-
tal casts pursuant to a court order. Marx later consented 
to the impressions. At autopsy, the pathologist believed 
a patterned injury to be a possible bitemark but no bite-
mark evidence was collected at that time. Following 
autopsy, the body was embalmed and buried in Texas. 
In March, after Marx finally agreed to the teeth impres-
sions, Benovsky’s body was exhumed; a Dallasdentist 
made photographs and impressions of the nose and this 
material was sent to California (Figure 1.7).
Three forensic dentists worked both independently 
and together on the analysis of the bitemark, the first 
known case of a team approach to testing, evaluation, and 
comparison of a bitemark on the skin of a victim to the 
Figure 1.7 images of the nose (left) and three-dimensional model (right) of the bitemark on the nose of lovey Benovsky. 
the dental models compared are those of walter Marx.
12 Bitemark evidence: a color atlas and text, 2nd edition
teeth of a suspect. Test bites were performed in this case 
and a three-dimensional model of the nose was made. 
Overlays, three-dimensional comparisons, and scan-
ning electron microscopy were also used. None of these 
techniques had been documented as having been used 
in previous cases. Direct comparisons were also made 
utilizing the dental casts from the only suspect, Walter 
Marx, to the three-dimensional model of the nose.
The three dentists, Drs. Gerald Felando, Reidar 
Sognnaes, and Gerald Vale, testified at trial. All agreed 
that the teeth of Walter Marx made the bitemark in the 
nose of Lovey Benovsky. The admissibility of the bite-
mark evidence and the conviction of Walter Marx were 
challenged and upheld on subsequent appeals, effectively 
establishing the legal acceptability of bitemark evidence. 
Without the bitemark evidence, the prosecution did not 
have a strong case against Marx. He was convicted of 
voluntary manslaughter, not murder, based in part on 
the testimony of a psychiatrist [36].
1.3.5 State v. Bundy, 1979, 1980; 
Bundy v. State, 1984 (Florida)
Theodore Robert Bundy was believed to have killed many 
young women across the United States from Washington 
to Florida. He had escaped prison in Colorado and set-
tled in Florida. He was arrested after a traffic violation 
and held on suspicion of two murders and the assaults 
on three other female victims in Tallahassee, Florida, in 
January of 1978. One of the Florida State University Chi 
Omega sorority house murder victims had patterned 
injuries on her left buttock suggesting bitemarks.
One photograph out of the thousands taken at the 
scene and at autopsy included a ruler held near the pat-
terned injury. This photograph allowed the injury to be 
sized for comparison by Dr. Richard Souviron, the chief 
forensic odontologist for the Miami-Dade medical exam-
iner. Dr. Lowell Levine and Dr. Norman “Skip” Sperber 
independently performed evaluations of the materials. 
All agreed that the bite pattern left on the victim was of 
evidentiary value and showed class and individual char-
acteristics of a double bitemark. They also agreed that 
Mr. Bundy’s teeth were unusual and distinctive and, 
more likely than not, had left the bitemark.
A Tallahassee, Florida, circuit court judge heard 
evidence and ruled on the admissibility of bitemark evi-
dence in the courts of the state of Florida. Drs. Souviron, 
Levine, and Sperber all testified at the evidentiary hear-
ing. In a change of venue, the trial, State v. Bundy, was 
moved to Miami, Florida. The proceedings began in 
July of 1979. The defense called Dr. Duane T. Devore, a 
board-certified forensic odontologist who testified that 
Bundy’s teeth were “not that unique” and produced pre-
orthodontic treatment dental models of individuals that 
had similar lower anterior teeth arrangement.
The prosecution pointed out that the models prof-
fered were preorthodontic treatment models of 11- to 
13-year-old individuals, none of whom had been in 
Tallahassee in January 1978. The prosecution’s experts 
testified that Bundy’s teeth (Figure 1.8) were distinctive 
and demonstrated the common features between his teeth 
and the marks. Drs. Levine and Souviron and Dr. Homer 
Campbell testified for the prosecution. Mr. Bundy was 
convicted of the aggravated battery of three victims and 
the murder of the two Chi Omega sorority sisters, Lisa 
Levy and Margaret Bowman. He was sentenced to death 
on both counts of murder and life without parole on the 
aggravated batteries. Bundy appealed but the appeals 
court upheld the lower court’s decision [37].
In 1980, Mr. Bundy was again on trial for murder, this 
time of 12-year-old Kimberly Leach of Lake City, Florida. 
Following the trial, he was found guilty and again sen-
tenced to death. The appeals on the Leach murder con-
viction were exhausted before those for the Florida State 
University students. At age 42, on January 24, 1989, Ted 
Bundy was executed in the electric chair for the murder 
of Kimberly Leach.
Mr. Bundy had been a suspect in approximately 40 
homicides of young females in the states of Washington, 
Oregon, Colorado, Utah, and Florida. The Bundy case 
was significant for forensic odontology, firmly establish-
ing the admissibility of bitemark evidence in Florida and 
bringing bitemark evidence to national prominence.
1.3.6 other Significant Cases
1.3.6.1 State v. milone, 1973 (Illinois)
Richard Milone was charged with the 1972 murder of 
Sally Kandel, who had a bitemark on her inner right 
thigh. He was tried and convicted in 1973 in a bench 
trial in DuPage County, Illinois.
Three prosecution dental experts testified for the 
prosecution that Milone was the biter. Four dental 
experts for the defense disagreed in this now classic 
“battle of the experts” case. On appeal, three additional 
dental experts concurred with the original prosecution 
experts. The defense attempted to offer the testimony of 
an additional defense expert but was denied, bringing 
the total number of dental experts involved with this 
still controversial case to 11.
Milone was convicted and his state appeal was 
denied in 1976. A federal appeal was denied in 1994. 
Part of the basis of the federal petition was the assertion 
that, at the original trial in 1973, “forensic odontology” 
history of Bitemark evidence 13
was in its infancy and unreliable; however, in the inter-
vening years the “science of forensic odontology” had 
“advanced considerably” and now evidence was avail-
able that tended to exclude Milone and was “shown to 
match” another man.
That other man was Richard Macek, a confessed and 
convicted serial killer. Macek had confessed on multiple 
occasions to the murder of Sally Kandel. Sources disagree 
on whether he later recanted those confessions. Macek 
committed suicide in his jail cell in 1987 [38,39]. The 
1994 court affirmed the earlier state dismissal of Milone’s 
petition and included this statement regarding bitemark 
evidence in the case: “With respect to its probative value, 
while the science of forensic odontology might have been in 
its infancy at the time of trial, as Milone asserts, certainly 
there is some probative value to comparing an accused’s 
dentition to bite marks found on the victim” [39].
1.3.6.2 Wilhoit v. State, 1991 (Oklahoma)
Greg Wilhoit was accused of the 1985 murder of his 
former wife. Two prosecution dental experts testified 
that Wilhoit’s teeth matched a bitemark found on the 
victim and that bacteria cultured from the bite area were 
unique to him. No defense dental expert testified at the 
original trial. Following Wilhoit’s conviction and death 
sentence, Dr. Thomas Krauss, who had been hired by 
the Wilhoit family but not used at trial, sent the case 
evidence to 11 other board-certified forensic dentists. 
Dr. Krauss and all 11 of the consulted forensic odontolo-
gists independently excluded Wilhoit as the creator of 
the bitemark on Mrs. Wilhoit.
At an appellate pretrial hearing, Dr. Krauss and 
Dr. Richard Souviron testified that Wilhoit could be 
excluded as the biter. Both also stated that the bacterial 
evidence proffered by the prosecution dental experts, 
Drs. R. T. Glass and R. K. Montgomery, was flawed. 
They stated that more than 50% of the population would 
be expected to have the same types of oral bacteria 
reportedly found. Citing, in part, the defense attorney’s 
failure to investigate and utilizebitemark evidence, the 
appeal court ruled that his attorney was deficient and 
that Wilhoit had ineffective counsel. The prosecution 
decided not to retry him. Wilhoit was freed after spend-
ing more than 5 years in prison on death row [40].
Figure 1.8 an anterior view ted Bundy’s teeth in 1979. images of the varying faces of Bundy.
14 Bitemark evidence: a color atlas and text, 2nd edition
1.3.6.3 People v. moldowan and Cristini, 
1991; People v. moldowan, 2002; 
People v. Cristini, 2004 (Michigan)
Following the 1990 kidnapping, assault, and rape of 
Maureen Fournier, she named five men who she said 
participated in the attack. Two of the men had allegedly 
bitten her. At trial in 1991, both Michael Cristini and 
Jeffrey Moldowan were convicted of the attacks. The 
convictions were based on the victim’s identifications 
and two forensic odontologists’ testimony that the bite-
mark associations were positive.
Dr. Alan Warnick, a forensic odontologist, was a con-
sultant to the Wayne County Medical Examiner’s Office. 
He was also a consultant to Macomb County, Monroe 
County, and the Michigan State Police. Dr. Warnick 
offered expert testimony that bitemarks on Fournier’s 
neck were consistent with dental impressions taken from 
Moldowan and that bitemarks on Fournier’s right arm 
and right side were consistent with Michael Cristini’s 
dentition. In describing his conclusions, Dr. Warnick 
testified that “chances are … 2.1 billion to 1 that another 
individual can make those same marks” (J.A. 2544) [41].
The other prosecution dental expert at the origi-
nal trial testified in support of Dr. Warnick’s conclu-
sions, but later recanted her testimony. In recanting, 
Dr. Pamela Hammel stated that “Dr. Warnick had been 
deceptive in order to mislead [her] into testifying in 
support of his conclusions” (J.A. 2568) [41]. On appeal 
in 1997, two dental experts, Drs. Homer Campbell and 
Richard Souviron, testified for the defense that both 
Moldowan and Cristini could be excluded as Fornier’s 
biters (R. Souviron, personal communication, 2008). 
Cristini and Moldowan were both later acquitted of the 
charges in separate trials [42].
1.3.6.4 State v. krone, 1992, 1995 (Arizona)
Kimberley Ancona was attacked and killed in the early 
morning hours of December 29, 1991, at the CBS Lounge 
in Phoenix, where she worked as a bartender. A forensic 
dentist called to the scene noted a probable bitemark on 
the decedent’s left breast (Figure 1.9). He stated that the 
biter likely had “crooked” teeth.
The investigation led police to a frequent cus-
tomer of that bar, U.S. Postal worker Ray Krone, who 
was arrested and charged. Phoenix forensic odontolo-
gist Dr. John Piakis consulted first Dr. Norman “Skip” 
Sperber and later Dr. Ray Rawson. At trial, Drs. Piakis 
and Rawson testified for the prosecution. Dr. Piakis tes-
tified that Krone was the probable biter and Dr. Rawson 
that Krone was the biter with “reasonable medical cer-
tainty.” Dr. Sperber was not called by the prosecution. No 
dental expert testified for the defense at the original trial. 
Krone was convicted in the highly publicized “snaggle-
toothed killer” case and given a death sentence.
In 1995 the Arizona Supreme Court reversed the 
conviction on procedural grounds and Krone was to 
have a new trial. Four forensic odontologists, including 
Dr. Sperber, independently excluded Krone as the per-
son who made the bitemarks. Dr. Rawson again testi-
fied for the prosecution. Krone was found guilty in this 
retrial but sentenced to life in prison. As a result of the 
efforts of a relative and the Innocence Project, DNA evi-
dence from the case was finally analyzed in 2002. The 
analysis not only excluded Krone but also resulted in 
a positive comparison to another man, coincidentally 
incarcerated in the same prison as Krone. At the time 
of the Ancona murder, Kenneth Phillips had lived very 
near the ABC Lounge and was a frequent customer. 
When questioned, Phillips confessed his involvement. 
Ray Krone was released and exonerated after spending 
13 years in prison, including 3 years on death row.
1.3.6.5 State v. Brewer, 1995; Brewer v. State, 
1998, 1999 (Mississippi)
Kennedy Brewer was accused of the 1991 sexual assault 
and murder of 3-year-old Christine Jackson, the daugh-
ter of the girlfriend with whom he lived. Jackson’s 
body had been found in a nearby creek 3 days after her 
Figure 1.9 image of the ancona breast bitemark compared with a polystyrene exemplar of krone’s maxillary teeth (left). 
one odontologist’s tooth numbering (universal) scheme for the bitemarks (right).
history of Bitemark evidence 15
disappearance. On the night in question, Christine 
Jackson’s mother was out and Brewer was her babysit-
ter. The prosecution’s dental expert, Dr. Michael West, 
reported that he found 19 human bitemarks on Jackson’s 
body that were “peri-mortem in nature” and “were 
indeed and without doubt inflected [sic] by Kennedy 
Brewer” [43]. Dr. West later testified that “to a reason-
able degree of medical certainty,” the teeth of Mr. Brewer 
made five of those marks and that it was “highly consis-
tent and probable that the other 14 bite mark patterns 
were also inflicted by Brewer” [44]. The defense dental 
expert, Dr. Richard Souviron, testified that the injuries 
were not human bites at all: “There could be insect activ-
ity there. There could be fish activity or turtle activity or 
who–God knows what” [44].
Brewer was convicted and sentenced to death. All 
appeals were unsuccessful until extensive efforts were 
undertaken by the Innocence Project. Those efforts 
included a comprehensive review of all the patterned 
injury material by forensic odontologists Drs. Iain 
Pretty, David Senn, and David Sweet, who concluded—
first independently and then jointly—that “none of the 
injuries seen in the photographic and video evidence 
are human bitemarks. Therefore, we are able to exclude 
human biting as a cause of these injuries” [45]. The effort 
also included an analysis of the aquatic animal popula-
tion of the creek in which Jackson’s body had been found. 
Forensic entomologist Dr. John Wallace and Innocence 
Project attorney Vanessa Potkin collected crawfish from 
the creek and Dr. Wallace transported them back to his 
laboratory at Millersville University in Pennsylvania. In 
experiments using sacrificed pigs, he was able to observe 
the feeding habits of the crawfish and found that they 
created very similar patterned injuries to pigskin, an 
acceptable experimental analogue for human skin.
In 2001, the Innocence Project was also successful 
in arranging a reanalysis of the victim’s vaginal swabs 
taken at autopsy. The swabs contained semen with DNA 
profiles of two men. Neither profile was consistent with 
Kennedy Brewer but did point to another early suspect, 
Justin Albert Johnson. Confronted in 2008, Johnson 
confessed to sexually assaulting and killing Jackson and 
to earlier killing another girl of similar age in almost 
exactly the same manner. Dr. West had also testified in 
that earlier case that Levon Brooks had bitten the victim: 
“It could be no one else but Levon Brooks that bit this 
girl’s arm” [46]. Despite the 2001 DNA evidence exclud-
ing Brewer, he was not released on bail until 2007 and 
not exonerated until after Johnson’s confession in 2008, 
almost 13 years after Brewer’s conviction, most of which 
time he spent awaiting execution.
1.3.7 Cases in modern Europe 
and the united kingdom
1.3.7.1 Fredrik Fasting Torgersen, 
Oslo, Norway, 1957
Firemen responding to a basement fire on the night of 
December 7, 1957, found the body of Rigmor Johnsen. 
The discovery of a bitemark on the left breast of the sexu-
ally assaulted and strangled 16-year-old girl initiated the 
longest running bitemark case in history (Figure 1.10).
Fredrik Fasting Torgersen was arrested in the neigh-
borhood that same night and became a suspect in the 
attack. Professor Ferdinand Strom collected the bite-
mark evidence fromthe victim and the suspect and he 
and Dr. Warhaug testified at the 1958 trial that Torgersen 
had made the bitemark. Torgersen was convicted and 
sentenced to life in prison.
A 1958 appeal confirmed the conviction. Torgersen 
served 16 years and was released in 1974. He maintained 
his innocence throughout and repeatedly sought a new 
trial. He received assistance from a large team of sup-
porters in Norway and there were multiple efforts before 
Figure 1.10 Rigmor Johnsen prior to autopsy (left). the only scaled image of the patterned injury to Johnsen’s left breast 
(right).
16 Bitemark evidence: a color atlas and text, 2nd edition
Supreme Court committees and the Commission for 
Criminal Case Review to procure a new trial. Over the 
years, many forensic odontologists have reviewed the 
evidence in this case and written reports. Those conclud-
ing that Torgersen was the biter include Drs. Ferdinand 
Strom, Jens Waerhaug, and Tore Solheim of Norway; 
Dr. Gisle Bang of Sweden; and Drs. Gordon MacDonald 
and David Whittaker of the United Kingdom. Forensic 
dentists excluding Torgersen as the biter include 
Drs. Marden Alder, Michael Bowers, David Senn, and 
Paul Stimson, all of the United States.
At the time of the writing of this chapter, there is 
still an ongoing effort to secure a new trial for Torgersen, 
52 years after his conviction in 1958 (E. Moss, personal 
communication, 2010).
1.3.7.2 Gordon Hay, Biggar, Scotland, 1967
Fifteen-year-old Linda Peacock was found murdered in 
a cemetery in Biggar, Scotland, on August 6, 1967. She 
had been strangled and there was a suspected bitemark 
on her right breast (Figure 1.11).
Gordon Hay was a detainee at a nearby school for 
troubled boys and became one of 29 persons initially 
considered to be viable suspects. Dr. Warren Harvey 
had examined many Biggar residents, including the 
boys from the Loaningdale School. Five of the boys were 
selected for additional scrutiny but only Hay showed 
unusual pits at the tips of the cusps of the canine teeth. 
Those pits, along with other features, were shown to be 
consistent with features seen in the bitemark. Dr. Harvey 
consulted with Professor Keith Simpson, a well known 
forensic pathologist with bitemark case experience. 
Dr. Harvey and his associates made a remarkably 
detailed study of the mark, the suspects, and the fre-
quency of occurrence of pits at the tips of canine cusps. 
Dr. Harvey and Professor Simpson testified at trial that 
Hay was the biter. Gordon Hay was convicted and, 
because he was a minor, sentenced to serve a term of 
undetermined length “at Her Majesty’s pleasure” [47].
1.3.8 Cases in modern Africa
1.3.8.1 State v. Shabangu, 1998
In the High Court of South Africa, before the Honorable 
Justice Curlewis, the case involved a piece of cheese 
with very clear teeth marks found next to the body of 
an elderly woman who had been raped and murdered. 
Dr. Piet van Niekerk, Professor Vince Phillips, and 
Professor Herman Bernitz piloted the forensic den-
tal evidence. All three concurred that Shabangu had 
indeed inflicted the bitemark in the cheese, but could 
not convince Justice Curlewis. At issue were these points 
(H. Bernitz, personal communication, 2010):
Which dental features are common, uncom-•	
mon, and very uncommon within the relevant 
populations
The need to refine pattern association and explain •	
how warping, shrinkage, and distortion do not 
affect pattern association analysis of bitemarks
The use of metric analysis in bitemark cases•	
The use of microscopic analysis in individual-•	
izing features within the bitemarks
The application of all the preceding in skin bite-•	
marks, which are very much more challenging
1.3.8.2 State v. nxele, 1999
This case was heard in the Pietermaritzburg High Court. 
Microscopic analysis of bitemarks was performed for the 
first time. A piece of cheese with very clear bitemarks 
was analyzed macroscopically and the analysis tested 
with a DMC comparison microscope used for analyzing 
Figure 1.11 crime scene in Biggar, Scotland, 1967 (left). Strangulation marks on neck and bitemark on right breast 
(center). Detail of bitemark on peacock’s right breast (right).
history of Bitemark evidence 17
firearm barrels and bullets. The sledge/scratch marks 
were matched to a point of absolute certainty because 
the suspect had very characteristic incisal patterns on 
his anterior central teeth. Senior superintendent Burgert 
Kloppers, a ballistics expert at Silverton Forensic Labor-
a tory, testified; his many years of court experience 
enhanced the ability of forensic odontologists to present 
evidence in this court case correctly. Since his inclusion 
on the bitemark team, no evidence has been submitted 
without his corroboration. “This partnership I believe 
has been the cornerstone of our success and should 
be practiced more regularly by our colleagues around 
the globe” (H. Bernitz, personal communication, 2010).
1.3.8.3 Vierfontein, Free State, 2002
A farmer and his wife were attacked and murdered on 
their small holding in the Vierfontein area of the Free 
State. The woman was also raped. Following a thorough 
forensic investigation, it became clear that the perpetra-
tors had used gloves during the robbery and had used 
condoms during the rape. This created a situation where 
very little evidence was present at the crime scene. Police 
found a half-eaten apple in the driveway. The apple had 
a very characteristic dental arch pattern profile on the 
surface skin where the incisal edges of the teeth had 
entered. The pattern could be accurately matched to 
the suspect’s dentition with a high degree of certainty. 
In this case, both macroscopic and microscopic analy-
sis confirmed the high degree of concordance present 
(H. Bernitz, personal communication, 2010).
1.3.9 Cases in modern Australia
1.3.9.1 Ipswich, Queensland, 1973
At dawn on Saturday, April 14, 1973, 17-month-old 
Deidre Kennedy’s body was found tossed onto the roof 
of a toilet block, 500 m from the Kennedy family’s two-
bedroom flat in Ipswich. The infant had been abducted 
sometime after 10 p.m. the previous night while sleep-
ing beside her sister, Stephanie. She had been sexually 
assaulted and strangled. Three bitemarks were identified 
on the outside of Deidre’s left leg. The killer had dressed 
the tiny girl in a woman’s half-slip, panties, and step-ins, 
all stolen from a clothesline next door. The case was vig-
orously investigated but, one by one, the suspects were 
cleared and the case went cold.
Then, in 1984, Raymond John Carroll came under 
suspicion in a case similar to the Kennedy murder. Hair 
samples and dental impressions were collected with 
Carroll’s consent. Investigators were told by forensic 
odontologist Cornel Romaniuk, who had examined the 
Kennedy evidence, “This is your killer” [48]. At Carroll’s 
trial in February 1985, dental evidence was given by 
Romaniuk and two other odontologists, Kenneth 
Brown and Bernard Sims. Carroll was convicted and 
sentenced to life imprisonment. Brown later stated that 
he was “very, very confident” that Carroll had made the 
bitemarks on Kennedy’s body. Nevertheless a court of 
criminal appeals overturned the verdict, citing that the 
odontology evidence was “unsafe and unsatisfactory.”
After the reversal, further evidence was found, but 
Carroll could not be charged again with the same murder. 
He was charged instead with perjury—that he had lied at 
his murder trial when he said he had not killed Kennedy. 
This second jury found him guilty of perjury in 2000. That 
conviction, however, was also overturned on appeal. 
The high court also rejected an application from the 
Queensland government to annul the appeals court deci-
sion [49]. A single pubic hair found on Deidre Kennedy’s 
body could have been critical evidence. Unfortunately, 
the hair failed to yield a DNA profile, reportedly because 
the evidence was destroyed by a “laboratory bungle” [48]. 
Citing Australia’s double jeopardyrule, the high court 
has held that Carroll could never again face a criminal 
trial with regard to Kennedy’s murder.
1.3.9.2 Darwin, Northern Territory, 1986
A Darwin woman left the Victoria Hotel after an argu-
ment with her boyfriend, Dean Teau. After a side trip 
to a discotheque, she decided to return to her hotel. A 
young man whose advances she had rejected followed 
her there and attacked and raped her. After the attack, 
she felt ill and, unbelievably, the man offered to take her 
to a hospital. He hailed a taxi, and both were in the taxi 
when Teau arrived at the scene. Screaming that she 
had been raped, Teau pulled the assailant from the taxi 
and held him in a headlock, but he escaped by severely 
biting Teau on the chest.
Michael Anthony Lewis was later arrested and 
accused of the attack. He consented to the gathering of 
dental evidence by Dr. J. R. Plummer, who consulted 
with Dr. B. Sims. Both gave evidence at trial that the 
wound on Teau’s chest was a bitemark made by Lewis’s 
teeth. Dr. S. D. Dalitz testified for the defense. All agreed 
that there were bruises left by five lower teeth and no 
marks from upper teeth. Lewis was tried and convicted 
of rape on October 24, 1986. The judge in the original 
trial stated in part that “the evidence clearly established 
that the study of the characteristics of human bite marks 
and consequent identification of persons responsible 
18 Bitemark evidence: a color atlas and text, 2nd edition
for such marks fall within a field of expertise, and the 
witnesses called for the Crown (no expert was called for 
the defense) are all experts in that field.”
On appeal, the petition was granted and the con-
viction was quashed. One appellate judge noted that 
“there is a very considerable risk that the jury were awed 
by Mr. Sims’ credentials and the confident manner in 
which he expressed his conclusion, notwithstanding 
that its probative value in linking the appellant to the 
rape was not demonstrated to be great” [50].
1.4 Forensic odontology organizations
1.4.1 international organization for Forensic 
odontostomatology (ioFoS)
This international organization has 18 component soci-
eties or associations. The IOFOS publishes newsletters 
three times each year and has also published the Journal 
of Forensic Odontostomatology twice annually since June 
1983. In 1987 the journal became the official publication 
of the IOFOS. Starting in 2008, this refereed, fully indexed 
journal ceased its print version and began publishing the 
journal in an electronic version only. The journal is avail-
able without subscription on the organization’s Web site 
at http://www.odont.uio.no/foreninger/iofos/.
Member societies and associations include:
American Society of Forensic Odontology
Australian Society of Forensic Odontology
Austrian Society of Forensic Medicine (OGGM)
British Association for Forensic Odontology
Croatian Association of Forensic Stomatologists
Arbeitskreis für Forensische Odontostomatologie 
—Germany
Danish Society of Forensic Odontology
Finnish Association of Forensic Odontology
Flemish Association of Dental Experts
Forensische Zahnärzte der Schweiz (FOCH) 
—Switzerland
Association Francaise d’Identification Odontologic 
(AFIO)
Icelandic Society of Forensic Odontology
Japanese Society of Forensic Odontology
Korean Committee of Forensic Odontology/Dental 
Jurisprudence
Nederlands Forensische Medische Genootscap
New Zealand Society of Forensic Odontology
South African Society for Forensic Odonto-
stomatology
Swedish Society of Forensic Odontology
The IOFOS also maintains a list of worldwide foren-
sic odontology contacts known as the “Burgmann list.” 
Although not necessarily current, it lists forensic odon-
tologists from 123 countries worldwide.
1.4.2 The odontology Section of the American 
Academy of Forensic Sciences (AAFS)
In 1970 forensic odontology was recognized by the 
forensic science community as a specialty of forensic 
science with the formation of the odontology section of 
the AAFS. Dr. Lowell Levine served as the first section 
chairman and Dr. Edward Woolridge was the first sec-
tion secretary.
1.4.3 The American Society of Forensic 
odontology (ASFo)
The AFSO was also formed in 1970. Col. Robert Boyers 
and others from the faculty of the Armed Forces 
Institute of Pathology (AFIP) forensic odontology 
course were instrumental in the organizational effort. 
From those beginnings, the ASFO has grown into the 
largest single forensic odontology organization in the 
world (it is a component of the IOFOS), offering annual 
educational programs at its meeting in conjunction with 
the annual AAFS meetings. It also publishes the Manual 
of Forensic Odontology, now in its fourth edition, with a 
fifth edition planned.
1.4.4 Canadian Society of Forensic Science 
(CSFS), odontology Section
That seminal year of 1970 also included the merger 
of the Canadian Association of Forensic Odontology 
with the Canadian Society of Forensic Odontology. This 
group became the odontology section of the CSFS in 
1972.
1.4.5 American Board of Forensic odontology
In 1976, with the initial sponsorship of the American 
Academy of Forensic Sciences (AAFS) and the encour-
agement and assistance of the National Association of 
Medical Examiners (NAME), the American Board of 
Forensic Odontology (ABFO) was formed. The charter 
members of the ABFO were Drs. Edward Woolridge, 
Richard Souviron, Curtis Mertz, Arthur Goldman, 
Gerald Vale, Stanley Schwartz, Lowell Levine, Robert 
Dorion, Paul Stimson, David Scott, Manuel Maslansky, 
and George Ward. Dr. Curtis Mertz served as the ABFO’s 
first president from 1976 until 1978.
history of Bitemark evidence 19
The ABFO was organized to provide, in the inter-
est of the public and for the advancement of the sci-
ence, a program of certification in forensic odontology. 
The objective of the board is to establish, enhance, and 
revise, as necessary, standards of qualification for those 
who practice forensic odontology and to certify as qual-
ified specialists those applicants who comply with the 
requirements of the board.
The ABFO maintains standards and guidelines 
relating to bitemark evidence. These can be found in the 
ABFO Diplomates’ Reference Manual, which is updated 
and posted on the organization’s Web site at www.abfo.
org. The standards address analytical methods and bite-
mark terminology.
Standards for analytical methods:
 1. All diplomates of the American Board of 
Forensic Odontology are responsible for 
being familiar with the most common ana-
lytical methods and should utilize appropri-
ate analytical methods.
 2. A list of all the evidence analyzed and the 
specific analytical procedures should be 
included in the body of the final report. All 
available evidence associated with the bite-
mark must be reviewed prior to rendering 
an expert opinion.
 3. Any new analytical methods not listed in the 
previously described list of analytical meth-
ods should be explained in the body of the 
report. New analytical methods should be 
scientifically sound and verifiable by other 
forensic experts. New analytical methods 
should, if possible, be substantiated with 
the use of one or more of the accepted tech-
niques listed in these guidelines.
Standards for terminology:
 1. Terms assuring unconditional identification 
of a perpetrator, or without doubt, are not 
sanctioned as a final conclusion.
 2. Terms used in a different manner from 
the recommended guidelines should be 
explained in the body of a report or in 
testimony.
 3. All boarded forensic odontologists are 
responsible for being familiar with the stan-
dards set forth in this document.
The guidelines are extensive and periodically updated. 
They can be viewed on the Web site.
1.5 History of Bitemark Education 
in north America
1.5.1 Armed Forces institute 
of Pathology (AFiP)
In 1962 a course in forensic odontology was implemented 
by the Armed Forces Institute of Pathology (AFIP) in 
Washington,D.C. Drs. Albert Dahlberg, Louis Hansen, 
John Salley, Viken Sassouni, and David Scott gave presen-
tations in the initial 4-day course. Soon the course became 
an annual event and the 2010 course was billed as the 46th 
Annual Forensic Dental Identification and Emerging 
Technologies course. The week-long course includes edu-
cation in all phases of forensic odontology including bite-
marks. The 2010 course directors were Duane R. Schafer, 
Capt., DC, USN, and Christopher G. Fielding, Col., DC.
1.5.2 mcgill university and the laboratoire 
de Sciences Judiciaires et de 
médecine légale (lSJml)
Believed to be the first North American forensic labo-
ratory formed under legislative authority, the laboratory 
in Montreal known today as the Laboratoire de Sciences 
Judiciaires et de Médecine Légale was founded in Quebec 
in 1914. Dr. Robert B. J. Dorion has been the director 
of forensic dentistry since 1973. As a member of McGill 
University’s faculty of dentistry, Dr. Dorion has also been 
the director of a combined distance learning and on-site 
course since 2004. The course runs from September to 
August of the following year. Theory, readings, assign-
ments, and weekly live chats between participants and 
the course director take place over 24 weeks. Two addi-
tional weeks (10 days) are spent at the aforementioned 
forensic laboratory for practical hands-on training in 
May (identification) and in August (human bitemark 
analysis with a gold standard). Successful completion of 
the program leads to a certificate in forensic dentistry. 
Past graduates have traveled from as far away as Israel 
and New Zealand. Program information is available at 
http://www.mcgill.ca/dentistry/conted/forensic.
1.5.3 university of Texas Health Science 
Center at San Antonio Dental School
In 1979 at the Dental School of the University of Texas 
Health Science Center in San Antonio (UTHSCSA), 
Dr. James A. Cottone, assisted by Dr. S. Miles Standish, 
directed a symposium on forensic dentistry. Initially 
an annual symposium, the Southwest Symposium on 
Forensic Dentistry changed to biannual sessions in 1984. 
20 Bitemark evidence: a color atlas and text, 2nd edition
The 2010 week-long course was the 19th symposium. 
Dr. Cottone was the symposium director from 1979 
to 1994, Dr. Marden E. Alder directed it from 1996 to 
1998, and Dr. David R. Senn became director in 2000. 
Codirectors have included Drs. Paul G. Stimson, John 
D. McDowell, Paula C. Brumit, and Bruce A. Schrader. 
Dr. Stimson has been on the symposium faculty since the 
beginning in 1979 and has been a codirector since 1996.
In 1999, UTHSCSA opened the Center for Education 
and Research in Forensics (CERF) and accepted the 
first fellow in forensic odontology, Dr. John Williams 
of Minneapolis, Minnesota. Through 2010, 38 dentists 
have completed the fellowship and nine of those for-
mer fellows have become board certified by the ABFO. 
Dr. David R. Senn directs CERF and the fellowship in 
forensic odontology.
1.5.4 Bureau of legal Dentistry (BolD)
In 1997 in Vancouver, British Columbia, Canada, the 
Bureau of Legal Dentistry (BOLD) began full-time oper-
ation in forensic odontology research, casework, and 
undergraduate and graduate teaching. BOLD was made 
possible by contributions from the provincial govern-
ment and with support from the Faculty of Dentistry of 
the University of British Columbia. Dr. David J. Sweet, 
O.C., has been the director of BOLD since its creation.
1.5.5 other Courses
Northwestern University Dental School, Chicago, Illinois 
(1891–2001), sponsored courses in bitemark analysis 
before the school closed its doors in 2001. The University 
of Detroit (Michigan) Mercy School of Dentistry offers 
annual courses in forensic odontology that include edu-
cation in bitemark recognition and analysis. Dr. Allan 
Warnick is the course director.
1.6 Challenges to the legitimacy 
of Bitemark Evidence
Investigators from both outside and within forensic 
odontology have challenged the reliability and accuracy 
of bitemark analysis. Most of these challenges cite the 
paucity of scientific research into the bases for the disci-
pline. The specific issues include questions about (1) the 
uniqueness of the anterior human dentition, (2) human 
skin as a bite registration medium, (3) the scientific bases 
for analytical methods, (4) management of observer 
effects and bias, and (5) the levels of conclusions possible 
for specific types of cases.
1.6.1 Bitemark Evidence Controversies
Many early and modern forensic odontologists have 
urged that bitemark evidence be viewed and reported 
with caution. The sensational nature of the cases involv-
ing bitemarks may have contributed to the acceptance 
of the evidence in courts before the science supporting 
it was fully developed. Many of the cases described pre-
viously and in the following chapters illustrate the need 
for that caution. Later chapters will also explore the root 
causes of and offer strategies for avoiding or minimizing 
future controversies.
1.6.2 national Academy of Sciences 
2009 report
Beginning in April 2007, the Committee on Identifying 
the Needs of the Forensic Science Community reviewed 
and investigated many facets of forensic science, includ-
ing forensic odontology. The reported aim of the commit-
tee was “to chart an agenda for progress in the forensic 
science community and its scientific disciplines.” In 
February 2009, the committee released its report, titled 
Strengthening Forensic Science in the United States: 
A Path Forward. Chapter 5, “Descriptions of Some 
Forensic Science Disciplines,” includes a section titled 
Forensic Odontology. With the exception of the first 
paragraph, the entire section deals with problems asso-
ciated with bitemark analysis and bitemark evidence.
In the summary, the report states that “although 
the majority of forensic odontologists are satisfied that 
bite marks can demonstrate sufficient detail for positive 
identification, no scientific studies support this assess-
ment, and no large population studies have been con-
ducted.” The report also says, “In numerous instances, 
experts diverge widely in their evaluations of the same 
bite mark evidence. The committee received no evidence 
of an existing scientific basis for identifying an individ-
ual to the exclusion of all others.” The committee closed 
the section on forensic odontology by stating that “some 
research is warranted in order to identify the circum-
stances within which the methods of forensic odontol-
ogy can provide probative value” [51].
This report is widely viewed as a “wake-up call” 
to practitioners of forensic odontology to take steps to 
firmly establish the scientific bases for bitemark analysis 
and bitemark evidence.
history of Bitemark evidence 21
1.7 Perspective on the relationship 
between the Past and Future 
of Bitemark Evidence
“Those who cannot remember the past are condemned 
to repeat it” [52]. This often misquoted George Santayana 
maxim is a wise warning to practitioners of bitemark 
analysis. To ignore the warning and to fail to study the 
history of bitemark evidence is to risk repeating earlier 
errors of omission and commission. The acceptance (some 
would say premature acceptance) of bitemark evidence in 
the Doyle and Marx cases led to the wide use and misuse 
of bitemark evidence by forensic dentists and others.
That so much is heard and written about the rela-
tively few problem bitemark cases and almost nothing 
of the many cases that were properly handled is unfor-
tunate. However unfortunate that may be, forensic den-
tists are not absolved of the responsibility to study and 
understand those cases so that errors can be minimized 
in the present, thereby improving the discipline in the 
future. Forensic odontologists must engage in continu-
ous research to develop and expand the scientific bases 
of the discipline. The examination of current practices 
and theories and the rejection of those shown to beerroneous or inadequate are mandatory. Forensic odon-
tology’s certifying bodies must effectively test and peri-
odically retest their certified members for proficiency in 
bitemark analysis.
It is the opinion of this author that bitemark evi-
dence is too potentially valuable to our systems of jus-
tice to be discounted or abandoned. Such evidence offers 
useful information and specific advantages, especially 
in certain types of cases.
Acknowledgments
Information on the African cases was excerpted from 
material generously provided by Professor Herman 
Bernitz, School of Dentistry, University of Pretoria, 
Pretoria, South Africa. He is also president of the 
IOFOS. Professor Bernitz added (personal communica-
tion 2010):
We are now regularly required to give expert witness 
testimony in bite mark cases around South Africa, 
which we do with confidence in the knowledge that we 
understand the dynamics of biting, the effects of warp-
ing, shrinkage and distortion, the shortfalls of metric 
analysis and the reliability of pattern association. It is 
important to realize that we are selective as to which 
skin bite mark cases we choose to analyze. Not all bite 
marks are suitable for analysis: We only analyze skin 
bite marks where individual dental features can be 
clearly identified. 
Information on Australian cases was gleaned from 
material suggested by Dr. Anthony J. Hill, president of 
the Australian Society of Forensic Odontology.
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human progress. New York: C. Scribner’s Sons (5 v.).
http://www.ourcivilisation.com/signs/deidre.htm
http://www.ourcivilisation.com/signs/deidre.htm
iiBitemark recognition
25
2
2.1 overview of Biting Associated 
with Domestic violence
North Americans and Europeans continue to report that 
violence in society is one of their main concerns, and 
domestic violence is continuing to increase in both loca-
tions. Whereas the home should be a safe haven from 
violence, the family is anything but safe for many indi-
viduals. Children, women, the disabled, and the elderly 
are more likely to be victims of intentional trauma 
within their own homes than they are at any other single 
location. Most domestic violence goes unreported and 
therefore undocumented.
Citing the work of Jaden and Thoennes [1], the 
National Center for Injury Prevention and Control, a divi-
sion of the Centers for Disease Control and Prevention, 
has reported that in the United States (1) approximately 
1.5 million women and 0.8 million men are raped and/or 
physically assaulted by an intimate partner each year, 
(2) more than 500,000 women injured during IPV (inti-
mate partner violence) require medical treatment, and 
(3) one in four women has been physically assaulted or 
raped by an intimate partner, and one in fourteen men 
has reported assault or rape by an intimate partner.
Because intentionally inflicted trauma can be per-
petrated upon any member of the family, it is difficult 
to separate one form of domestic violence from another. 
Battered women are arguably the most common subset 
of domestic violence victims within dysfunctional fami-
lies. Not surprisingly, a battered woman is at greater risk 
of generating a battered child. A child reared within a lov-
ing, supportive, nonviolent home is less likely to become 
an abuser. Concurrence rates of intimate partner abuse 
and child abuse (an abused mother with an abused child 
or children) have been reported approximating 50% of 
all cases [2,3]. Witnessing violence is a risk factor for 
long-term mental and physical health, including being a 
victim of abuse or perpetrating abuse [4,5].
Without intervention, inflicted trauma tends to 
persist throughout the time that families live together. 
Some abused children learn that violent behavior is a 
way of accomplishing short- or long-term goals. Abused 
children might grow into abused or abusive adults. This 
violent learned behavior can lead to dysfunctional and 
abusive relationships that may continue for years, even 
beyond the seventh and eighth decades of life.
Regardless of age or ability, the individual within a 
violent relationship can be the recipient of any number of 
different injuries. These include shooting, stabbing, hitting, 
slapping, kicking, pushing, and biting. Biting as a means of 
inflicting injury has been reported in nearly every devel-
oped country. Excellent articles on recording and analyz-
ing bitemark evidence originate from the United States, 
Canada, all of the countries within the United Kingdom, 
India, Russia, and Germany, to name a few [6–14]. Bitemark 
injuries appear to be a universal problem.
2.2 Child Abuse
Child abuse is a major public health threat in North 
America. Most reporting agencies indicate that approxi-
mately 1 million American children suffer nonfatal, 
intentionally inflicted physical injuries during any given 
year. For the past several years, the National Center for 
Injury Prevention and Control has consistently reported 
that homicide is the fourth leading cause of death in 
children between the ages of 1 and 10 years and the 
third leading cause of death for children aged 10–14. 
Approximately 1,200 children die in the United States 
The role of Health Professionals 
in Diagnosing Patterned injuries 
from Birth to Death
John D. McDowell
Contents
2.1 Overview of Biting Associated with Domestic Violence 25
2.2 Child Abuse 25
2.3 Intimate Partner Abuse 27
2.4 Bitemarks in Elder Abuse 28
2.5 Conclusion 29
References 30
26 Bitemark evidence: a color atlas and text, 2nd edition
every year from abuse and neglect; many die because of 
physical injuries inflicted by one or both parents. Among 
many other forms of trauma, evidence of biting is fre-
quently seen in fatal and nonfatal child abuse cases.
Bitemarks can take many forms and can be seen 
in various stages of healing in the living abused child. 
Figure 2.1 (left) reveals a recent cheek bitemark on a 
3-year-old African American. According to the mother, 
the child was left in the care of the boyfriend for a brief 
period. Upon her return, the child had been badly burned 
by water immersion. The mother immediately noticed 
the cheek injury and made sure that medical personnel 
attending to the child’s burns photographed the bite-
mark. The bite is reportedly less than 2 hours old.
Figures 2.1 (right) and 2.2 (left) demonstrate two 
separate bitemarks in a child abuse victim with signifi-
cant head injuries. Figure 2.1 (right) shows a bitemark on 
the child’s left upper arm and attests to the importance of 
making several photographs of the bitemark on a curved 
surface. The photograph should include as much of the 
dental arches as possible in one frame while remaining 
perpendicular to the majority of the bitemark. In this 
example, the canine-premolar region is recorded but 
the incisor regions are unclear. Figure 2.2 (left) illus-
trates the proper photographic technique for localizing 
and orienting the bitemark with the American Board of 
Forensic Odontology (ABFO) no. 2 scale. It is also rec-
ommended that additional photographs be taken from 
a more distant vantage point without scale and with the 
removal of any materials or equipment. Although some 
bitemarks associated with child abuse may be reason-
ably clear, more commonly the diagnosed bitemark is 
a diffuse ecchymosis that may initially appear to be of 
little evidentiary value. Notwithstanding the limitations 
rightfully associated with these diffuse injuries, valu-
able evidence may also be associated with these marks. 
Figure 2.2 Bitemark on the upper chest (left) and diffuse bitemark on the abdomen (right).
Figure 2.1 Bitemark on cheek and arm.
the Role of health professionals in Diagnosing patterned injuries from Birth to Death 27
Figure 2.2 (right) shows a diffuse abdominal bitemark on 
a 4-year-old homicide victim. There are few individual 
dental characteristics detected within the class charac-
teristics. However, the bitemark may contain significant 
evidence in the form of saliva from which the perpetra-
tor’s DNA can be recovered.
Color and black-and-white photographs are not the 
only bitemark-recording media. Bitemarks and other 
healing pattern injuries might be recorded by imaging 
techniques not commonly available to medical emergency 
personnel. Infrared, ultraviolet, and alternate light record-
ing systems might be available through law enforcement, 
forensic labs, or medical examiner offices. These imaging 
systems record beyond the visual light spectrum.
It is also important to note that the ABFO no. 2 
scale (available through Lightning Powder Company) in 
Figures 2.1 (right) and 2.2 (left) references the bitemark 
metrically. Whether recorded on film or digitally [15], 
an additional gray-scale reference is present for density 
reproduction of the captured image. The less acceptable, 
one-dimensional ruler in Figure 2.2 (right) also shows a 
Kodak color control patch, which is used by some pho-
tographers to verify color accuracy.
2.3 intimate Partner Abuse
Intimate partner abuse (also called spouse or spousal 
abuse) is the commonest form of domestic violence. 
There has been much debate over which gender is more 
likely to commit abuse or which member in the partner-
shipis more likely to be abused.
Historically, most authors have reported that women 
are more frequently recipients of abuse and receive the 
more severe injuries. However, several recent studies, 
including meta-analyses, conclude that men are just as 
likely to be abused as women [16–21]. A review of the 
behavioral science literature indicates that some studies 
report that women were more likely than men to com-
mit acts of aggression and more frequently use aggres-
sive acts [22–26]. It does not matter whether the man or 
the woman is more likely to be physically aggressive; that 
both may commit acts of violence against an intimate 
partner is important. This includes biting [27–29].
As in child abuse, bitemarks associated with spouse 
abuse may be found on any part of the body. Figure 2.3 
(left) reveals an ill-defined bitemark on the mons pubis. 
After other physical evidence was collected and the area 
was photographed extensively under various lighting 
conditions, the pubic hair was shaved to demonstrate 
the diffuse bruising more clearly. The maxillary canines 
produced the prominent contusions. When detected by 
health care providers, law enforcement personnel, or 
others, bitemarks should be treated and documented 
in accordance with standard institutional practices. 
Additionally, any forensic evidence should be recovered 
including, when indicated, salivary evidence from the 
wounds. Photography remains a significant means of 
evidence collection and preservation. When curved sur-
faces like breast tissue or extremities are photographed, 
it is often necessary to take photographs in two or more 
planes. Figure 2.4 demonstrates one technique for 
aligning the film plane with the bitemarks. Figure 2.3 
(right) shows a bitemark on the woman’s upper back. 
Note how the bitemark can be recorded in one photo-
graphic frame. Depending on the biter’s force and move-
ment, avulsive injuries can occur. Bitemark analyses are 
often more complex when tissue has been distorted or 
removed. Medical intervention, including suturing and 
bandaging, inflammation, and the healing process itself, 
Figure 2.3 Bite on the mons pubis and on the back.
28 Bitemark evidence: a color atlas and text, 2nd edition
may compound the problem. Figure 2.5 (left) displays 
a bitemark on an abused woman’s upper right chest. 
Although the victim was very specific on the perpetra-
tor’s identity and timing of the event, the bitemark anal-
ysis could not provide identity confirmation. Figure 2.5 
(right) depicts a nose bitemark produced during a vio-
lent struggle. The bite was so deep that the tip of the nose 
was nearly lost in transport.
Figure 2.6 (left) demonstrates a neck bitemark 
inflicted during domestic violence. Several hours after the 
assault, the woman presented to the emergency depart-
ment for treatment of other injuries. When asked about 
the neck bruise, the woman admitted that she had been 
bitten. Individual teeth marks cannot be identified within 
the inflammation; however, serial photographs should 
be taken with various films and light sources. 
2.4 Bitemarks in Elder Abuse
The 2000 census revealed that more than 20% of the U.S. 
population was 65 years of age or older. Most of these 
individuals resided in homes where the quality of life 
exceeded that of previous generations. As they age, some 
will remain in good health; others will develop chronic 
and disabling diseases that limit their daily activity. A 
few will eventually become totally dependent on oth-
ers. Unfortunately, some will be subjected to abuse and 
neglect. A recent estimate indicates that nearly 500,000 
elderly persons annually experienced abuse, neglect, or 
both in the domestic setting [30].
In the United States, self-neglect, the condition 
where an elderly, self-sufficient person loses autonomy, is 
prevalent. Another common form of neglect is uninten-
tional neglect, the condition whereby a person is incapa-
ble of caring for another. Intentional neglect arises with 
the deliberate withholding of essential services, medica-
tions, or support necessary to maintain a good quality 
of life. As in child neglect, elderly neglect can result in 
injury, disease, or death, whether intentional or not.
Abuse and neglect often result from familial con-
flict. Factors contributing to intrafamily elder abuse 
include postretirement depression, infirmities, depen-
dency, and physical, mental, and emotional illness [28]. 
Fortunately, a stressful situation does not often result 
in physical trauma to the aged. Although spouse abuse 
may begin late in life out of frustration or anger, it more 
likely involves a long history.
The diagnosis of intentional trauma can be more 
difficult in the aged population. Systemic diseases and 
medications can lead to increased bruising. Medications, 
hypotension, visual deficiencies, arrhythmias, and ver-
tigo can lead to falls. Caretakers or persons in authority 
Figure 2.4 photographic angulation.
Figure 2.5 Bitemark on the upper right chest and nose.
the Role of health professionals in Diagnosing patterned injuries from Birth to Death 29
might misinterpret the accidental self-induced trauma. 
All cases of suspected elder abuse should be evaluated 
by a team of knowledgeable and experienced medical, 
dental, nursing, social, and law enforcement personnel 
in a supportive, nonaccusatorial manner. The elderly 
abused often exhibit denial and shame and might even 
minimize the sequelae of an assault.
Whenever bitemarks are detected, they should be 
handled similarly to those of child and spousal abuse. 
Figure 2.6 (right) shows two arm bitemarks on an elderly 
homicide victim. Note that the proximal mark is quite 
clear because there was little inflammatory response.
Figure 2.7 (left) exhibits a mark on the back of 
the same victim. Notice how the dependent lividity, 
resulting in blood pooling within the individual tooth 
imprints, has caused the marks to become quite clear. 
Figure 2.7 (right) illustrates a bitemark on the forearm 
of an 83-year-old Caucasian man. This 4-day-old mark 
should be compared to the victim’s dentition to elimi-
nate the possibility of a self-inflicted injury.
A bitemark on the upper right chest of a 77-year-
old Hispanic man is shown in Figure 2.8 (left). The 
nursing-home resident, assaulted by his roommate, 
received at least two bites in addition to other injuries. 
The bite was inflicted about 3 days prior to this photo-
graph. Figure 2.8 (right) shows the forearm of the same 
patient, who claimed that the bitemarks were inflicted 
at the same time. Note the difference in healing.
2.5 Conclusion
Whenever there is direct, violent contact between 
individuals, many forms of trauma can occur, includ-
ing evidence of biting. Several studies have shown that 
bitemarks are seen in every form of domestic violence. 
The first step in bitemark analysis is recognition. The 
unrecognized bitemark will usually go undocumented 
and will potentially be lost as a valuable piece of forensic 
evidence. When bitemarks yield individual dental char-
acteristics, identification of the perpetrator is possible.
Figure 2.6 Diffuse neck bitemark and on the arm.
Figure 2.7 Bitemark on the back (left) and on the forearm (right).
30 Bitemark evidence: a color atlas and text, 2nd edition
references
 1. Jaden. P., and N. Thoennes. 2000. Extent, nature and con-
sequences of intimate partner violence: Findings from 
the National Violence against Women Survey. Report for 
grant 93-IJ-CX-0012, funded by the National Instate of 
Justice and the Centers for Disease Control. Washington, 
D.C.: NIJ.
 2. McKibben, L., E. DeVos, and E. Newberger. 1989. 
Victimization of mothers of abused children; a con-
trolled study. Pediatrics 84:531–535.
 3. Wright, R. J., R. O. Wright, and N. E. Isaac. 1997. Response 
to battered mothers in the pediatric emergency depart-
ment; a call for an interdisciplinary approach to family 
violence. Pediatrics 99:186–192.
 4. Felitti, V., R. Anda,D. Nordenberg, D. Williamson, A. 
M. Spitz, V. Edwards, et al. Relationship of childhood 
abuse and household dysfunction to many of the leading 
causes of death in adults. American Journal of Preventive 
Medicine 14 (4): 245–258.
 5. Holtzworth-Monroe, A., L. Bates, N. Smutzler, and 
E. Sandin. 1997. A brief review of the research on hus-
band violence. Part I: Maritally violent versus nonvio-
lent men. Aggressive and Violent Behavior 2 (1): 65–99.
 6. Fenton, S. J., J. E. Bouquot, and J. H. Unkel. 2000. 
Orofacial consideration for pediatric, adult and elderly 
victims of abuse. Emergency Medical Clinics of North 
America 18 (3): 601–617.
 7. Lee, L. Y., J. Ilan, and T. Mulvey. 2002. Human biting of 
children and oral manifestations of abuse: A case report 
and literature review. Journal of Dentistry for Children 69 
(1): 92–95.
 8. Sweet, D., and I. A. Pretty. 2000. A look at forensic den-
tistry. Part 2: Teeth as weapons of violence—Identifica-
tion of bitemark perpetrators. British Dental Journal 190 
(8): 415–428.
 9. Pretty, I. A., and D. Sweet. 2001. The scientific basis for 
human bitemark analyses—A critical review. Science and 
Justice 41 (2): 85–92.
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child abuse. Journal of Indian Society of Pedodontics and 
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The Russian experience. Journal of Forensic Odonto-
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cial trauma of child abuse/neglect. Texas Dental Journal 
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Dentistry’s role in recognition and reporting of domes-
tic violence, abuse and neglect. Dental Clinics of North 
American Forensic Odontology 45 (2): 343–363.
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of bite marks and human identification. Dental Clinics of 
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1996. Aggression in British heterosexual relationships: A 
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Figure 2.8 Bitemark on the upper chest (left) and on the arm (right).
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Thousand Oaks. CA: Sage Publications.
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1998.
33
3
3.1 Death investigative Systems
Most death investigators, including consultant forensic 
odontologists, are familiar with their own jurisdiction 
but may not be aware of the variables that exist through-
out the world, including the United States. In general, 
systems tend to fall into three broad categories. Most 
common throughout much of the non-English- speaking 
world is a system where a magistrate or prosecutor 
supervises the death investigation. When an autopsy is 
needed, it may be provided by governmental or univer-
sity sources. The English-speaking nations tend to follow 
the coroner system, in which the coroner is appointed as 
a quasi-judicial agent who supervises death investiga-
tions and may conduct inquests of the dead. When the 
colonies broke away from Britain, the coroner system 
was brought to the United States, usually as a county 
elective office. In some states, a justice of the peace office 
was combined with coroner functions. Medical qualifi-
cations were not required.
Some elected coroner systems of the United States 
have been replaced by a system of appointed medical 
examiners. The first system with a pathologist supervi-
sor and a central laboratory in the United States was in 
New York City, circa 1915. Maryland replaced its elected 
lay coroner system with an appointed pathologist medi-
cal examiner system in 1939. Other jurisdictions fol-
lowed in the period following World War II. Today, the 
United States has a varied mix of systems, including 
sheriff–coroners in some parts of California and medical 
examiners in other parts. Some states have only medi-
cal examiners and others a mix of coroners and medical 
examiners [1]. In some jurisdictions, the coroner may be 
called a medical examiner even though he or she is not 
a pathologist. Historical, political, and economic factors 
seem to determine what system exists. Canada has gen-
erally followed the coroner model, although some juris-
dictions follow the medical examiner model [1].
A major summation of the death investigative sys-
tems of the United States authored by an experienced 
forensic pathologist and historian was published in late 
2009. Dr. Jeffrey M. Jentzen was the chief medical exam-
iner for Milwaukee County, Wisconsin, for many years. 
His undergraduate education included history. While in 
Milwaukee he achieved a master’s degree in history and 
continued history research and study to receive a doc-
torate of philosophy; he is presently on the faculty of the 
University of Michigan.
Dr. Jentzen’s dissertation was published as Death 
Investigation in America: Coroners, Medical Examiners, 
and the Pursuit of Medical Certainty [2]. It is an excellent 
resource regarding the evolution of death investigative 
service in the United States. Its 209 pages are a distil-
lation of how the U.S. systems evolved into what exists 
today. Ten chapters plus an epilogue are supported by a 
total of 733 notations and an additional selected bibli-
ography. All chapters are worthy; however, certain sec-
tions of Chapter 10, “In Search of Reasonable Medical 
Certainty,” are of functional value to death investigators: 
Science and the Law, The Burden of Proof, Reasonable 
role of the medical Examiner, 
Coroner,and Pathologist
JoSeph h. DaviS
Contents
3.1 Death Investigative Systems 33
3.2 A Complete Medical Examiner System 34
3.3 The Florida Model 34
3.4 Case Investigative Principles 35
3.5 Forensic Odontology Service Unavailable 35
3.6 Forensic Odontology Service Becomes Available 37
3.7 Bitemarks 37
3.8 Consultations 39
3.9 Pattern Variables 39
3.10 Discord among Experts 40
3.11 Summary 40
References 40
34 Bitemark evidence: a color atlas and text, 2nd edition
Medical Certainty, Admissibility of Expert Evidence, 
Evidence-Based Medicine, and Expert Testimony.
The most recent summary of death investigative 
systems of the world was presented at the National 
Association of Medical Examiners (NAME) Interim 
Meeting in Seattle, Washington, on February 23, 2010. 
The program title was “Global Forensic Medicine: Learn-
ing from One Another,” Thomas T. Noguchi, chairman, 
and Jeffrey Jentzen, cochairman. Topics included:
Coroner’s Tradition and Current Development in 
the United Kingdom
The Coronial System in Australia
Recent Changes Affecting Canadian Practice of 
Forensic Pathology
Recent Developments in Death Investigation in 
Singapore
Legal Medicine in France
Italian Legal Medicine
The German Development in Legal Medicine and 
Forensic Pathology
Current Japanese Practice in Death Investigation
Overview of Forensic Medicine in the People’s 
Republic of China and Taiwan
Forensic Medicine in the Arab and Islamic Middle 
East
Current Practice and New Developments in Death 
Investigation in Mexico
Current Development in Legal Medicine and 
Forensic Pathology in Peru
It was clear that the speakers possessed a common 
desire to render the best service possible. It was equally 
clear that traditional governmental systems determine 
how well forensic pathology and legal medicine are or 
are not rendered. NAME has published a 64-page sum-
mary of the proceedings and issued it to the attendees at 
the session.
3.2 A Complete medical Examiner System
It might be good to define a complete medical examiner 
system as one where the agency director is an appointed 
pathologist with authority to carry out scene investiga-
tions and to authorize and perform autopsies of public 
concern. The usual statute defines such deaths as appar-
ent homicide; suicide; accident; suspicious, sudden death 
when in apparently good health; death unattended by a 
licensed physician; death of occupational origin; death 
as public health threat; and so forth. In some states coro-
ners must be physicians, but not in others. A recent trend 
is the election of forensically trained nurses as coroners. 
A universal awareness of the need for training exists.
A National Institute of Justice publication, Death 
Investigation: A Guide for the Scene Investigator, was the 
first of a series of forensic guidelines and relied upon 
working groups and reviews by experienced medical 
examiners and death scene investigators [3]. A number 
of the guideline projects followed the death investiga-
tion model: “Crime Scene Investigation,” “Eye Witness 
Evidence,” and “Explosion and Bombing” [4].
The death investigator guideline and many other 
reports (e.g., NAME Forensic Autopsy Standards) are 
posted free on the Web site of Occupational Research 
and Assessment (www.orainc.com). Forensic odontol-
ogy information and pertinent links are found on the 
American Board of Forensic Odontology (ABFO) Web 
site (www.abfo.org). Click on “ABFO Manual” for the 
latest edition [5].
3.3 The Florida model
Florida is the second largest land area east of the 
Mississippi. Its death investigative systems evolved 
according to local needs. Statehood in 1847 included 
coroners and peace justices. The constitutional revision 
of 1885 abolished coroners and provided that the peace 
justices could hold inquests. As population increased, 
counties and judicial circuits evolved. The judicial cir-
cuits relied upon physicians or pathologists to assist 
when requested.
In 1951, Broward County (Ft. Lauderdale) voted out 
the peace justices and for the first time the term “medi-
cal examiner” was used in Florida. A special act of the 
legislature, Chapter 27439, Laws of Florida, Special 
Acts of 1951, set the stage for the county commission to 
appoint a pathologist in private practice to be designated 
as the medical examiner. After the death of that pathol-
ogist, another was appointed. In time, an associate was 
appointed to cover the northern part of the county. The 
office pathology staff grew and served the county well for 
19 years.
However, the special act included a stipulation that 
the prosecuting attorney was to be the initiator of an 
autopsy request. Over time, this stipulation had been over-
looked until a lawsuit was filed. As a result of an adverse 
judgment, the medical examiners resigned and a well-
functioning entity that served the courts was destroyed 
through court action [6]. In the meantime, some judicial 
circuits had created part-time medical examiner systems; 
others had not.
The 1955 legislature enacted a law that established 
the first full-time central laboratory medical examiner 
Role of the Medical examiner, coroner, and pathologist 35
facility in Florida; this was population based and thus 
applied only to Dade County [7]. It commenced opera-
tion on March 15, 1956. Following the untimely death 
by stroke of the chief medical examiner, Dr. Stanley 
Durlacher, I was appointed to head the office 1 year 
after it began operation and remained until retirement. 
During my tenure, we certified over 270,000 deaths 
and performed over 81,000 autopsies, of which I per-
formed 12%.
Due to the lack of uniformity of death investiga-
tion within the state, the Florida Medical Association 
sponsored a bill to create a statewide medical examiner 
system in 1968. I served on the panel of physicians and 
pathologists who drafted a proposed statute that serves 
as a model for large area and population jurisdictions. 
The statute was designed to cope with the rapid demo-
graphic, fiscal, and political changes taking place within 
Florida. In 1970 a statute was enacted that created a 
statewide medical examiner system [8]. It provided for 
the state to be composed of separate districts, each serv-
ing under a district medical examiner pathologist. The 
Dade County Medical Examiner Department became 
District 11.
Funding for the system is based upon local needs and 
fiscal abilities. Categories of deaths requiring medical 
examiner investigation are listed. A commission pro-
vides oversight with Florida Administrative Code rule-
making authority [9]. Included in the rules is the Florida 
Association of Medical Examiners Practice Guidelines, 
which includes requirements for dental identification 
and dental records in cases in which a body cannot be 
viewed [10]. Homicides constitute about 0.8% of total 
deaths in Florida. Within that small pool are found 
those few homicides associated with bitemarks.
3.4 Case investigative Principles
Proper case investigative principles do not deviate, 
regardless of the system. However, system variations 
may prevent implementation of proper principles. The 
objective of a death investigation is to derive sufficient 
data to determine cause and manner of death, to assure 
civil and criminal justice, and to assure proper certifica-
tion and disposal of the dead. A system that favors total 
expeditious investigations by educated, trained, and 
ethically impartial professionals is preferred. Oversight 
and review mechanisms ought to exist.
In Florida the Medical Examiners’ Commission 
designates district boundaries, participates in the nomi-
nation process for district medical examiners, and has 
disciplinary and rule-making authority. It has set stan-
dards for mandated performance of autopsies in certain 
types of cases and for record preparation and preser-
vation; it even specifies personal participation of the 
pathologist during the autopsy procedure [9]. Not all 
systems in the United Statesoperate with these controls, 
leaving room for variations based on personal whim; 
such systems may fail to adhere to proper principles 
of investigation. A positive influence upon investiga-
tive quality is participation in the American Academy 
of Forensic Sciences and the National Association of 
Medical Examiners.
A death investigation involves different agencies 
with varied personnel. All must act together in harmony 
to produce a correlated investigation. The death investi-
gation requires a synthesis of information derived from 
the scene and witnesses, past medical and social his-
tory, and examination of the environment in which the 
death or injury occurred. Participants in this process 
are police, crime scene technicians, crime laboratory 
scientists, medical examiner or coroner investigators, 
pathologists, toxicologists, and various consultants—
forensic odontologists, anthropologists, entomologists, 
engineers, and so forth. In general, most investigative 
and decision processes are shared between two agen-
cies: police and coroner or medical examiner. All inves-
tigations must be sufficient to develop a database that 
assures answers for potential future questions pertain-
ing to criminal, civil, scientific, family, and public con-
cern. The key to success is the correlative and cognitive 
capabilities of the supervisors on all sides.
3.5 Forensic odontology 
Service unavailable
The genesis of forensic odontology service within a busy 
medical examiner practice may be exemplified by the 
following personal experience. It began nearly a half-
century ago in cramped quarters with a limited budget 
and no prior local experience to use to forecast needs. 
The earliest forensic dental identification problem con-
cerned a 35-year-old intoxicated male, blood alcohol 
0.22 g percent, who perished from smoke inhalation 
while smoking in a parked automobile. The body was 
charred beyond recognition (Figure 3.1). Papers in a 
wallet and witnesses furnished presumptive identity.
Police telephoned the chief dental officer of the 
Bureau of Medicine and Surgery, Department of the 
Navy, in Washington, D.C. He in turn telephoned 
the Naval Records Management Center in St. Louis for a 
record dated July 24, 1946. The information was relayed 
to the dental officer at the Marine Corps Air Station in 
Miami, which prepared a chart and compared it with 
36 Bitemark evidence: a color atlas and text, 2nd edition
the victim’s teeth. The transmission of record informa-
tion from the initial inquiry to receipt in Miami was 
accomplished in only 20 minutes.
The initial “bite” case for the medical examiner’s 
office concerned a brawl in which a man struck a mouth 
with his fist. Lacerations on his hand became infected. 
He delayed seeking medical care, gas gangrene set in, 
and he died.
Local knowledge of bitemark analysis was nil in 
those days. In 1959, a 53-year-old murdered spinster 
was found strangled in her bedroom. A breast had been 
amputated and the vaginal area was mutilated after 
death. Found later at the morgue, beneath dense pubic 
hair on the skin of the mons pubis, was a curvilinear arc 
of faint indistinct focal markings that raised a question 
of a bitemark (Figure 3.2). The overlying pubic hair could 
have acted as an intermediary to obscure fine detail. At 
that time the possibility of a bitemark was discussed 
but not pursued. The assailant confessed to the murder 
12.5 years later. A partial palm print and a fingerprint 
documented his presence at the crime scene. The medi-
cal examiner file does not indicate whether his confes-
sion mentioned any biting.
When skeletal remains were found, the treating 
dentist confirmed the identity. In one case, a canvas bag 
containing a skeleton, including skull, was found in a 
small lake. The initial examination by a dentist noted 
new gold crowns. The lack of wear facets (Figure 3.3, left) 
indicated that they had been inserted less than 2 months 
before death. Eventually, the treating dentist identified 
the body. The murder victim had been buried in a shal-
low grave, exhumed by the killers, and dumped in the 
lake. However, in many skeletal investigations, there are 
sufficient identity markers apart from the teeth.
Dental consultations in those days were limited. 
The medical examiner would examine the teeth for con-
sistency with known characteristics of the presumed 
Figure 3.1 Body in the first dental identification case 
in Miami.
Figure 3.2 Miami’s first questionable bitemark case: bite-
mark on the murdered victim’s mons pubis.
Figure 3.3 lack of wear on gold crowns indicates that death probably occurred within 2 months of dental treatment 
(left). Meticulous charting of amalgams at age 11 permitted matching to the teeth of a decomposed adult murdered 
15 years later (right).
Role of the Medical examiner, coroner, and pathologist 37
victim. There was no dental profiling nor was there a 
National Crime Information Center (NCIC) for den-
tal queries for possible matches of the missing to the 
unknowns. In one presumed identity case, the victim 
presented with amalgam fillings placed at 11 years of 
age. The dentist had drawn their outlines on an odon-
togram (three- dimensional drawing of the dentition) 
(Figure 3.3, right). About 15 years later, the match 
between ante- and postmortem records was confirmed 
and the victim identified.
Gustafson’s 1966 textbook [11] was at the time 
most useful in the assessment. Today, one might con-
sider the Manual of Forensic Odontology, a publication 
of the American Society of Forensic Odontology [12]. 
An Internet search might provide information on bite-
marks, but knowledge of the source, applicability, and 
veracity of the information must be verified.
3.6 Forensic odontology Service 
Becomes Available
Subsequently, a dentist involved in a skeletal identity 
of a former patient expressed interest in forensic cases. 
He volunteered his services, became proficient, and is 
now an open-ended contractual consultant, an arrange-
ment that encourages visits. Frequency of participation 
by an unpaid volunteer or a fee-for-service consultant is 
restricted by the reimbursement system. Medical exam-
iner case investigations frequently involve the mouth. 
The present consultant is notified for all things of dental 
interest even if it is an obvious pseudo bite pattern.
Whether or not a dental consultant is used depends 
upon the interest of the consultant and the lack of fiscal 
restraints on consultations. The more time a dental con-
sultant is encouraged to spend in a medical examiner’s 
office, the more frequent is the use of dental expertise in 
problem solving and teaching. The optimum is a rela-
tionship that facilitates the use of dental consultations 
rather than restricts them. As a result of this policy, 
our dental consultant, Richard R. Souviron, DDS, has 
examined over 2,300 cases in the Miami-Dade County 
Medical Examiner Department.
Dr. Souviron and his present associate have gener-
ated an experience-based instructional publication, a 
teaching pattern that served me well a half-century ago. 
I recall when I was about to depart from the U.S. Public 
Health Service to join the faculty of the Department of 
Pathology in the School of Medicine at Louisiana State 
University. I would augment my income by performing 
autopsies for the coroner of Orleans Parish. In prepara-
tion, I studied the 1,349 pages of illustrations in Legal 
Medicine, Pathology and Toxicology, newly published in 
1954 by Gonzales et al. [13]. It had scant bibliographic 
references because it was based upon the combined 
experience of the authors at the New York City Medical 
Examiner Office. I prefer to learn from those who have 
been forced to solve forensic problems instead of those 
who depend upon publications often copied from previ-
ous publications.
The culmination of decades of association between 
forensic odontologists and the Medical Examiner 
Department of Miami-Dade County is abook by 
Dr. William E. Silver and Dr. Richard R. Souviron enti-
tled Dental Autopsy [14]. Similarly to the book I studied 
in 1954, its strength derives from an absence of biblio-
graphic references. It does not copy from publications 
of others, but rather depends upon extensive practical 
service at the medical examiner department. A major 
factor that created the foundation for the book is their 
enthusiasm and enjoyment, unimpeded by artificial 
restrictions such as fee for service. They could devote as 
much time as they wished to build a case to their sat-
isfaction. They could participate in case investigations 
that were fascinating without restrictions based upon 
budget concerns.
Without doubt, other forensic odontologists share 
their interests; otherwise they would not become foren-
sic odontologists. How many could visit the death 
investigative facility unfettered by budget restrictions? I 
know not.
Multiple cases of diverse types and degrees of dental 
considerations, coupled with their unbounded enthu-
siasm and lack of restrictive elements, can be found in 
Silver and Souviron’s book. Its table of contents covers 
a wide range of topics and includes information about 
forensic odontology for the neophyte in dentistry and 
others who render dental opinions in court.
3.7 Bitemarks
Suspect bitemarks merit special consideration. If the 
medical examiner or coroner lacks dental resources and 
no forensic dentist is going to be available to examine 
the body, the next best thing is to document so that 
future study may be feasible. The marks should be care-
fully scrutinized for evidence of abrasions, contusions, 
petechia in skin, and impressions left by teeth. The bite 
should be swabbed for DNA, making certain that the 
swabs and containers are not cross-contaminated.
Orientation and close-up photographs must be 
arranged. A quality camera and film sufficient for future 
enlargements is needed. Digital photography may suf-
fice if camera resolution permits enlargements without 
distortion. Color slide film has greater resolution than 
38 Bitemark evidence: a color atlas and text, 2nd edition
print film. A series of photographs without a scale and 
a series of photographs with a scale in the same plane 
as the mark are essential. The ABFO no. 2 scale is pre-
ferred. Composition, lighting, color balance (use a color 
scale in pictures), and focus are critical. A macrolens is 
useful for the closer views.
When satisfactory photographs are completed, a 
cast or other form of documentation may be made of 
the bitemark in the event that indentations are present. 
Local police crime scene personnel or a local dentist 
may be able to assist. After all documentation to scale 
is completed, careful total excision of the bitemark—
avoiding tissue distortion through shrinkage or other 
means—is made for two ulterior purposes: to preserve 
photographically the color and depth of the underly-
ing contusion and for microscopic slide preparations. 
Eventual histopathological examination is desirable and 
is outlined in other chapters. Microscopic slides must be 
identified as to their source. It is well to have the report 
contain a chart of the bite and the identified sites from 
which microscopic slides have been prepared. Ideally, a 
forensic odontologist should participate.
The attacker may transfer personal identity sub-
strates to the victim or vice versa; these may include 
blood, sperm, sweat, or hair. While human bitemarks 
may be visible, DNA containing saliva is usually not. The 
crime scene and circumstances might indicate a poten-
tial oral transfer regardless of the state of the persons 
involved. The first step in the investigation is recognition 
that a set of circumstances might indicate the potential 
for mouth contact absent of teeth marks. If conscious, 
the patient might indicate possible sites of mouth con-
tact. If unconscious or dead, exposed portions of skin 
may indicate a similar potential. These potential areas 
should be protected and swabbed for DNA as soon as 
possible. Clothing potentially contaminated with an 
assailant’s DNA should be carefully preserved and not 
further contaminated. The attacker’s skin may be found 
under the victim’s fingernails.
One may not assume that first responders thought 
of this potential. Only in recent years has the value of 
DNA evidence from saliva been appreciated. Police may 
focus on bloodstains or obvious injury patterns but may 
overlook the potential for saliva transfer at other points. 
Those who follow in the investigative steps must be con-
cerned despite the fact that they were not involved in the 
initial investigative phase.
In fatal events, sooner or later coroner or medical 
examiner personnel enter the investigation. Systems, 
response of personnel, and training and experience of per-
sonnel are not uniform from one jurisdiction to another. 
Yet the principles of proper investigation remain the same 
throughout all jurisdictions. Accordingly, we should famil-
iarize ourselves with the investigative systems in our juris-
dictions and be prepared to respond properly.
The coroner or medical examiner investigator may 
be part of the initial response, although not always. The 
first rule is that the scene remains undisturbed until 
crime scene evidence technicians have documented by 
proper photography the relationship of the body to its 
surroundings. Any items of potential evidence must 
be documented. At some point the body is examined. 
This critical examination may disclose the potential for 
saliva transfer to any part of the body or its clothing, 
the potential for patterns of teeth injury, the potential 
for fingernail scraping evidence, and even latent finger-
prints upon skin.
Latent fingerprints upon skin, long thought to be 
impossible, are possible under certain circumstances 
[15]. An example is a deceased young woman who 
was found at her place of employment. Her nude body 
was dusted for fingerprints and a set appeared on a leg 
above the ankle. Police photographed the prints with a 
Rolliflex camera equipped with auxiliary clip-on magni-
fying lenses and used print film. The medical examiner 
used a Nikon with an expensive macro lens and color 
slide film. Only the medical examiner’s photographs 
revealed resolution detail sufficient for classification of 
the prints.
Two lessons were learned: It is wise to build redun-
dancy into the documentation process, and resolution 
is essential. Camera and film quality must meet specific 
needs. Police subsequently switched to Nikon cameras 
with quality lenses. Another lesson learned was that ambi-
ent temperature plays a role in the detection of fingerprints 
on human skin [15]. Similar high-resolution quality pho-
tographs must also apply to bitemark evaluation.
Clothing may or may not be removed from the body 
prior to transport. If it is removed, the pathologist and 
especially the bitemark specialist must know the nature 
of the clothing and the areas covered by the clothing. 
A recent example concerned a forensic odontologist 
who rendered an erroneous bitemark opinion because 
he failed to require police crime scene photographs. 
Magnification of the skin may reveal a cloth weave pat-
tern. Also, when clothing is interposed between teeth 
and skin, saliva DNA should be expected on the clothing, 
not the underlying skin. Pathologists and their consul-
tants must therefore be certain that all pertinent circum-
stantial information be furnished before rendering an 
opinion. If clothing interposition is suspected, the sus-
picion must be immediately relayed to the police and the 
forensic laboratory to search the clothing for DNA.
Role of the Medical examiner, coroner, and pathologist 39
It is incumbent upon all first responders, treatment 
personnel, police, crime scene investigators, medi-
cal examiner or coroner, and pathologist to realize the 
potential interpersonal victim–assailant linkage within 
the crime scene and circumstances.3.8 Consultations
A pattern injury may clearly be a bitemark, may be a 
suspicious bitemark, or may clearly not be a bitemark. 
In any case, a forensic odontologist should be given 
the opportunity to examine the lesions and judge their 
relevance. The problem is that not all pathologists or 
dentists are equally trained, knowledgeable, or experi-
enced. For these reasons, it is prudent to have a qualified 
set of eyes review the evidence.
Two murder victims were found in an adjacent juris-
diction. To the pathologist and the consultant odontolo-
gist, some patterns on a body appeared to be human 
bitemarks. Prudence prevailed and they sought the 
assistance of a more experienced forensic odontologist, 
who brought the present author along. Although some 
patterns might have suggested human teeth marks, an 
incision into the suspect area clearly demonstrated the 
superficial nature of surface erosions caused by ants. 
Prudence on the part of the investigators resulted in a 
proper final opinion as to the cause of the patterns.
Unfortunately, wrongful criminal charges can result 
when evidence is weak and opinions are strong. Ant bite 
erosions and irritative dermatitis patterns have been 
equated with human bite patterns by some odontolo-
gists and pathologists with dire consequences. A wise 
pathologist is familiar with patterns and should judge 
the validity of consultant opinions. The police and pros-
ecuting attorney are not expected to possess this talent. 
The forensic pathologist retains accountability and lia-
bility for pathology opinions and in some jurisdictions 
might be liable for consultant opinions.
3.9 Pattern variables
Scene investigators, pathologists, and odontologists rec-
ognize that bitemarks can present variable patterns. The 
inflicted violence is variable. At one end of the spectrum 
there is licking, mouthing, or sucking without any abra-
sive or crushing action by teeth. Circumstances must 
be carefully evaluated before rendering an opinion that 
potential DNA sites are absent. At the other end of the 
spectrum is the avulsive bite. An example is the noto-
rious, highly publicized example of boxer Mike Tyson, 
who bit off part of his opponent’s ear.
Sites may be located anywhere on the body. One 
study suggested that 40% of cases had two or more 
bites. Males were bitten more commonly on the arms or 
shoulders; females were bitten on the breast, arms, and 
legs. This differs from live clinical studies, where hands 
and fingers were more commonly bitten, reflecting the 
nature of the problem altercation [16]. Skin thickness 
varies widely, from the thin skin of the eyelids, nipple, 
scrotum, and penis to the thick skin of the back, the 
nose’s overlying cartilage, and calloused palms and feet. 
Skin varies with age from the thin skin of the infant to 
the atrophic fragile skin of the elderly.
The pattern injury produced by teeth will vary 
depending on surface contour and interpersonal posi-
tions. The observed pattern on a body lying flat on the 
autopsy table may or may not reflect the pattern of inflic-
tion in positional relationship at the precise moment of 
attack. A bite in the region of the axillary fold will vary 
with positional change (Figure 3.4).
In a situation of the same victim, the same attacker, 
and more than one bite, the patterns may appear to be 
from different sources to the untrained eye. Alternatively, 
a dental impression on the back of the hand or forearm 
may be caused by the victim’s own mouth resting on 
that portion of the anatomy after collapse.
The pathologist and consultant should anticipate 
future questions that may arise as the investigation 
Figure 3.4 posterior axillary fold bitemark without arm extension (left) and with arm raised (right).
40 Bitemark evidence: a color atlas and text, 2nd edition
unfolds and wends its way through court. Was the bite 
inflicted before, during, or after death?
Commenting on circumstances of a bite, MacDonald 
points out a spectrum from amorous to aggressive [17]. 
One may anticipate a defense claim that a bite was con-
sensual and not associated with the crime. Would a bite 
leave permanent marks or scarring? In a living victim, 
permanence of damage may constitute the difference 
between third-degree battery and second-degree battery 
and thus affect the criminal charges.
3.10 Discord among Experts
What happens when experts disagree on bitemark inter-
pretation? Theoretically, equally well-trained experts 
ought to come to the same conclusions. The first con-
sideration is to determine whether they examined the 
exact same evidence. For example, original slides and 
duplicates are not necessarily the same. Original pho-
tos that have been digitized are not originals. That being 
so, the next step is to determine if one of the experts is 
a pseudoexpert whose motives may be suspect. In an 
informative and entertaining fashion (including the title 
“Mountebanks among Forensic Scientists”), Starrs pres-
ents 12 case examples with ample references from trial 
testimony [18]. In reviewing the cases, it is noteworthy 
that untrustworthy testimony often includes exaggera-
tion of credentials. Aberrant opinion may be difficult to 
challenge, but falsification of credentials is easy to detect.
The greatest problem is when the differing experts 
are equally well trained, knowledgeable, experienced, 
and well respected. In theory, discordance of interpre-
tation should be lacking. Nordby, whose background 
includes medical examiner death scene investigation, 
has a unique qualification—a doctorate in philosophy 
with a dissertation on logic. One needs to study his 
analysis of the factors leading to disagreement between 
forensic experts, including odontologists [19]. The eyes 
see, but the viewer observes. Observation is affected by 
investigative expectation. From observation is derived 
opinion, which may have been affected by an artifact 
induced by expectation. The Nordby paper deserves 
repeated study.
Despite great advances in the application of science 
to forensic problem solving, problems remain. Recently, 
the National Academy of Sciences issued a report on 
serious problems within the forensic sciences. A free 
executive summary report can be downloaded through 
the Internet [20] with the full version [21].
3.11 Summary
The medical examiner or coroner is usually the person 
to notify a consultant forensic odontologist that a sus-
pect bitemark is present. Police or coroner or medical 
examiner investigators are most likely the first to notice 
suspect patterns. If they fail, the forensic pathologist 
is the next step in the detection. At this point the full 
resources of forensic odontology must prevail. The role 
of the forensic odontologist as part of the death investi-
gative team is today an accepted fact.
A complex bitemark case may occur in any police 
or coroner or medical examiner jurisdiction, large or 
small, rural or urban. Lack of local resources is no excuse 
for an inadequate investigation. Local egos must never 
override a need to seek consultation. Police, forensic 
pathology, and forensic odontology networks exist. 
Initial “what to do” consultation is only a telephone call 
away. If an arrest is made and a criminal trial ensues, 
courts will not tolerate a lack-of-resources excuse for an 
inadequate investigation. Coroner or medical examin-
ers and their forensic pathologists must plan for this 
eventuality if their community and justice will be served. 
Ideal planning should encompass the total death inves-
tigation system, including infrastructure and training, 
professional standards and quality, the criminal and 
civil justice systems, public health needs, disasters, 
and homeland security.
references
 1. Combs, D. L., R. G. Parrish, and R. Ing. 1995. Death 
investigation in the United States and Canada. Atlanta: 
Centers for Disease Control and Prevention.
 2. Jentzen J. M. 2009. Death investigation in America, coro-
ners, medical examiners, andthe pursuit of medical cer-
tainty. Cambridge, MA: Harvard Univ. Press.
 3. NIJ death investigation: A guide for the scene investigator. 
http://www.ncjrs.gov/pdffiles/167568.pdf
 4. Other NIJ guidelines of interest to forensic odontolo-
gists: Crime scene investigation (http://www.ncjrs.gov/
pdffiles1/nij/178240.pdf); Eye witness evidence (http://
www.ncjrs.gov/pdffiles1/nij/1782X0.pdf); Explosion and 
bombing (http://www.ncjrs.gov/pdffiles1/nij/181819.pdf); 
www.abfo.org (click on “ABFO Manual” for download).
 5. Rupp, J. C. 1971. Death of a medical examiner system. 
Journal for Sciences 16:420–437.
 6. Chapter 30228, Laws of Florida, 1955.
 7. Chapter 406, Florida Statutes.
 8. Rules 11G 1–5, Florida Administrative Code.
 9. http://www.fdle.state.fl.us/Content/CJST/Documents/
Medical-Examiners-Commission-(MEC).aspx
http://www.ncjrs.gov/pdffiles1/nij/178240.pdf
http://www.ncjrs.gov/pdffiles1/nij/178240.pdf
http://www.ncjrs.gov/pdffiles1/nij/1782X0.pdf
http://www.ncjrs.gov/pdffiles1/nij/1782X0.pdf
http://www.fdle.state.fl.us/Content/CJST/Documents/Medical-Examiners-Commission-(MEC).aspx
http://www.fdle.state.fl.us/Content/CJST/Documents/Medical-Examiners-Commission-(MEC).aspx
Role of the Medical examiner, coroner, and pathologist 41
 10. Scroll down to and click on MEC 2008 Annual Workload 
Report.
 11. Gustafson, G. 1966. Forensic odontology. London: Stapler 
Press.
 12. Bowers, C. M., and G. Bell, eds. 1995. Manual of forensic 
odontology, 3rd ed. Lubbock, TX: American Society of 
Forensic Odontology (online at www.newabfo.com).
 13. Gonzalez, T. A., M. Vance, M. Helpern, and C. J. 
Umberger. 1954. Legal medicine, pathology and toxicol-
ogy, 2nd ed. New York: Appleton–Century–Crofts.
 14. Silver, W. E., and R. R. Souviron. 2009. Dental autopsy. 
Boca Raton, FL: Taylor & Francis.
 15. Sampson, W. C. 1996. Latent fingerprint evidence on 
human skin (part 1). Journal of Forensic Identification 
46:188–195.
 16. Vale, G. L., and T. T. Noguchi. 1983. Anatomical distribu-
tion of human bitemarks in a series of 67 cases. Journal of 
Forensic Sciences 28:61–69.
 17. MacDonald, D. G. 1974. Bitemark recognition and inter-
pretation. Journal of Forensic Sciences 14:229–233.
 18. Starrs, J. E. 1988. Montebanks among forensic scientists. 
In Forensic science handbook, vol. 2, ed. R. Saferstein. 
Englewood Cliffs, NJ: Prentice Hall.
 19. Nordby, J. J. 1992. Can we believe what we see, if we 
see what we believe? Expert disagreement. Journal for 
Sciences 37:1115–1124.
 20. http://www.nap.edu/nap-cgi/report.cgi?record_id=12589 
&type=pdfxsum
 21. http://www.nap.edu/openbook.php?record_id=12589 
&page=1
http://www.nap.edu/nap-cgi/report.cgi?record_id=12589&type=pdfxsum
http://www.nap.edu/nap-cgi/report.cgi?record_id=12589&type=pdfxsum
http://www.nap.edu/openbook.php?record_id=12589&page=1
http://www.nap.edu/openbook.php?record_id=12589&page=1
43
4
4.1 introduction
Integrating the philosophy of multidisciplinary team-
work during bitemark investigation will increase suc-
cess in the recognition, collection, chain of possession, 
storing, analysis, and effective court presentation of 
bitemark evidence. Investigators are increasingly chal-
lenged to deliver scientific evidence of the highest evi-
dentiary value in bitemark investigations. Jury members 
and the public have developed high expectations con-
cerning scientific forensic evidence as a result of being 
exposed to forensic science in the popular media [1].
Bitemark evidence is considered a strong factor in 
the investigation of many crimes [2], and the forensic 
dental consultant is the logical professional to lead the 
way in designing the team’s protocol. Forensic odontolo-
gists, also called forensic dentists, tend to work within a 
framework of accepted standard operating procedures 
(SOPs). The majority of odontologists, whether they are 
certified diplomates of the American Board of Forensic 
Odontology (ABFO) or not, routinely follow the prin-
ciples set forth by the ABFO guidelines [3].
Despite recent technological advances in bitemark 
analysis, the most important asset is still a thorough 
and well-planned collaborative investigation. Whether 
or not the investigation takes place in a jurisdiction with 
unlimited resources, high-tech equipment, and mod-
ern laboratory facilities, any bitemark investigation will 
benefit from the interaction of well-trained personnel 
working as a multidisciplinary team.
The Team Approach in 
Bitemark investigation
veRonique F. DelattRe
Contents
4.1 Introduction 43
4.2 Advantages of the Team Approach during Bitemark Investigation 44
4.3 Potential Team Members and Their Roles 44
4.3.1 Forensic Odontologist 44
4.3.2 First Responders 44
4.3.3 Law Enforcement Officials and Crime Scene Investigators 44
4.3.4 Sexual Assault Nurse Examiner 45
4.3.5 Medical Examiner 45
4.3.6 Coroner 45
4.3.7 Forensic Pathologist 45
4.3.8 Forensic Photographer 45
4.3.9 Criminalist 45
4.4 Bitemark Evidence Detection, Description, and Collection 45
4.4.1 Initial Forensic Dental Evaluation 45
4.4.2 Trace Evidence Detection and Collection 47
4.4.3 Forensic Dental Evidence Collection 47
4.5 Developing a Teamwork Protocol for Bitemark Investigation 47
4.5.1 Initial Phase 47
4.5.2 Protocol Development Phase 47
4.5.3 Testing Phase 48
4.5.4 Updates and Revisions 48
4.6 Sample Team Protocol for Collecting Patterned Injury Evidence 48
4.6.1 At the Crime Scene 48
4.6.2 At the Morgue 48
4.7 Teamwork in Smaller Jurisdictions 48
4.8 Conclusion 48
References 48
44 Bitemark evidence: a color atlas and text, 2nd edition
Preplanning a multidisciplinary team approach to 
bitemark investigations will ensure that (1) no evidence 
is overlooked, (2) no evidence is altered or destroyed 
before collection, and (3) each of the forensic specialists 
involved in the investigation participates in the most 
appropriate sequence for optimal evidence collection.
4.2 Advantages of the Team Approach 
during Bitemark investigation
The team approach is especially appropriate for con-
ducting tasks that are high in complexity and have many 
interdependent subtasks. A team is defined as a group 
of people linked by a common purpose, such as during 
a bitemark investigation. Teamwork will reduce feelings 
of isolation among the various forensic scientists work-
ing on the same case and will keep the “big picture” at 
the center of the investigation. Teamwork among foren-
sic scientists also ensures that one forensic specialty’s 
method of evidence collection will not damage the par-
ticular evidence needed by another specialty or under-
mine the efforts of others on the same case. Even the 
most modern, high-tech methods of evidence analysis 
may be of no evidentiary value if the primary evidence 
is overlooked, altered, damaged, or destroyed before each 
expert is able to adequately collect his or her portion of 
the bitemark evidence to complete his or her portion 
of the investigation.
The team approach allows each member to under-
stand specific duties ahead of time, delineates his or her 
area of evidence collection, and reinforces the respon-
sibilities in the overall investigation scenario. These 
expectations should be clearly spelled out in a written 
protocol to minimize confusion, duplication, and errors. 
This multidisciplinary approach will enhance the per-
ceived cohesiveness and validity of the various forms of 
evidence presented to the jury [4].
4.3 Potential Team members 
and Their roles
There are two obvious categories of bitemark recipients: 
the living and the deceased. While the overall evidence 
needed for bitemark analysis will generally be the same 
in both the living and deceased, the team protocol 
and specific team members will vary depending upon 
the specific circumstances in the case. Presented in this 
section is a brief review of potential bitemark investiga-
tion team members and their roles.
4.3.1 Forensic odontologist
The forensic odontologist is central to any bitemark inves-
tigation.A forensic odontologist is a dentist who special-
izes in the proper handling, examination, and evaluation 
of dental evidence, which may then be presented in the 
interest of justice. An odontologist’s duties on the bite-
mark investigation team include the recognition, record-
ing, collection, preservation, analysis, and comparison of 
pattern injuries—or, more specifically, bitemarks.
As a result of the recommendations of the 2009 
National Academy of Sciences report, Strengthening 
Forensic Science in the United States: A Path Forward [5], 
medical examiner and coroner offices are increasingly 
choosing to work with certified forensic odontologists 
rather than with those who are not certified. Among 
other recommendations, the report advises that all 
forensic science disciplines must have a strong scientific 
foundation, that all forensic scientists should be cer-
tified, and that all forensic scientists should hold them-
selves to a code of ethics.
In the field of forensic odontology, certification is 
granted by the American Board of Forensic Odontology 
based upon the candidate’s personal and professional 
record of education, training, experience, and achieve-
ment, as well as the results of a formal examination. 
The ABFO is recognized by the American Academy 
of Forensic Sciences and accredited by the Forensic 
Specialties Accreditation Board [6]. A directory of cer-
tified diplomates of the American Board of Forensic 
Odontology can be found on the ABFO’s Web site [7].
4.3.2 First responders
First responders (paramedics, emergency medical techni-
cians, forensic nurses, and emergency room physicians) 
may be the first to recognize a suspected bitemark. Their 
role is to alert law enforcement officials or protective 
services. They may also begin the forensic evidence col-
lection process, in accordance with their training and 
institutional protocol.
4.3.3 law Enforcement officials and Crime 
Scene investigators
Law enforcement officials and crime scene investigators 
are responsible for securing, evaluating, and photograph-
ing the scene. They also assemble physical evidence for 
future scientific evaluation. Their expertise in recogniz-
ing and properly collecting physical evidence is essential 
to solving as well as prosecuting crimes. Law enforce-
ment officials and crime scene investigators produce 
detailed reports on the crime scene, including their own 
the team approach in Bitemark investigation 45
observations and interviews with witnesses, suspects, 
and victims.
4.3.4 Sexual Assault nurse Examiner
The sexual assault nurse examiner (SANE) is a registered 
nurse who has completed both didactic education and 
clinical training in caring for patients who have been 
sexually assaulted. The basic training includes methods 
of evidence collection for the adult or adolescent popu-
lation, leading to the SANE-A (adult/adolescent) desig-
nation. With more experience and continued education, 
the SANE-A is educated regarding the interpretation 
of findings specifically associated with child sexual 
abuse, leading to the SANE-P (pediatric/adolescent) 
designation [8]. Certification is achieved through the 
International Association of Forensic Nurses’ Forensic 
Nursing Certification Board (FNCB) [9].
4.3.5 medical Examiner
The medical examiner is a physician who investigates 
the facts when a person has died a sudden, unexpected, 
or violent death. He or she is elected or appointed to 
serve a specific jurisdiction and is tasked with determin-
ing the identity of an unknown person and the cause 
and manner of the death that is under investigation [10]. 
The manner of death will be declared one of the follow-
ing: natural, homicide, suicide, accidental, or undeter-
mined. The cause of death is the disease or injury that 
initiated the lethal chain of events. While a number of 
complications and contributing factors may have been 
involved, the cause of death is the initial underlying rea-
son that led to the individual’s death.
4.3.6 Coroner
The coroner is a public official charged with inquiry into 
deaths that fall into certain categories. The coroner is 
not required to be a physician or be trained in medicine. 
Depending upon the jurisdiction defining the responsi-
bilities, the coroner may not necessarily be a physician 
and may contact physicians or forensic pathologists to 
perform autopsies when there appears to be a suspicious 
manner of death that requires a forensic autopsy [11].
4.3.7 Forensic Pathologist
In the course of bitemark investigation, the forensic 
pathologist can be especially valuable in evaluating the 
tissue involved in any suspicious pattern injury, with 
the main goal of determining the timing and extent 
of the injury. Forensic pathologists are specifically 
trained to perform forensic autopsies, to evaluate patient 
medical history and law enforcement reports that may 
help determine the manner and cause of death, to col-
lect biological trace evidence and secretions, to docu-
ment evidence of sexual assault, and to reconstruct how 
a person received injuries, including direction, type, and 
manner thereof [12].
4.3.8 Forensic Photographer
A forensic photographer visually records the crime scene 
and the body for documentation, further study, and use 
in court presentation. The duties of a forensic photogra-
pher are determined by the hiring agency. Some duties 
may include photographing crime scenes, autopsies, and 
articles of evidence, and digitizing hard copy photo-
graphs or radiographs. A forensic photographer should 
be well trained in alternate lighting techniques; mac-
rophotography; specialized lighting such as ultraviolet 
(UV), infrared (IR), and alternate light imaging (ALI) 
techniques; and the use of filters [13].
4.3.9 Criminalist
Many agencies employ criminalists, who have at least a 
bachelor’s degree in chemistry, biology, physics, molec-
ular biology, or a related science. They are charged 
with analyzing, comparing, identifying, and interpret-
ing physical evidence. A criminalist’s duties may vary 
within different agencies, depending upon the needs of 
the jurisdiction. Criminalists can be relied upon to work 
well with a wide variety of evidence, such as hair, fiber, 
blood, body fluids, soil, ballistics, and tool marks. With 
their expertise in trace evidence analysis, they are often 
the backbone of a bitemark investigation. The criminalist 
may also be the scientist tasked with DNA investigation 
by extracting, amplifying, and comparing DNA samples 
to determine if there is a correlation between a suspect 
and a bitemark. The certifying organization for crimi-
nalists is the American Board of Criminalistics [14].
4.4 Bitemark Evidence Detection, 
Description, and Collection
4.4.1 initial Forensic Dental Evaluation
When possible, the forensic odontologist should first 
view the pattern injuries that are under investigation 
with the medical examiner in charge of the case. The 
purposes of the initial collaborative session are to deter-
mine a consistent numbering system to distinguish each 
injury to be evaluated, agree upon the terminology to 
46 Bitemark evidence: a color atlas and text, 2nd edition
describe the anatomical location of each injury, and 
agree upon the terminology to describe each injury. 
Using a table and diagrams or orientation-type photo-
graphs will facilitate the communication process among 
members. Figure 4.1 depicts a table that summarizes the 
agreed-upon terminology of multiple injuries seen dur-
ing a bitemark investigation.
Other team members should strive to use the same 
numbering and terminology system to present their 
particular evidence. Of course, the individual team 
members’ official reports will use appropriate terms as 
stated in their specialties’ guidelines. A consistent num-
bering system and terminology by all experts will serve 
to maximize the effectiveness of any future testimony 
regarding the injuries, particularly in cases where thereare multiple injuries. Figure 4.2 depicts orientation-type 
photographs of two of the injuries described in the sum-
mary table.
Figure 4.2 orientation-type photograph, with information about the injury number and anatomical location of the sec-
ond and the ninth bitemark described previously in the summary table.
Case number 123
The victim’s maxillary intercuspid distance meas ures: approximately 32 mm
The victim’s mandibular intercuspid distance meas ures: approximately 27 mm
Injury # Anatomical Location
Approximate Size 
At Widest Points 
(mm) Description
Consistent 
With A Human 
Bitemark? Evidentiary Value
 1 Back 30 × 31 Discoloration Yes Moderate
 2 Flexor right forearm 26 × 28 Discoloration Yes Low
 3 Medial right forearm 28 × 30 Discoloration and 
areas of mild abrasion
Yes Moderate with some 
details visible
 4 Extensor right forearm 26 × 29 Discoloration Yes Moderate with some 
details visible
 5 Extensor left wrist 25 × 25 Dark discoloration Yes High
 6 Extensor left forearm 25 × 27 Indistinct area of 
discoloration
Yes Low
 7 Extensor medial left forearm 25 × 27 Discoloration Yes Low
 8 Medial left wrist 26 × 30 Diffuse discoloration Yes Low
 9 Flexor left forearm 30 × 30 Discoloration Yes Moderate
10 Left bicep 29 × 32 Discoloration Yes Moderate with some 
details visible
11 Posterior left thigh 30 × 30 Discoloration Yes Moderate with some 
details visible
Figure 4.1 this table summarizes the mutually agreed-upon terminology that was used during an investigation on a 
victim with 11 suspected bitemarks. use of consistent terminology among team members will maximize the effective-
ness of future testimony regarding the injuries.
the team approach in Bitemark investigation 47
4.4.2 Trace Evidence Detection and Collection
Trace evidence detection and collection begins with the 
covered or bagged body parts. Evidence detection pro-
ceeds using white light, ultraviolet, and alternate light 
sources and, at times, infrared light. Obvious injuries and 
fluorescent areas are marked on diagram sheets, such as 
those seen in Figure 4.3. Similar diagram sheets can be 
found on the Web site of the Armed Forces Institute 
of Pathology [15]. Fluorescing items, such as dried 
bodily fluids, are photographed in vivo, catalogued, col-
lected using sterile saline, and appropriately stored for 
DNA analysis.
To avoid contamination with one’s own saliva, one 
should not moisten an evidence-envelope seal by lick-
ing. Collected items and trace evidence swabs are labeled 
with case number, date, and collector initials and are 
placed in appropriate sealed and labeled containers.
4.4.3 Forensic Dental Evidence Collection
Only a summary of steps will be presented in this sec-
tion. The guidelines to follow in any bitemark investiga-
tion can be found in other chapters of this book and in 
the American Board of Forensic Odontology Diplomates’ 
Reference Manual [16].
Determine whether each injury in question is a •	
potential bitemark [17].
Swab each injury if you cannot verify that it has •	
previously been processed.
Photograph and document the potential bite-•	
mark injury.
Take impressions of the potential bitemark, if •	
indicated.
Consider whether total excision, preservation, •	
or fixation of the injured skin is indicated.
4.5 Developing a Teamwork Protocol 
for Bitemark investigation
4.5.1 initial Phase
During the initial phase, when a teamwork protocol in 
bitemark investigation of the deceased is being devel-
oped, it is important for each forensic specialist to 
provide an overview of his or her evidence needs and 
guidelines to the team members. Some critical ques-
tions should be answered during this phase. Who will 
collect DNA samples? How and when? How will the 
body be protected from further contamination during 
transportation to the morgue? Who records the chain of 
possession? How is it registered? Who is responsible for 
the transfer of evidence? To which specialist should the 
exhibit or specimen go?
4.5.2 Protocol Development Phase
During a scheduled conference of all team members, 
the specialty-specific guidelines should be reviewed for 
redundancy or steps that might damage another mem-
ber’s evidence. For example, in vivo photographs may 
be taken first; then, the trace evidence can be collected 
and the injury washed to allow further photographs to 
be taken as appropriate.
Figure 4.3 Diagram of the arms and hands, which can be helpful in documenting areas of injury and facilitate com-
munication between team members.
48 Bitemark evidence: a color atlas and text, 2nd edition
4.5.3 Testing Phase
As many potential members of the team as possible 
should attend a simulated case scenario as part of a 
training process to assure that each member clearly 
understands his or her duties, limits, and responsibili-
ties. It should quickly become apparent that a particular 
team member will be skilled at orchestrating parts of the 
investigation and that a certain flow of duties will result. 
During this phase, the team will need to identify specific 
roles, the order in which each member will function, and 
the evidence to be collected by each member.
4.5.4 updates and revisions
Once the team protocol has been developed, tested, and 
undergone real-life implementation, it is important to 
review the protocol and make any necessary updates or 
revisions as needed.
4.6 Sample Team Protocol for Collecting 
Patterned injury Evidence
4.6.1 At the Crime Scene
Document the suspected bitemark injuries.•	
Photograph the suspected bitemark injuries.•	
Collect DNA samples at the scene.•	
Cover any body part suspected to have trace •	
evidence material: bag the hands and feet, cover 
breasts, etc.
Place deceased in a new or thoroughly decon-•	
taminated, sealed body bag.
Transport body to the morgue.•	
4.6.2 At the morgue
Issue a case number.•	
Follow routine check-in procedures of the •	
decedent.
Take sequential photographs throughout the •	
check-in procedures.
In some jurisdictions, full-body radiographs are •	
taken through the body bag before unsealing it.
Remove the body bag’s seal and open the body •	
bag in the presence of the appropriate persons.
Take full-body radiographs.•	
Begin the evidence collection and autopsy •	
protocol.
4.7 Teamwork in Smaller Jurisdictions
In smaller jurisdictions, it may take only a few forensically 
trained individuals to serve as the bitemark investigation 
team. Regardless of specialty, each team member must 
become familiar with and trained in the skills involved 
in recognition, proper collection, and storage of all types 
of bitemark evidence for the purpose of evaluation by 
outside consultants or for effective court presentation.
4.8 Conclusion
Many factors can affect the development and use of the 
team concept in bitemark investigation, including num-
bers and types of forensic scientists in a jurisdiction, 
jurisdictional rivalries, and financial resources. There 
can be as many organizational models as there are cit-
ies, counties, states, and countries. Teamwork in bite-
mark investigation requires that each forensic scientist 
perform a specific task efficiently in order to produce the 
requisite unbiased scientific result.
Committing to the philosophy of a multidisciplinary 
teamwork approach during bitemark investigation will 
increase the potential for consistently high-quality evi-
dence recognition and collection and will facilitate the 
cohesiveness of various forensic specialties in a court 
presentation of bitemark evidence.
Preplanning a multidisciplinary team approach to 
bitemark investigations will help make certain that no 
pertinent piece of evidence is overlooked, altered, or 
destroyed before collection and that each of the team 
members participates in the most appropriate sequence 
for optimal evidence collection. When it comes to bite-
mark investigation, the acronym “TEAM” serves to 
remind the individual forensic specialists that “together 
everyone achieves more.”references
 1. Shelton, D. E., Y. S. Kim, and G. Barak. 2006. A study 
of juror expectations and demands concerning scientific 
evidence: Does the “CSI effect” exist? Vanderbilt Journal 
of Entertainment and Technology Law 9 (2): 331–368.
 2. Vale, G. L. 1996. Dentistry. Bite marks and the investiga-
tion of crime. Journal of California Dental Association 24 
(5): 29–34.
 3. McNamee, A. H., and D. J. Sweet. 2003. Adherence of 
forensic odontologists to the ABFO guidelines for victim 
evidence collection. Forensic Science 48 (2): 382–385.
the team approach in Bitemark investigation 49
 4. Delattre, V. F., R. Reynolds, A. Santos, and P. G. Stimson. 
2002. Teamwork in action—Integration of the forensic 
sciences during bitemark investigations. Proceedings 
of the American Academy of Forensic Sciences Annual 
Meeting, Atlanta, 2002.
 5. National Academy of Sciences. 2009. Strengthening foren-
sic science in the United States: A path forward. Committee 
on Identifying the Needs of the Forensic Sciences 
Community: Committee on Applied and Theoretical 
Statistics, National Research Council. Washington, D.C.: 
National Academies Press.
 6. American Board of Forensic Odontology diplomates refer-
ence manual. October 2009. Colorado Springs, Section I, 
p. 9.
 7. American Board of Forensic Odontology. October 2009. 
Member list. http://www.abfo.org/member_list.htm
 8. Forensic Nursing Certification Board. 2009. Certification 
board and history. http://www.iafn.org/displaycommon.
cfm?an=1&subarticlenbr=8
 9. International Association of Forensic Nurses. Member-
ship handbook. http://www.iafn.org/associations/8556/
files/Membership Handbook.pdf
 10. National Association of Medical Examiners. 2007. So 
you want to be a medical detective. http://thename.org/
index.php?option=com_docman&task=doc_details&gi
d=14&Itemid=26load&gid=14&Itemid=26
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a coroner? http://thename.org/index.php?option=com_ 
content&task=view&id=36&Itemid=42
 12. National Association of Medical Examiners. 2006. What 
is a forensic pathologist? http://thename.org/index.php 
?option=com_content&task=view&id=38&Itemid=42
 13. International Association for Identification. Frequently 
asked questions for forensic photographers. http://www.
theiai.org/certifications/imaging/faq.php
 14. American Board of Criminalistics. http://www.criminal-
istics.com/cert_ovw.cfm
 15. Armed Forces Institute of Pathology. Autopsy diagrams. 
http://www.afip.org/consultation/AFMES/forms/
 16. American Board of Forensic Odontology Diplomates’ 
Reference Manual. October 2009. Colorado Springs, 
Section III.
 17. Delattre, V. F., and P. G. Stimson. 1998. Bite marks vs. 
other injuries—Forensic odontological evaluation of a 
homicide. Proceedings of American Academy of Forensic 
Scientists 5:133.
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http://www.iafn.org/displaycommon.cfm?an=1&subarticlenbr=8
http://www.iafn.org/associations/8556/files/Membership Handbook.pdf
http://www.iafn.org/associations/8556/files/Membership Handbook.pdf
http://thename.org/index.php?option=com_docman&task=doc_details&gid=14&Itemid=26load&gid=14&Itemid=26
http://thename.org/index.php?option=com_docman&task=doc_details&gid=14&Itemid=26load&gid=14&Itemid=26
http://thename.org/index.php?option=com_docman&task=doc_details&gid=14&Itemid=26load&gid=14&Itemid=26
http://thename.org/index.php?option=com_content&task=view&id=36&Itemid=42
http://thename.org/index.php?option=com_content&task=view&id=36&Itemid=42
http://thename.org/index.php?option=com_content&task=view&id=38&Itemid=42
http://thename.org/index.php?option=com_content&task=view&id=38&Itemid=42
http://www.theiai.org/certifications/imaging/faq.php
http://www.theiai.org/certifications/imaging/faq.php
http://www.criminalistics.com/cert_ovw.cfm
http://www.criminalistics.com/cert_ovw.cfm
iiiDescription of the Bitemark
53
5
5.1 Definition
A bitemark can be generally defined as a pattern made 
by teeth in a substrate. Since the teeth can be of human 
or animal origin and the substrate can be skin, food, or 
a firm but compressible substance, more specific defi-
nitions are needed. Most bitemarks of forensic interest 
involve the contact between human teeth and skin. The 
American Board of Forensic Odontology defines the 
human cutaneous bitemark as follows: “An injury in 
skin caused by contacting teeth (with or without the lips 
or tongue) which shows the representational pattern of 
the oral structures” [1].
The definition excludes other nonpatterned injuries 
made by teeth contacting skin such as might be encoun-
tered by a fist to the mouth. It also excludes the closing 
action of jaws during intended biting if a recognizable 
pattern is not produced. These other tooth-to-skin inter-
actions are still important even if not distinguished by 
the term “bitemark” because they can be responsible for 
infection, tissue destruction, or transmissible diseases, 
and they can transfer DNA in saliva. However, by con-
vention, the term “bitemark” signifies to the forensic 
odontologist an injury that, by its pattern, helps estab-
lish its origin from teeth.
5.2 Spelling
Three terms—bitemark (one word) [2], bite mark (two 
words) [3–8], and bite-mark (hyphenated) [9–12]— 
appear in the literature. “Bite mark” is most widely used. 
The nature of Bitemarks
MaRk l. BeRnStein
Contents
5.1 Definition 53
5.2 Spelling 53
5.3 Evidentiary Value 54
5.4 Demographics 54
5.5 Pathology of the Cutaneous Bitemark 55
5.6 Anatomy of the Typical Cutaneous Human Bitemark 55
5.7 Class Characteristics of the Human Cutaneous Bitemark 55
5.8 Variations of Bitemark Patterns 57
5.8.1 Central Contusion 57
5.8.2 Linear Abrasions and Contusions 57
5.8.3 Lingual Markings 58
5.8.4 Tongue Thrusting 58
5.8.5 Acute Inflammatory Reaction 58
5.8.6 Uninterrupted Arches 58
5.8.7 Tooth Indentations 58
5.8.8 Double Bite 59
5.8.9 Multiple and Superimposed Bites 59
5.8.10 Weave Patterns 60
5.8.11 Excessive Ecchymosis and Abrasion 60
5.8.12 Partial Bitemarks 60
5.8.13 Indistinct or Faded Bitemarks 61
5.8.14 Avulsive Bites 61
5.8.15 Healed Bitemarks 61
5.8.16 Postmortem Bitemarks 62
5.9 Individual Characteristics of the Human Bitemark 62
5.10 Dog Bites 62
5.11 Bitemarks in Other Substrates 64
References 64
54 Bitemark evidence: a color atlas and text, 2nd edition
This form implies a type of mark, whereas “bitemark” 
connotes an entity unto itself and that is recognizable as 
such. It is considered to be a more progressive term, sig-
nifying that odontologists have accumulated a sufficient 
body of knowledge to dignify the form. “Bite-mark” 
should be reserved for use as a compound adjective as 
in “bite-mark analysis” [1]. The point may be moot since 
all forms are acceptable, yet it is important to consider all 
terms when performing a computer literature search. 
(Editor’s note: For the purposes of this edition, the term 
“bitemark” has been adopted, excepting cited quotations 
and references where it is spelled differently.)
5.3 Evidentiary value
The presence and recognition of a bitemark in a living or 
deceased individual or in a substrate at a crime scene is 
relevant in both civil and criminal cases. The mere pres-
ence of an identifiable bitemark in a purported crime is 
significant even if the pattern fails to implicate a specific 
biter. In a case of disputed child abuse, where the injuries 
are arguably accidental, the presence of a bitemark sup-
ports an accusation of abuse. In alleged sexual assault, 
when DNA evidence is apt to confirm the identity of the 
accused, the defense of consensual sex is less believable 
if bitemarks are found. Even a poor-quality bitemark, if 
recognized, can prompt trace evidence collection for 
salivary DNA and amylase.
Many bitemarks do record the distinctive morpho-
logic features of the biter’s dentition, offering an oppor-
tunity to identify the biter based on metric and pattern 
analysis. The discovery of bitemarks, like fingerprints,offers hope of perpetrator identification, but there are 
important differences between the two. When latent 
fingerprints are discovered at a crime scene, this means 
only that a certain person touched something at an 
unspecified time. There is not necessarily a link to the 
crime. In contrast, the presence of a bitemark in skin 
indicates a violent interaction between individuals as 
well as a rough temporal connection to the event.
5.4 Demographics
Bitemarks are seen in crimes of passion—homicide, rape 
or sexual assault, domestic violence (child, partner, elder 
abuse), and battery. The bitemark recipient may be the 
victim of a crime or the perpetrator of a crime—either 
as an aggressor or in self-defense. Rarely, self-biting has 
been reported in association with mental retardation, 
psychological disturbance, organic brain disease [13], 
severe pain [14], epileptic seizures, an attempt to frame 
another individual, or forcible insertion of an arm into 
the victim’s mouth during a fight to subdue the victim or 
prevent crying out [10,15]. An unusual one-arched bite-
mark was reported in a woman who fell on her denture 
[16]. Other sources of human bitemarks include partly 
eaten food or chewing gum discarded during robber-
ies, or teeth contacting inanimate objects during fights. 
Animal bites, particularly from dogs but also from 
other mammals, reptiles, and fish, are of forensic inter-
est, including postmortem predation from field animals 
and insects.
Bitemarks may appear on any skin surface [7,9,17], 
although they are found with greatest frequency on the 
breasts, arms, legs, and head. Females are bitten four 
times as often as males. In heterosexual assaults on 
women, breasts, arms and legs, face and neck, pubic 
area, and buttocks are frequent sites; in male homosex-
ual attacks, the upper back, shoulders, axillae, penis, and 
scrotum are favored. Abused children are randomly bit-
ten with frequent bites on the face and back [6,7]. Rawson 
et al. reported that 43% of bites on children occurred in 
the head and neck [18]. In Pretty and Sweet’s study, all 
male children had genital bites [19]. Meta-analysis of 
these multiple studies is not entirely accurate because 
they derived cases from different sources: hospital-based 
populations [18,20], coroner’s cases [9], and court cases 
[19]. Multiple bites are found in 40–48% of bitemark 
cases [19,20]. Pretty and Sweet caution that, when one 
bite is detected, others should be sought [19].
In dog maulings where multiple bites are sustained, 
the extremities are bitten and deep, perforating bites 
of the neck and avulsive bites of the scalp are common 
(Figure 5.1).
Figure 5.1 Fatal neck perforation and avulsion of scalp in 
a dog mauling.
the nature of Bitemarks 55
5.5 Pathology of the Cutaneous Bitemark
Fingerprints, impressions, and patterned injuries all 
represent a transfer of a pattern from one medium to 
another. This is where the similarity ends. The visibil-
ity of a fingerprint derives from deposits of sweat and 
dirt on the crests of the friction ridges that are passively 
transferred to a smooth surface. The deposit faithfully 
reproduces the anatomy of the ridge detail in much the 
manner of a rubber stamp imprint. An impression is a 
three-dimensional indentation occurring when a hard 
material displaces a softer material. It retains the depres-
sion after the two materials are separated.
A patterned injury such as a bitemark is made vis-
ible not by a transfer of material and not often by inden-
tations, but rather by a vital response of the bitten tissue. 
It may include the superficial scraping of epithelium by 
the contacting teeth (abrasion), the bleeding within skin 
by the pressure of the teeth (contusion), or the tearing 
of skin by teeth (laceration) that renders the bitemark 
visible. Bleeding or scraping of skin under assault is not 
obliged to conform precisely to the anatomy of the object 
that produced it. The bleeding can extend beyond the 
tooth marks. Conversely, bitten skin may not have been 
sufficiently damaged to react at all. The bitemark is not 
an imprint or impression, but rather a reactive response 
generated by injured skin that is invariably less precise 
than a direct recording.
A myriad of other unpredictable and nonreproduc-
ible variables further confound the patterns displayed 
in a bitemark. These include skin thickness, elasticity, 
curvature, texture, vascularity, pigmentation, underly-
ing support, and position during biting. Also important 
are the age and gender of the victim and the presence 
of systemic diseases and medications. The dynamics of 
biting—force and direction—affect the resulting pat-
tern, as do surface characteristics of contacting teeth. 
In spite of all these variables, it remains a maxim of 
forensic pathology that abrasions and contusions often 
reproduce the pattern of the offending agent. It is this 
observation that affords odontologists the opportunity 
to determine whether or not a specific dentition might 
have produced a given bitemark.
5.6 Anatomy of the Typical Cutaneous 
Human Bitemark
The human dental formula is I2/2, C1/1, P2/2, M3/3—
indicating two incisors, one cuspid, two premolars, and 
three molars in each upper and lower quadrant. The 16 
maxillary and 16 mandibular teeth are arranged along 
parabolic arches. Typically, it is only the six anterior 
teeth in each arch (incisors and cuspids) that participate 
in a bitemark. Occasionally, first premolars and, rarely, 
molars mark. During biting, the jaws approximate one 
another, the biting (incisal) surfaces of the teeth contact 
skin with various degrees of force, and the skin reacts, 
registering a pattern that resembles a mirror image of 
the incisal signature.
Our genetics determine the general characteris-
tics that define the size, shape, and arrangement of our 
dentition. All humans are expected to share these basic 
dental characteristics, which are similarly reproduced in 
well-inflicted bitemarks. This enables the forensic inves-
tigator to examine a patterned injury and, by virtue of 
these characteristics, identify it as a human bitemark. 
“Class characteristics” is a term borrowed from tool 
mark analysis [6]. It refers to morphologic features in a 
transfer pattern that are expected to be reproduced by 
any and all members of a certain class or set and serve to 
identify the set from which it was derived. Thus, a cer-
tain pattern in a footprint or tread mark would enable 
the identification of the brand of sole or tire. For our 
purposes, class characteristics of the human dentition 
are features that, when seen in a patterned injury, allow 
its identification as a generic human bitemark.
5.7 Class Characteristics of the Human 
Cutaneous Bitemark
The classic human bitemark in skin appears as a cir-
cular or oval, ring-shaped or doughnut-shaped injury 
composed of two opposing U-shaped arches facing one 
another and separated from each other at their bases. 
Each arch features an alignment of individual contu-
sions, abrasions, and/or lacerations that approximate 
the size, shape, and arrangement of human teeth. The 
incisors, located toward the center of each arch, record 
as a row of four linear or rectangular marks per arch. 
The cuspids (or canines) produce circular, triangular, or 
 diamond-shaped marks toward the edges of the arches, 
with their size determined by their incisal surface area 
and depth of penetration of their conical cusps. If a pre-
molar marks, it produces a cuspid like marking aligned 
with the arch and possibly a second mark a few milli-
meters within the arch, representing the lingual cusp.
Since the upper and lower arches have distinguish-
ing features, class characteristics can be defined for the 
maxillary and mandibular dentitions. Upper central 
incisors are broad and can be expected to leave linear 
56 Bitemark evidence: a color atlas and text, 2nd edition
markings meas ur ing 8–9 mm. The narrower lateral inci-
sors leavesimilar marks of 6–7 mm. Since lateral inci-
sors do not typically reach the occlusal plane, these 
shorter teeth do not place as much pressure on skin 
and may leave less intense marks or no marks at all. The 
longer, pointed cuspids often leave well-defined marks. 
Their position at the corners of the arch marks the area 
where the arch curves most sharply. In the lower arch, 
the incisal widths of the central and lateral incisors are 
less disparate, meas ur ing ∼5.5 and 6.0 mm, respectively. 
If lower premolars mark, only the buccal cusps are likely 
to record since the lingual cusps are diminutive. The 
meas ure ments are based on the study of Moorrees et al. 
[21], which should be consulted for more precise values, 
standard deviations, and ranges.
The upper arch is larger than the lower, and its inter-
cuspid distance averages from 32.3 mm [22] to 33.6 mm 
[23] ± 2.5 mm for 1 standard deviation (SD). The range, 
based on nearly 400 cases, was 21.3–41.0 mm [22]. The 
mandibular intercuspid distance averages 25 mm [22,23] 
± 1.85 mm for 1 SD and ranged from 11.6 to 33.0 mm 
[22]. Barsley and Lancaster obtained slightly higher 
mean intercuspid distances of 35.9 ± 3.3 mm (maxillary) 
and 28.1 ± 2.9 mm (mandibular) because they meas ured 
from the disto-occlusal aspects of worn canines rather 
than the cuspal midpoints [24]. They also found that 
98.7% of all mandibular arches meas ured <35 mm and 
78% meas ured <30 mm.
For maxillary arches, 3.4% are less than 30 mm and 
38.8% are less than 35 mm from cuspid to cuspid. The 
differences between male and female intercuspid dis-
tance averaged 1.6 mm for the maxilla and 1.0 mm for 
the mandible, but there was considerable overlap. Racial 
and age differences over the age of 12 were also insignifi-
cant [24]. Thus race, gender, and age cannot be predicted 
from an adult bitemark. The entire adult bitemark injury 
usually meas ures in width from 3.5 to 4.0 cm when a 
full complement of anterior teeth is involved. Its length, 
meas ured from upper to lower incisors, varies with 
degree of jaw opening and amount of skin gathered dur-
ing the bite. The average maximal opening diameter 
is ∼42–45 mm but can exceed 70 mm. The amount of 
skin gathered will be less on flat, taut surfaces than on 
curved or pliable surfaces such as extremities, breasts, 
and buttocks.
The dynamics of biting usually cause the mandibu-
lar bitemark to appear more intense and more sharply 
defined than the maxillary. This has been attributed to 
the fact that the lower is the movable jaw or, as Sperber 
opined, that the skin contacting the upper teeth during 
biting is not squarely pressed against the incisal edges 
as in the lower, but rather along the broad slope of the 
lingual surfaces of the overlapping upper teeth [25]. The 
idealized bitemark is diagramed in Figure 5.2.
The value of defining class characteristics for the 
human bite is twofold: First, it defines objective criteria 
upon which to distinguish the human bite from other 
patterned injuries; second, the data suggest that many 
bitemarks will be similar based on shared characteris-
tics and that a “match” between a bitemark and suspect 
based on these nonspecific class characteristics does not 
necessarily “identify” the biter. A bitemark with a max-
illary and mandibular intercuspid distance of 34 and 
25 mm, respectively, 9.0-mm maxillary central incisors, 
5.6-mm mandibular incisors, and aligned arches will 
accommodate a large percentage of human dentitions.
Bites inflicted by children also bear class charac-
teristics that define this subset. Compared to adult 
teeth, the deciduous dentition of children below the 
age of 6 years typically features smaller, rounded, bow-
like arches; smaller teeth; and spacing between teeth. 
Upper central incisors, at an average mesiodistal width 
of 6.5 mm, are only slightly larger than lateral incisors 
at 5.3 mm. Lower incisors meas ure about 4–4.5 mm 
[21,26]. The mean maxillary intercuspid distance meas-
ures 28–29 mm from ages 3–6 years, and the mean man-
dibular intercuspid distance is ∼22.6 mm. This is about 
4.4 and 2.5 mm smaller than the respective intercuspid 
distances of adults [23].
Reflecting these attributes, bitemarks from children 
are typically smaller than adult bitemarks (3–3.5 cm), 
with spaces between the teeth (Figure 5.3, left). Marks 
from the upper centrals are only slightly larger than 
other incisors. Children between the ages of 7 and 11 
have a mixed dentition, which effaces the anterior spac-
ing once the larger permanent incisors erupt. This causes 
the anterior segment to widen while the narrower poste-
rior segments are relatively constricted lingually [26].
3.5–4.0 cm
Figure 5.2 Diagram of a prototypical human bitemark 
showing class characteristics.
the nature of Bitemarks 57
5.8 variations of Bitemark Patterns
Unfortunately, a well-inflicted, undistorted bitemark 
showing 12 or more teeth is uncommonly seen. There 
are variations in bitemark morphology due to additional 
injury patterns sustained during the dynamics of biting 
as well as degradations and deficiencies due to distortion 
or partial recording.
5.8.1 Central Contusion
A central area of contusion or ecchymosis is frequently 
noted within the confines of the bite (Figure 5.3, right). 
In the past, this has been attributed to suction with or 
without the pressure of tongue thrusting, and its eti-
ology has been ascribed to prolonged, sadistic, sexual 
biting activity. Today the pathogenesis for central contu-
sion is attributed to the compression of tissue squeezed 
in between the upper and lower teeth causing rupture of 
capillaries. The mechanism was witnessed at the 1984 
ABFO Bitemark Workshop when a set of models on an 
articulator compressed abdominal tissue of a volunteer, 
causing an instant and intense central bruise. There was 
no possible suction.
The literature persists in calling these bruises “suck 
marks” [8] with the implication of a sexual motivation—
an inappropriate deduction. Both mechanisms (positive 
and negative pressure) contribute to central contusions. 
The appearance of central contusion is not helpful in 
identifying a biter since it is nonpatterned and not made 
by teeth. However, it does help support that the lesion 
represents a bitemark. (Editor’s note: See Section 21.10.19 
in Chapter 21.)
5.8.2 linear Abrasions and Contusions
A series of linear abrasions or contusions is often found 
radiating at right angles to the arches external to the 
periphery of the bitemark. These represent the action of 
teeth scraping as they slip across skin during closing or 
as the victim attempts to pull free. These “drag marks” 
distort the anatomy of the teeth and are not welcome in 
terms of biter identification, but they do help corrobo-
rate the nature of the injury as a bite (Figure 5.4).
Figure 5.3 typical bitemark from a child showing small, spaced teeth (left). Bitemark showing central contusion 
with pale area from tongue thrusting (right). note continuous ring due to approximation of maxillary and mandibu-
lar arches.
Figure 5.4 Drag marks left by mandibular teeth scraping across face (left). three drag marks in a bitemark made by 
mandibular left teeth (right).
58 Bitemark evidence: a color atlas and text, 2nd edition
5.8.3 lingual markings
Occasionally, short linear or gumdrop-shaped patterns 
appear centripetally, radiating inward from the arches. 
These represent the outlines of the lingual surface of teeth. 
Entire outlines of embrasures, gingival margins, and papil-
lae can be reproduced. Harvey attributed these markings 
to tongue thrusting in which the tongue pressed the cap-
tured skin against the teeth [9]. Noting that lingual mark-
ings were more common on upper teeth, Sperber related 
their presence to pressing of skin by lower teeth against 
the lingual surfaces of overlapping upper teeth when bites 
were inflicted in a centric relationship [25].
Other potential factors contributing to lingual 
markingsinclude soft skin, thin skin supported by adi-
pose, and labially inclined anterior teeth. The pressure 
of the lingual surfaces does not have to be great to reg-
ister markings; some lingual markings may not repre-
sent a wound at all but rather an area of sparing when 
central contusion follows a path of least resistance and 
flows into skin adjacent to the skin compressed by the 
cingula and marginal ridges of the incisors. The incisor 
imprints appear pale, outlined by thin, red tracts of con-
tusion where relief was afforded by embrasures and gin-
gival soft tissue (Figure 5.5). (Editor’s note: See Section 
21.10.8 in Chapter 21.)
5.8.4 Tongue Thrusting
The tongue can leave a pale area within a central contu-
sion where its pressure against the skin either forced out or 
failed to admit the blood extravasated during central con-
tusion formation (Figure 5.3, right). (Editor’s note: This phe-
nomenon has been produced experimentally with mounted 
dental casts and is therefore not necessarily produced by 
tongue thrusting. See Section 21.10.19 in Chapter 21.)
5.8.5 Acute inflammatory reaction
A bitemark may show the hallmarks of acute inflamma-
tion within minutes of infliction. This includes the wheal 
and flare reaction, where redness and swelling predomi-
nate. The bitemark appears diffusely erythematous and 
slightly raised. The ring appearance may be replaced by 
a solid red oval, obliterating arches and tooth marks. The 
acute reaction subsides within hours to a day, restoring 
the identifying class characteristics [15]. Such events are 
most common on children’s faces (Figure 5.6).
5.8.6 uninterrupted Arches
Most bitemarks show a separation between the maxil-
lary and mandibular arches, representing the unbitten 
skin that curves between two arches. If the skin is suf-
ficiently thin and the bite force is intense, the upper and 
lower teeth at the posterior margin of the bite can nearly 
approximate, causing a continuous, uninterrupted ring 
of tooth marks representing both arches. Since similar 
patterns can be made by oval and round objects like 
rings, care must be exercised in designating an origin 
from such patterns.
5.8.7 Tooth indentations
Actual depressions representing impressions of teeth in 
skin do occur at the moment of biting and do not require 
much force. Because of the elastic memory of skin and 
the swelling that might occur in the acute phase, these 
Figure 5.5 lingual markings formed when pressure from mandibular cingula prevented spread of central contusion 
(left). (From aBFo Bitemark workshop.) Five maxillary and five mandibular teeth recorded as lingual markings (right).
the nature of Bitemarks 59
indentations usually smooth out within 20 minutes and 
are seldom available for evaluation (Figure 5.7). (Editor’s 
note: See Chapter 21 for many examples of this condition.)
5.8.8 Double Bite
Literally a bitemark within a bitemark, this variant occurs 
when a mass of skin captured between teeth is grasped 
and the victim partly pulls free, followed by a reapplica-
tion of biting force. The result is two concentric sets of 
arches with duplication of the bite pattern. Accompany-
ing drag marks might be seen (Figure 5.8, left). (Editor’s 
note: This phenomenon has been produced experimentally 
with mounted dental casts and is therefore not necessar-
ily produced by the victim pulling free. See Chapter 21 for 
many examples of double and superimposed bites.)
5.8.9 multiple and Superimposed Bites
Two or more bites are found in 40–48% of bitemark 
cases [19,20]. Multiple bites made by the same biter allow 
the odontologist to search for reproducible patterns 
among the bites that can then be considered nonarti-
factual stable characteristics (Figures 5.8, right, and 5.9). 
Superimposed bites, on the other hand, can confound 
bitemark analysis because they overlap and degrade 
detail (Figures 5.8, right, and 5.10, left). (Editor’s note: 
See Chapter 21 for many examples of this condition.)
Figure 5.6 acute inflammation and swelling account for solid appearance of bitemarks photographed within hours of 
infliction (left). the same bitemarks as in the left-hand figure, photographed a day later when subsiding inflammation 
revealed the ring pattern of arches (right).
Figure 5.7 temporary indentations of teeth in a bitemark 
photographed minutes after infliction.
Figure 5.8 “Double bite” occurring as teeth slipped, fol-
lowed by reapplication of force, creating concentric dupli-
cation of pattern.
Figure 5.9 (a) Multiple bites in a gunshot homicide vic-
tim. Superimposed bites and two single bites are seen.
60 Bitemark evidence: a color atlas and text, 2nd edition
5.8.10 Weave Patterns
Bitemarks through clothing can leave the weave pattern 
of the fabric embossed in contusion. Clothing can also 
dull or eliminate the detail of tooth marks and prevent 
saliva and DNA deposition, which must then be obtained 
from the garment (Figure 5.10, right). (Editor’s note: See 
Chapter 21 for many examples of this situation.)
5.8.11 Excessive Ecchymosis and Abrasion
Excessive bleeding outside the confines of the bitemark 
can obscure pattern details and cause the bitemark to 
appear larger than normal. Secondary injury unrelated 
to biting, such as holding of the part being bitten, may 
account for some examples. Ostensibly, biting of previ-
ously injured skin can cause peculiar patterns. Levine 
reported a case in which the biter inflicted abrasions in 
an attempt to obliterate the bite pattern [7]. Excessive 
bleeding is also encountered in those who bruise read-
ily (females, elderly, children, thin skin, skin supported 
by adipose, and patients on steroids, on anticoagulants, 
or with coagulopathies or liver disease). Care is nec-
essary to find the characteristic arch form and tooth 
marks so that the injury can be properly identified 
(Figure 5.11, left).
5.8.12 Partial Bitemarks
If skin is not squarely bitten, only portions of the den-
tition mark. Resulting variants include unilateral (one-
sided) bitemarks (Figure 5.11, left) in which only the left 
or right side of both arches marks, one-arched bitemarks 
(Figure 5.12, left) showing only an upper or lower arch, or 
bitemarks showing only a few teeth (Figure 5.12, right). 
Unilateral bitemarks occur when the bite is skewed or 
the anatomy of the bitten tissue curves away from the 
teeth on one side. Bitemarks showing few teeth can be 
due to a poorly inflicted bite, superimposed clothing, 
highly curved skin contours, variations in underlying 
skin support within the bitten tissue, or missing teeth 
in the biter.
Single-arched bitemarks are most likely to be dis-
puted. Logic predicts that both arches are needed to 
produce the required pressure; however, bitemarks with 
one arch have been documented, despite the fact that the 
biter had a full dentition [7]. Interposed clothing or for-
eign object, dull surfaces of teeth, variations in skin and 
Figure 5.9 (B,c) close-up of bitemarks seen in Figure 5.9a. Bitemark medial to axilla shows a suggestion of distinctive 
individual characteristics (B). Repetition and improvement in pattern seen in bitemark posterolateral to axilla (c). note 
severe labial crowding and rotation of number 27; overlapping of numbers 26, 25, and 24 (universal System), and drag 
marks of entire anterior maxillary arch.
Figure 5.10 two superimposed bites converging at the nipple (left). linear arrangement of tiny contusions reflecting the 
weave pattern in the sweater in this bitemark through clothing (right).
the nature of Bitemarks 61
skin support, or more rapid fading of one arch (usually 
the upper) can account for single-arched marks. Falling 
or lying upon a removable denture has produced a one-
arched bite pattern [16].
5.8.13 indistinct or Faded Bitemarks
“Toothless” bitemarks frequently appear. The class char-
acteristic of facing arches is present, but individual teeth 
are not seen. There may be a suggestion of scalloping, 
indicating a fusion ofindistinct tooth marks or merely a 
uniform contusion with little or no abrasion. Such bite-
marks occur when the collective pressure of teeth within 
an arch leaves a continuous curved contusion. This is 
most often seen in soft, yielding skin (children, women) 
and skin cushioned by abundant adipose, which is very 
vascular and easily bruised. It also occurs as bitemarks 
heal. An otherwise well-defined bitemark can show fad-
ing of the tooth marks before the background contu-
sions (Figure 5.13).
5.8.14 Avulsive Bites
Severe, vicious bitemarks can lacerate and avulse tis-
sue to the point of loss of soft tissue. This results in 
gaping wounds that are not readily identifiable as bite-
marks and rarely permit identification of a perpetrator. 
Avulsive bites, common in dog maulings, are infrequent 
in human bites. They are most apt to occur on project-
ing anatomic areas such as nipples, noses, ears, fingers, 
genitals [9,15,27], or tongues (Figure 5.14, left).
5.8.15 Healed Bitemarks
Any injury can heal with more, less, or the same amount 
of melanin as the surrounding skin. Increased melanin 
is known as postinflammatory pigmentation. Decreased 
melanin is seen in some scars. Both phenomena are 
more readily appreciated in dark-pigmented individu-
als. These pigmentary changes may maintain the pattern 
of a bitemark for many months (Figure 5.14, right). 
Figure 5.11 excessive hemorrhage surrounding bitemark (left). partial bitemark created by left maxillary and mandibu-
lar arch (right). (Both photos courtesy Dr. william Smock.)
Figure 5.12 one arched bitemark (left). (From aBFo Bitemark workshop.) Bitemark showing only two maxillary and 
two mandibular incisors (right).
62 Bitemark evidence: a color atlas and text, 2nd edition
Sometimes the pigmentary patterns are too subtle to be 
seen visibly and are present as latent injuries that can 
be imaged only by ultraviolet photography.
5.8.16 Postmortem Bitemarks
Bitemarks created after death do not show the vital 
responses that facilitate visualization of the injury. Post-
mortem abrasions lack the scab composed of serum, 
fibrin, and red blood cells formed in a living subject. They 
appear yellow, translucent, and parchmentlike [28]. It 
should be noted that a severe blow inflicted within a few 
hours of death might produce contusions [29]. (Editor’s 
note: I have produced 34 postmortem bites experimentally 
from 1 minute to several days after death and have never 
been able to create a postmortem contusion at the bite site. 
See Chapter 21 for many examples of this situation.)
5.9 individual Characteristics 
of the Human Bitemark
An individual characteristic is a feature or pattern that 
represents a departure from an expected finding within 
a defined group. It represents an individual variation that 
serves to identify a particular member of the group. A 
tear or wear pattern in a tire or shoe sole that imprints in 
a tread mark or footprint is an example. For bitemarks, a 
tooth malposition or diastema can produce individual 
characteristics. Such characteristics are due to a com-
bination of genetics and environment. When seen in 
bitemarks, individual characteristics allow the forensic 
dentist to eliminate, narrow down, or identify suspects 
depending on the bitemarks’ degree of distinctiveness.
5.10 Dog Bites
Large dogs, most notably rottweilers, pit bulls, chows, 
German shepherds, and Doberman pinschers, account 
for most serious or fatal bites in the United States. 
Canine dentitions show considerable variations among 
breeds with regard to tooth and arch size and arch shape. 
Dogs such as collies and Doberman pinschers have long 
Figure 5.14 avulsed human bitemark in soft tissue above the eyelid (left). (courtesy of Dr. william Smock.) old healed 
bitemark showing postlesional pigmentation (right). (courtesy of Dr. Richard Souviron.)
Figure 5.13 toothless bitemarks showing only arch form 
and size as class characteristics.
the nature of Bitemarks 63
muzzles, while rottweilers, chows, and pit bulls have 
wider arches.
Yet, in spite of variations, there are defining class 
characteristics that allow identification of a bitemark as 
a dog bite. The canine dental formula is I3/3, C1/1, P4/4, 
M2/3 (Figure 5.15, left). Each arch has six small incisors 
aligned in a gently curved arch. Following a space (larg-
est in the maxilla), two long, pointed cuspids are posi-
tioned at the corners of the arch; at this point the arch 
turns sharply posteriorly. Beyond the cuspids, there is 
a space followed by a small first premolar. The second, 
third, and fourth premolars are spaced and become 
increasingly larger. The first molar is the largest molar, 
followed by progressively smaller molars. Dogs and 
other carnivores possess tritubercular posterior teeth in 
which premolars and molars have three aligned cusps or 
tubercles forming a triangle [26]. Upper and lower cusps 
slide past and interlock with each other during biting, 
allowing these teeth to grasp and lacerate.
The well-inflicted dog bite shows a long, narrow 
arch compared to a human bite. The small incisors may 
not produce markings, but if all six incisors of an arch 
mark, they serve to exclude a human bite. The long, 
fanglike cuspids produce prominent markings—often 
deep punctures or lacerations that may not conform to 
the intercuspid distance of the bites since dog canines 
flare occlusally (Figure 5.15, right). The bitemark turns 
sharply posteriorly to the cuspids, converges lingually, 
and then flares buccally. Premolars and molar mark-
ings are common since the dog’s jaws can open widely 
(Figure 5.16, left).
In a defensive or anger bite, a dog may snap and let 
go. In these bites, anterior tooth marks predominate 
and can show superficial similarity to a human bite. In 
a mauling or predatory bite, the dog will grasp a large 
segment of tissue using posterior teeth and, by pulling 
and shaking, cause drag marks and lacerations. If the 
grip loosens, the dog attempts to thrust its head forward 
to seize more tissue, thus creating double or superim-
posed bites. Laceration and avulsions caused by large 
carnivores can be so sharply defined as to be mistaken 
for incisions. Accompanying long abrasions from claws 
Figure 5.15 occlusal views of the canine dentition. note constriction of arch posterior to the cuspid followed by flaring 
beginning in the premolar region (left). Flared mandibular cuspids fit into perforations in this dog bite. note concordance 
of incisor injuries to the arrangement and anatomy of incisor teeth (right).
Figure 5.16 Dog bite showing constriction and flaring of mandibular arch including molar teeth (left). Dog claw marks 
across back of victim of dog mauling (right).
64 Bitemark evidence: a color atlas and text, 2nd edition
may be seen in some cases (Figure 5.16, right). (Editor’s 
note: See Chapters 16 and 17.)
5.11 Bitemarks in other Substrates
Food and other compressible objects record a bitemark 
in the same manner as impression material; accu-
racy is determined by the substrate and its tendency 
to deform, dehydrate, or decompose following the 
bite. Foods like cheese, chewing gum, cake icing, and 
chocolate and other candy can produce useable three-
dimensional impressions under favorable conditions 
(Figure 5.17, left). Fruits, vegetables, butter, and pre-
served meats can also record identifiable bitemarks but 
with more opportunity for distortion. Tooth inden-
tations have also been recorded in wood and plastic 
(Figure 5.17, right).
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anatomy, physiology and occlusion, 8th ed., 75, 101–102, 
160, 168, 181, 188. Philadelphia, PA: W. B. Saunders 
Company.
 27. Rawson, R. D. 1986. Child abuse identification. California 
Dental Association Journal 14 (3): 21–25.
 28. DiMaio, D. J., and V. J. M. DiMaio. 2001. Forensic pathol-
ogy, 2nd ed., 92–104. Boca Raton, FL: CRC Press.
 29. Robertson, I., and R. A. Mansfield. 1957. Antemortem 
and postmortem bruises of the skin: Their differentia-
tion. Journal of Forensic Medicine 4:2–10.
67
6
6.1 organizational Construction 
for initial Analysis
Routinely, when called to examine a patterned injury, 
the odontologist follows a standard protocol, asking a 
series of increasingly specific questions:
Is it a bitemark?
Is it human or animal?
Can it be ascribed to an adult or a child?
Can upper and lower arch be discriminated for 
orientation purposes?
Are there individual characteristics that help to 
profile the biter’s dentition?
Are the bitemarks ante- or postmortem?
The answer to each question is neither intuitive nor 
based on an educated guess, but rather derives from the 
fulfillment of criteria that can be explained, demon-
strated, and justified. In a well-inflicted, characteristic 
bitemark, these determinations can be made.
6.2 Quality of the Bitemark
Determining the quality of a bitemark is an exercise that 
is performed in the reconstructive phase, prior to a com-
parison of suspect casts. The individual criteria used to 
determine quality are objective, yet an overall appraisal of 
quality is an algorithmic judgment based on these criteria.
Many odontologists assign a quality rating to bite-
marks. Since the standards for quality have not been 
formalized among odontologists, each investigator is 
apt to make subjective or objective assessments based on 
personal criteria. This has the potential for inconsistent 
determinations and miscommunications. If bitemark 
quality is defined as an assessment of value referenced 
to a criteria-based goal or standard, the exercise may be 
more meaningful. There are two quality assessments. 
The first simply allows a meas ure of confidence that the 
patterned injury is a bitemark and can be expressed as 
the ability of the pattern to reproduce the class character-
istics of the human bite. The second meas ure is intended 
to communicate the anticipated evidentiary value of the 
bitemark in perpetrator identification. In this case, both 
class and individual characteristics must be evaluated.
A bitemark deemed to be of exceptional quality 
would show the idealized class characteristics recorded 
in a distortion-free pattern. The incisal edges of individ-
ual teeth would be outlined and distinct, unencumbered 
by drag marks, superimposed distractions, or inaccu-
racies caused by skin elasticity. Each tier of specificity 
(identification as a bitemark, discrimination of animal 
vs. human, adult vs. child, and upper vs. lower arch) 
would be determinable.
For the second meas ure of quality, more is needed. 
Individual characteristics would have to show sufficient 
quantity or deviation from the norm so as to constitute 
a distinctive or unique pattern. All things being equal, 
the greater the quantity of features in a bitemark, the 
more opportunity there is for higher biter discrimina-
tion. However, the quantity of participating teeth is not 
as important as their degree of abnormality. Six well-
aligned teeth in an arch will render a bitemark of less 
quality than one with fewer teeth if some are malposed. 
Similarly, since arch size and shape are relatively con-
sistent among people, only clearly deviant arches would 
add quality to the bitemark.
A bitemark is considered to be poor or marginal in qual-
ity when the tooth marks are absent, uncertain, smudged, 
indistinct, faded, or distorted to the extent that incisal 
edge morphology is effaced. Partly inflicted tooth marks 
or sparse marks that fail to show a relationship between 
adjacent teeth alsodegrade the value of the bitemark.
reconstructive Bitemark Analysis
MaRk l. BeRnStein
Contents
6.1 Organizational Construction for Initial Analysis 67
6.2 Quality of the Bitemark 67
6.3 Profiling the Biter 68
6.4 Maintaining Perspective 69
6.5 Summary 70
References 70
68 Bitemark evidence: a color atlas and text, 2nd edition
Bitemarks showing features intermediate in value 
between these two extremes may be considered of good 
or fair quality. Thus, the discriminating value of any 
individual characteristics has to be weighed against 
the minimizing effect of any distortions or deficiencies. 
Well-inflicted bitemarks that are clear and distinct yet 
lack individual characterization may also be considered 
excellent in quality for assignment as a human bitemark, 
although conditional for assailant identification.
Although odontologists rarely disagree on interpre-
tations of exceptional or poor-quality bitemarks, judg-
ing the value of good- or fair-quality bitemarks is more 
inconsistent. There are no guidelines to assist odontolo-
gists in reliably constructing a precise hierarchy of bite-
mark quality. ABFO bitemark terminology guidelines [1] 
specify only two terms: bitemark (indicating that teeth 
created the pattern) and suggestive (inconclusive, miss-
ing or distorted tooth marks or arch configuration).
The initial assessment of bitemark quality should 
serve only as a guide to approaching the case rather than 
a formal and final determination. Other investigations 
may impact this initial judgment. Transillumination of 
the bitemark; photographic studies in ultraviolet (UV), 
infrared (IR), or alternate light imaging (ALI); scanning 
electron microscopy; and computer enhancement are 
only a few of the tertiary techniques that may add infor-
mation to elevate the quality of the bitemark. The find-
ing of other bitemarks on the body enhances the value 
of each component bitemark because individual features 
can be cross-referenced among the bitemarks to deter-
mine their stability and reliability (providing it can be 
determined that they were inflicted by the same person).
6.3 Profiling the Biter
It is tempting to “read” a bitemark and make predic-
tions about the teeth that produced it, but this can be a 
two-edged sword. Levine [2,3] urged against profiling, 
cautioning that bitemark patterns can “defy logic.” Bush 
et al. [4] and Dorion [4,5] warn that bitemark patterns 
can produce unexpected results. A space in a bitemark 
might merit a spurious comment such as “look for a per-
son with a missing tooth or a space between teeth,” only 
to be discredited when the tooth is present in the biter. 
The reason for its not appearing could be that it was 
chipped, did not reach the occlusal plane, was blunted, 
was loose, was buffered by superimposed clothing, or that 
Langer’s lines contributed to the illusion of its absence. 
Skin factors such as folding during the bite and lack of 
bony support can account for a tooth not leaving a mark 
(Figure 6.1). Likewise, if individual teeth in a bitemark 
are not clearly identifiable or if maxillary and mandibu-
lar arches cannot be discriminated with certainty, these 
“educated guesses” as to origin should not be communi-
cated informally or in a report. Such speculation can be 
the odontologist’s albatross. Bush et al. [4] reported that 
38% of experimentally produced bitemarks on cadavers 
showed distortions that did not conform to the biter’s 
dentition and might be incorrectly interpreted. About 
half of these related to arch size or curvature.
On the other hand, a prediction that correctly iden-
tifies an unusual characteristic in a suspect inspires 
confidence in the odontologist because it is objective 
and criteria based. This must be done with caution. For 
example, an experienced odontologist might reasonably 
predict a severely malposed incisor because of a repeti-
tive arch irregularity seen in several well-inflicted, non-
distorted bitemarks. It is better to make such predictions 
in a nonspecific fashion—for example, a prediction of an 
“anatomic abnormality expected in the biter’s upper cen-
tral incisors” rather than “look for someone with shovel-
shaped incisors.” Profiling a dentition is not an a priori 
fact and is not intended to initiate a search for a suspect 
in an open population. Rather, it should be used to check 
Figure 6.1 witnessed bitemark of a child showing apparent “missing” maxillary central incisors (left). the biter (right) 
has nonmobile central incisors that did not imprint because the skin was folded and clothed during the act of biting.
Reconstructive Bitemark analysis 69
the odontologist’s veracity prior to his or her examina-
tion of dental evidence on a viable suspect.
6.4 maintaining Perspective
When an odontologist is asked to inspect a pattern in 
an injury or object, he or she will formulate an initial 
assessment by applying the criteria reviewed in this 
chapter. Some patterns will fulfill enough criteria to 
merit distinction as a bitemark or be suggestive of a 
bitemark. Others will simply fail to reach a threshold of 
characteristics that would allow a designation of bite-
mark, let alone perpetrator identification. The odontolo-
gist is advised not to dismiss such injuries automatically. 
Even bitemarks deemed to be of poor or marginal qual-
ity have proven to be relevant. A poorly or partially reg-
istered tooth-to-substrate mark might have saliva trace 
evidence sufficient for perpetrator identification.
Similarly, identifiable bitemarks that lack individual 
characteristics should be given full attention and photo-
graphic documentation. The manner in which the case 
unfolds might make such a bitemark critical evidence. 
As mentioned earlier, a nondescript bitemark helps sup-
port the nature of some crimes even if it cannot implicate 
a particular perpetrator. A final determination of use-
fulness of a bitemark must consider the comparison of 
suspects’ teeth. In some crimes, particularly child abuse 
cases, it might be shown that only a limited number of 
people had opportunity to bite [3]. A nondescript bite-
mark in such a case could be used to rule out individuals 
if there are gross and unexplainable discrepancies or to 
implicate a suspect by exclusion of all others (Figures 6.2 
and 6.3).
Even an injury that mimics a bitemark should be 
fully documented and analyzed by a forensic odontolo-
gist. If such a lesion is disregarded because it is attributed 
to some other cause, opposing attorneys could capitalize 
on such a mark by identifying it as a bitemark that does 
not match the dentition of the accused. In some cases, 
a biter’s dentition might be so aberrant that his or her 
bitemark is unrecognizable as such and is overlooked. 
Failure to document such an injury could be a missed 
opportunity to record a unique pattern that would have 
generated convincing assailant identification. As is evi-
dent from these examples, the initial assessment of evi-
dentiary value of a bitemark might have to be modified 
once the comparison is performed.
Figure 6.2 this toothless bitemark is nondescript except 
for its relatively small, rounded arches.
Figure 6.3 overlay of a suspect’s arch on bitemark in preceding figure shows nonspecific similarity (left). overlay of a 
second suspect’s arch on the bitemark shows incompatible arch size and form (right). three other suspects were similarly 
eliminated. the dentition in the preceding figure was identified as the biter by exclusion.
70 Bitemark evidence: a color atlas and text, 2nd edition
6.5 Summary
Bitemarks are patterned injuries or impressions in 
substrates that can be relevant in the determination 
of the nature of crimes and the identification of per-
petrators. The collective wisdom of odontologists 
gained over 35 years of judicious and organized study 
of bitemarks has provided objective criteria upon 
which to evaluate these patterns. The subject is com-
plex, and fastidious techniques must be applied bothtechnically and analytically. Simple errors of analy-
sis, such as confusing upper and lower arch or failing 
to remember that a bitemark is a mirror image of the 
dentition, can cause catastrophic miscalculations that 
place the fate of suspects, the legal system, the disci-
pline of bitemark analysis, and the individual odon-
tologist in peril.
Because the odontologist can never anticipate the 
outcome of a given case, all patterned injuries or mark-
ings of questioned dental origin should be treated as 
bitemarks and processed accordingly, whether or not 
the odontologist initially suspects etiology from teeth. 
This also applies to nondescript injuries in which a vic-
tim claims to have been bitten.
references
 1. American Board of Forensic Odontology. ABFO bite-
mark terminology guidelines. Seattle, WA: American 
Board of Forensic Odontology 1995.
 2. Levine, L. J. 1982. Bitemark evidence. In Outline of foren-
sic dentistry, ed. J. A. Cottone and S. M. Standish, 112–
127. Chicago: Year Book Medical Publishers.
 3. Levine, L. J. 1977. Bitemark evidence. In The Dental 
Clinics of North America—Symposium on forensic den-
tistry: Legal obligations and methods of identification for 
the practitioner, ed. S. M. Standish and P. G. Stimson, 
145–158. Philadelphia, PA: W. B. Saunders Company.
 4. Bush, M. A., H. I. Cooper, and R. B. J. Dorion. 2010. 
Inquiry into the scientific basis for bitemark profil-
ing and arbitrary distortion compensation. Journal of 
Forensic Sciences 55:976–983.
 5. Dorion, R. B. J. 2010. Bite mark profiling based upon 
color, UV, and ALI photographic interpretation. 
Proceedings of the 62nd annual meeting of the American 
Academy of Forensic Sciences, Feb. 22–27, 2010, Seattle, 
WA. Colorado Springs, CO: American Academy of 
Forensic Sciences.
ivCollection of Bitemark Evidence
a: noninvasive analyses
73
7PhotographyGReGoRy S. GolDen 
FRanklin D. wRiGht
Contents
7.1 Introduction 74
7.2 Electromagnetic Spectrum: What It Means to Forensic Photography 74
7.2.1 Reflection 75
7.2.2 Absorption 75
7.2.3 Fluorescence 77
7.2.4 Diffusion 77
7.2.5 Summary 77
7.3 Conventional (Visible Light) Photography 77
7.4 Digital Photographic Systems 77
7.4.1 Professional, Pro-sumer, and Consumer Cameras 78
7.4.2 Lenses 79
7.4.3 Flash Accessories 80
7.4.4 Digital Video Cameras 80
7.5 Forensic Photographic Protocol 80
7.5.1 Photographic Scales 81
7.6 Visible Spectrum Imaging 81
7.6.1 Visible Imaging Technique 82
7.7 Digital Image Acquisition 82
7.7.1 Image Capture Sensors 83
7.7.2 Pixels and Color 83
7.7.3 Aspect Ratio 84
7.7.4 Resolution and Compression 84
7.7.5 ISO Equivalence 85
7.7.6 Lens Magnification 85
7.7.7 Storage Devices 86
7.7.8 Saving Digital Images 86
7.7.9 Digital Scanners 87
7.8 Considerations for Digital Photography in Order of Importance 87
7.8.1 Alternate Light Imaging 89
7.8.2 Digital ALI Technique for Bitemark Photography 91
7.9 Nonvisible Light Photography: Infrared Technique 94
7.9.1 Armamentarium for Digital Infrared Photography 95
7.9.2 Infrared Photography Technique 95
7.9.3 Focus Shift 96
7.10 Reflective Ultraviolet Digital Photography 96
7.10.1 Ultraviolet Digital Photography Armamentarium 97
7.10.2 Digital Ultraviolet Protocol 98
7.11 Application of Photographic Techniques Other Than for Bitemarks 98
References 102
74 Bitemark evidence: a color atlas and text, 2nd edition
7.1 introduction
As the fundamental principles of forensic photography 
have sustained the test of time, digital imaging has ele-
vated forensic photography into a completely new and 
profoundly different discipline. Changes and improve-
ments occur on a regular basis. One needs simply to 
compare the first edition of this textbook to the cur-
rent writing. Consequently, any treatise or chapter that 
addresses current levels of photo technology and imaging 
risks obsolescence by the time publication places it into 
the public domain. The technology of digital imaging is 
expanding that rapidly.
What the authors hope to accomplish in this chap-
ter on advanced digital photographic methods is to pro-
vide the reader with the fundamental building blocks 
necessary to understand each method’s protocol, the 
variations among techniques, and their applications in 
bitemark documentation. The primary intent is to con-
vey the information necessary to allow anyone with a 
basic comprehension of photography to document what 
happens biologically in injured tissue.
A discussion of equipment requirements for each 
technique will be included as well as an explanation 
of why certain parts of the visible and nonvisible spec-
trum produce images of the same bitemark that appear 
entirely differently from each other. The authors’ mutual 
goal is to assist the reader in ultimately becoming a bet-
ter photographer, thereby improving his or her profi-
ciency in capturing accurate photographic images of 
bitemark evidence.
It is beyond the scope of this chapter to teach the 
basic fundamentals of photography. Many high-quality 
introductory photography textbooks have been writ-
ten and are readily available at book and photography 
stores. This chapter takes information from the basics 
of photography and integrates it with the special techni-
cal requirements associated with forensic photography. 
Unless otherwise specified, the scientific data and tech-
niques described in this chapter apply to forensic bite-
mark photography and skin injuries.
7.2 Electromagnetic Spectrum: What it 
means to Forensic Photography
A significant portion of the electromagnetic spectrum 
extends from very short wavelength ultraviolet light 
in the 200-nm range through the visible light range of 
400–700 nm into the infrared range of 700–900 nm 
(Figure 7.1). A nanometer (nm) is one billionth (10–9) of a 
meter. Since the human eye cannot capture light outside 
the visible range, special photographic techniques using 
ultraviolet and infrared light have been developed for 
this purpose [1].
With varying light wavelengths illuminating the 
photographed object, very different appearances of 
the object can be portrayed. This is especially relevant in 
documenting patterned injuries such as bitemarks, tool 
marks, stab and gunshot wounds, fingernail scrapes, etc. 
These techniques can facilitate recognition of damaged 
tissue from adjacent normal tissue. Ultimately, a more 
complete and comprehensive collection of photographic 
evidence is obtained (Figure 7.2).
When full-spectrum light strikes skin, four resul-
tant events occur: reflection, absorption, diffusion, and 
λ nm
Epidermis
Dermis
Subcut.
300200 400 500 600 700 800 900
InfraredVisibleUltraviolet
Figure 7.1 penetration of light into skin with different wavelengths of the electromagnetic spectrum.
photography 75
fluorescence [2]. By changing the wavelength of the 
incident light, each of these four possible effects can 
be emphasized to reveal differing amounts of detail in 
the resultant images (Figures 7.2 and 7.3).
7.2.1 reflection
Reflection of incident light occurs as a result of a por-
tion of the total amount of light energy that bounces 
back from an illuminated surface and does not penetrate 
the surface. The complex properties of skin as well as the 
wavelength of incident light determine the amount of 
reflection. Light that is not reflected penetrates into the 
skin and becomes absorbed as it diffuses. Measurements 
of penetration of light into skin are calculated using 
Beer’s law (Figure 7.4).
Skin surface detail is best captured using ultraviolet 
(UV) light [3]. When UV light hits skin, neither reflec-
tion nor fluorescence can be seen with the unaided 
human eye. The fluorescent properties of light on skin are 
better captured using another technique: alternate light 
imaging (ALI), which is described later in this chapter. 
In surface skin disruption such as in a bite, the reflec-
tive UV photograph highlights the differences between 
normal and damaged tissue (Figure 7.2, lower left and 
lower right).
7.2.2Absorption
A portion of the incident light energy penetrates below 
the epidermis, particularly the longer wavelengths of 
light. Within the dermis, light absorption occurs. The 
Figure 7.2 color (upper left); black and white desaturated in photoshop (upper right); uv digital image. Fujifilm iS-pro, 
nikon quartz uv 105 lens, iSo 1600, F/4, 1/60 second, sRGB, nikon SB 140—full flash, Baader venus u filter (lower left); 
monochrome (uv) digital image desaturated in photoshop (lower right) photograph of a bitemark on the leg. (courtesy of 
the San Bernardino county Sheriff’s Dept.)
76 Bitemark evidence: a color atlas and text, 2nd edition
Figure 7.3 Same bitemark as in Figure 7.2: color infrared digital image (upper left). Fujifilm iS-pro, nikon quartz uv 
105 lens, iSo 200, f/25.4, 1/80 second, sRGB, #87 filter, synched flash; monochrome (iR) digital image desaturated in 
photoshop (upper right); color ali. canon eoS 10D, 50-mm canon lens, iSo 1600, F/3.5, 1/15 second, #15 tiffen filter, 
450-nm Spex crimeScope® light source (lower left); monochrome alternate light digital image desaturated in photoshop 
(lower right).
D
ep
th
% transmission
BEER’S LAW
Measures the exponential decay of
intensity as light travels through a media.
I = Ioe–αx
I = intensity measured in watts/cm2
Io = intensity at the surface
E = 1/2.71828 (essentially 1/3, an exponential constant)
A = absorption coefficient (how much light is absorbed
 per unit of media)
X = distance into tissue the light travels
Figure 7.4 explanation of Beer’s law.
photography 77
physical elements in the dermis (neurovascular com-
ponents, hair and sweat cells) and blood products 
associated with the bitemark injury are responsible 
for absorption. The longer the wavelength of light, the 
farther into the dermal layer it travels. If a bite has suf-
ficient force to cause bleeding in the deeper skin lay-
ers, the properties of the long-wavelength infrared (IR) 
light can be used. Infrared light penetrates up to 3 mm 
below the surface of the skin [4] and is highly absorbed 
by blood products associated with bruising. While not 
visible to the unaided human eye, IR light can assist in 
visualizing when bleeding has occurred well below the 
skin surface (Figure 7.3, upper left and upper right).
7.2.3 Fluorescence
Light energy striking skin also creates an excitation at 
the molecular level. As the molecules return to a nor-
mal energy state, they leave behind a faintly visible 
glow known as fluorescence. This phenomenon lasts for 
~100 ns (10–8 s) [5]. Alternate light imaging is required 
for the eye to see fluorescence. This technique also accen-
tuates differences between the injured and uninjured 
tissue (Figure 7.3, lower left and lower right).
7.2.4 Diffusion
The final event that occurs as light contacts skin is called 
diffusion (also sometimes referred to as transmission). 
This event involves the scattering of light within tissue 
when skin is illuminated. Because light diffuses through 
skin, it is not recovered or seen in photographic images.
7.2.5 Summary
In traditional color photography, visible light that strikes 
skin exhibits four phenomena: reflection, absorption, 
fluorescence, and diffusion. The combination of these 
phenomena characterizes what appears in the bitemark 
image. The dark areas associated to the bitemark rep-
resent absorption; the light areas indicate reflection. 
Although fluorescence occurs, it is not observed in the 
image without using special techniques with filters and 
monochromatic light. The diffusion of light within skin 
is not recoverable and therefore is not a useful compo-
nent of bitemark photographic images.
The set of photographs in Figure 7.5 will supplement 
Figures 7.2 and 7.3 and help familiarize the reader with 
the different appearance of bitemarks when different 
photographic techniques are used. These images were 
all taken during the same photographic session.
In some instances, even the best photographic 
efforts cannot improve the quality of a poor bitemark, 
regardless of the wavelength of light used, as witnessed 
by the four photographs of the same bitemark on the 
arm of a homicide victim in Figure 7.6. All photos were 
taken during the same session.
7.3 Conventional (visible light) 
Photography
By far, the most common method of documenting bite-
marks involves the use of conventional camera equip-
ment manufactured for the visible light spectrum. Digital 
technology has virtually replaced film photography in 
forensic applications and is now routinely accepted by 
the courts. Both film-based and digital camera systems 
are optically designed to work within the visible light 
spectrum of electromagnetic radiation. Under normal 
conditions, creating a digital image is relatively simple, 
predictable, and affordable, and it has the added conve-
nience of immediacy.
The imaging potential of currently available digital 
cameras, lenses, flash units, and image capture devices is 
ever increasing. It is becoming easier to take very high-
quality images using different combinations of camera 
equipment. Bitemark documentation requires that the 
resultant images accurately depict the bitemark pattern 
on skin. This requirement precludes the use of simple 
consumer-class cameras and inferior-quality optical sys-
tems. However, it must be stated that if only a low- quality 
camera is available, such as a disposable camera, the 
requirement of photographing the bitemark cannot be 
disregarded. This may be the only opportunity to record 
the trauma. The authors suggest using a digital single lens 
reflex (DSLR) camera with close-up (macro) capability 
and excellent optical resolution. Following these recom-
mendations will allow the photographer the opportunity 
to capture many images in a short period of time and 
potentially increase the amount of evidence recovered.
7.4 Digital Photographic Systems
The camera is only one of several components of the 
entire digital photographic system. It is suggested that 
one first decide what type of images are going to be gath-
ered, how they will be stored, how large of a print will 
be made from the image file, and which software will be 
used to transfer and/or adjust the images. Numerous 
manufacturers of digital components provide com-
plete systems with technical support. The authors sug-
gest the buyer contact a knowledgeable vendor that can 
guide their selection.
78 Bitemark evidence: a color atlas and text, 2nd edition
7.4.1 Professional, Pro-sumer, 
and Consumer Cameras
The decision about which level of sophistication one 
needs in a digital camera depends upon some funda-
mental ground rules that include price, features, and the 
quality of desired images. Digital cameras are very much 
like cars. There are high-priced stylish models, basic 
transportation models, and everything in between.
Professional digital cameras used during commercial, 
entertainment, and sporting events are at the high end 
of the camera spectrum. Usually priced in thousands of 
dollars, they have highly sophisticated features designed 
for the professional photographer who knows how to use 
them. A professional-grade camera will perform virtu-
ally any task required for digital image creation.
The pro-sumer class of camera is one that has many 
of the professional’s features but is midpriced in the 
several hundred to low thousands dollar range. This is 
the predominant class of cameras seen in most forensic 
investigations. The light-gathering capability and ISO 
equivalence are usually slightly less than the profes-
sional models but adequate enough for most crime scene 
documentation. The optics and autofocusing capability 
are of slightly lower quality and the file size (megapixels) 
of acquired images is usually lower.
Even with these limitations, a vast number of accept-
able midpriced digital cameras are available for various 
photographic applications and venues. The basic 35-mm 
format digital camera (DSLR) withelectronic through-
the-lens (TTL) capability is the ideal camera for most 
forensic photographic situations. The image framed in 
the viewfinder is the same as the captured image. Many 
reasonably priced high-quality digital cameras work 
with fixed or interchangeable lenses. There are also digi-
tal cameras with fixed “zoom” lenses that capture images 
in macro, portrait, and telephoto distances.
The consumer-class camera is designed for the less-
knowledgeable photographer who intends to use the cam-
era for more casual photographic images such as family 
photos, vacations, etc. There are more models of this class of 
Figure 7.5 color photograph of a bitemark on the shoulder on the day of the homicide. Fujipro S3 uv-iR camera, auto 
setting, synched nikon SB-140 flash, nikon nikkor uv 105 lens, Baader visible light band pass filter (upper left); black 
and white (upper right); uv photograph (lower left), Fujipro S3 uv-iR camera, iSo 100, f/5.6, nikon SB140 synched flash 
at uv setting, Baader venus uv band pass filter, 1/60 second; ali photograph desaturated in adobe photoshop (lower 
right), Fujipro S3 uv-iR camera, iSo 400, f/22, Rc forensics blue/uvleD at blue setting, 1/2 second, kodak 15 gel yellow 
band pass filter.
photography 79
camera than the two previous classes combined due to high 
public demand and low retail cost. Most of the less expen-
sive 35-mm format cameras (so-called “point and shoot”) 
are capable of taking good-quality photographs but have a 
non-TTL viewfinder. Many recent models circumvent the 
problem with a preview feature shown in an liquid crystal 
display (LCD) located on the back of the camera body. The 
lack of TTL may sometimes introduce a parallax problem 
when framing the image to photograph. This problem may 
not manifest itself until prints are in hand. Parallax prob-
lems and poor optical properties of plastic lenses are inher-
ent to disposable cameras. The authors do not recommend 
this type of camera for bitemark documentation. However, 
it is not a bad idea to have a low-end digital camera avail-
able as a backup if everything else fails. An image acquired 
from a pocket camera is better than no image at all.
7.4.2 lenses
The camera lens transmits light through a series of 
ground and polished glass elements and focuses it onto 
electronic sensors to create the image. As a general rule, 
the higher the quality of the lens, the more precise and 
sharp the image will be. Glass lenses work better than 
plastic ones. Compound multiple element lenses are best 
for highly detailed and sharply focused photographs. 
Lenses range in quality and cost; typically, the higher 
the cost is, the better the quality will be. If the camera 
uses interchangeable lenses, consider a lens that has both 
zoom capability and a calibrated macrosetting for close-
up photographs. Utilizing a zoom lens permits the acqui-
sition of subject orientation and close-up photographs 
with the same lens.
Focal lengths may range anywhere from 1 in. to 
infinity. Additionally, they often have a special chemical 
(fluorite) coating that blocks all UV and IR light. The 
photographer will need to experiment with the lens to 
know its capabilities prior to case use. As a rule, digital 
cameras with fixed “zoom” lenses are better time-savers 
in forensic fieldwork than cameras that require several 
lenses to document crime scenes.
Figure 7.6 color photograph of poor-quality bitemark on an arm (upper left), nikon n6000 camera, auto setting, nikon 
nikkor uv105 lens, nikon SB140 synched flash, Fuji color 100 iSo film; black-and-white photograph (upper right), nikon 
n6000 camera, auto setting, nikon nikkor uv105 lens, nikon SB140 synched flash, kodak tMaX 100 iSo film; uv 
photograph (lower left), nikon n6000 camera, f/5.6, 1/60 second, iSo 100 nikon nikkor uv105 lens, nikon SB140 syn-
ched flash, kodak plus X 125 iSo film, kodak wratten 18a uv band pass filter; iR photograph (lower right), nikon n6000 
camera, iSo 50, f/22; 1/60 second, nikon nikkor uv105 lens, nikon SB140 synched flash, kodak high-speed infrared 
film, kodak wratten 18a uv band pass filter.
80 Bitemark evidence: a color atlas and text, 2nd edition
7.4.3 Flash Accessories
The light required to expose an image properly can be 
supplemented with the use of a flash. When properly 
connected to the camera body and synchronized, the 
flash unit will strobe simultaneously during exposure to 
add sufficient light to create the optimal image. For mac-
rophotography, adjustable flash units or nonadjustable 
flashes with a guide number of 35–40 provide adequate 
light. Too much light leads to overexposure; too little light 
leads to underexposure. Since all cameras and flash units 
are not the same, the photographer should experiment 
with exposure settings and flash for the best results.
Many commercially available DSLR cameras 
have built-in software-controlled flash units; others 
lack user controls, and still others are fully program-
mable. Automatic fill flash provides light when condi-
tions require it. User override of the fill flash feature 
is frequently required in macrophotography. Other 
disadvantages of built-in flash units are their limited 
capacity for under- or overexposure and nondetach-
ability. The ability to change both exposure setting 
and flash angle is a desirable property in photograph-
ing three-dimensional bitemarks. This specialized 
flash-driven technique is not available with a fixed 
flash (permanently attached camera-controlled flash) 
(Figure 7.7, left).
Using a detachable flash, the photographer has the 
ability not only to control the flash output manually, 
but also to move the flash position to angles other than 
perpendicular (Figure 7.7, right). Too much light from 
a perpendicular angle may cause a “flash burnout” in 
which the reflection of direct light from the flash floods 
the injury and no detail is recorded in the image. This 
becomes more of a problem when the flash is fixed on the 
camera by the manufacturer and metered by the camera. 
The type and intensity of the light emitted by the flash 
as well as the direction from which the light strikes the 
bitemark will have a definite impact on the appearance 
of the injury. It is recommended that a detachable flash 
unit be used in bitemark photography to provide the 
photographer maximum versatility. Varying the angle 
of incident light can make the same bitemark appear 
totally different (Figure 7.8).
7.4.4 Digital video Cameras
Real-time digital imaging began with the invention of 
slaved video cameras connected to a computer. Histori-
cally, these cameras were large, boxy, heavy equipment 
with very poor optical resolution. Although they were 
quite ungainly, much research has been done in the 
area of reflective UV photography with mounted video 
cams (Hamamatsu Photonics, K. K., Hamamatsu City, 
Japan). In early tests, the images were recorded at a low-
 resolution, low frame-per-second rate and visualized on 
the computer monitor.
Thankfully, technological advances in digital cam-
corders have developed at an equal pace with digital still 
cameras. Today’s manufacturers often incorporate a tiny 
video camera lens embedded into the frame of the lap-
top computer or a cellular phone that will capture video 
files with excellent resolution and write it to memory at 
a surprisingly fast rate. Many 35-mm pro-sumer DSLR 
digital cameras also have a camcorder or video feature. 
From a forensic standpoint, video photography is valu-
able in numerous applications, including areas such as 
bitemark injury orientation, documentation, and crime 
scene and accident reconstruction.
7.5 Forensic Photographic Protocol
To incorporate aspects of the electromagnetic spectrum 
and the associated photographic techniques used to cap-
ture the images, it is necessary to develop a forensic pho-
tographic protocol, sometimes referred to as standard 
Figure 7.7 camera-based flash system (left). Detachable flash system (right).
photography81
technique. A typical standard technique for forensic 
photography would include wide-view color images of 
the body that act to orient and document the precise 
locations of the injuries, followed by macro (close-up) 
images, in color and black and white, taken with and 
without a photographic scale of all injuries. After cap-
turing the visible light images, special photographic 
technique images, including UV, IR, and ALI, are taken. 
If the digital camera has a video setting, digital video can 
be incorporated in the orientation to close-up bitemark 
evidence preservation. This sequence of image capture is 
followed for each injury photographed.
The standard technique requires that all recorded 
images be reviewed to verify correct camera position, 
clarity, focus, lighting, and any other detail involved 
in capturing sharply focused and detailed images. Any 
images deemed to be below an acceptable quality are 
retaken. Finally, after it is determined that all images 
are of acceptable quality, the number of images taken for 
each photographic technique (visible-light color, black 
and white, UV, IR, ALI) is individually recorded on 
the photographer’s case management log as a historical 
record of the entire photographic case. The latter is also 
referred to as logging, a standard operating procedure 
(SOP) discussed in an upcoming chapter.
Photography is the most common of the noninva-
sive techniques and may be the only opportunity for 
the investigator to document the injury. The use of the 
photographic scale is critical because it provides a vis-
ible reference showing the dimensional size of the bite-
mark. Without the scale, life-size enlargements cannot 
be accurately reproduced. Great care should be taken to 
avoid placing the scale so that is obstructs any part of 
the injury. It is for that precise reason that the standard 
technique requires taking images with and without a 
scale, ensuring that the scale is not used to obstruct any 
part of the injury.
7.5.1 Photographic Scales
Numerous types of photographic scales are used for 
forensic photography. The ABFO no. 2 scale designed 
by Hyzer and Krauss is strongly recommended for bite-
mark photography. This multifunctional scale helps 
with both dimensional accuracy and grayscale color ref-
erences. The right-angled shape provides a reference for 
meas ur ing (correcting) photographic distortion of the 
scale in two planes.
It is important to understand that applying digital 
correction of the ABFO no. 2 scale in two planes may 
further distort the bitemark image, so great care must 
be exercised before rendering a digital correction of per-
ceived photographic distortion in an image. If an ABFO 
no. 2 scale is unavailable, reference objects such as rulers, 
coins, or paper clips can also be used. Any object used in 
the images as a size reference, other than an ABFO no. 2 
scale, should be kept as evidence and maintained in the 
case’s chain of evidence.
7.6 visible Spectrum imaging
The most common images taken in bitemark cases are 
visible-light color and black and white. These images 
accurately capture the details of the bitemark as it 
was seen with the unaided eye. The resultant image 
appears exactly the same as it did in real life and will 
be the single best source of preserving the bitemark 
Figure 7.8 taken with a light source at perpendicular angle to the bitemark (left); note incisal edge detail. with a low-
angle light source (right); note pinched tissue at tooth embrasures.
82 Bitemark evidence: a color atlas and text, 2nd edition
historically. Evidentiary preservation using photographs 
is readily accepted as an accurate and reliable depiction 
of the details of the bitemark in the legal system.
As was previously discussed, most readily available 
medium- to high-quality off-the-shelf digital cameras 
can easily provide sufficient image quality to be used 
routinely in color digital bitemark photography. The best 
digital cameras, which are more expensive, allow many 
of the more desirable features of interchangeable lenses, 
removable independent flash units, and more precise 
manual camera settings and will render better image 
variety and quality. However, for the average bitemark 
photographer, the increased costs may not be justified if 
proper image capture techniques are used.
Following the standard technique for image acquisi-
tion, color orientation images are taken of the bitemarks 
followed by macroimages taken in color and black and 
white (if the digital camera offers a black-and-white 
image capture setting), with and without the photo-
graphic scale in place. Again, the scale should not cover 
any part of the bitemark injury. It is not usually neces-
sary to use a tripod when visible light images are cap-
tured, assuming the environment where the images are 
created has sufficient ambient light available to meet the 
requirements of the camera.
It may seem redundant to require taking both color 
and black-and-white visible-light images. But there are 
definite differences in how a bitemark appears when 
viewed in color versus black and white. Because the 
retina has more rods (which differentiate black and 
white) than cones (which differentiate color), removing 
the color can at times enhance minute details within 
the bitemark. The color images create a rendering of the 
bitemark in its most graphic appearance. Humans see 
in vivid color, so creating a color image of the bitemark 
preserves the injury as it was seen. However, the minute 
details of the bitemark are best seen in black and white.
A native black-and-white image created by the 
camera’s microchip is finest since it uses the camera’s 
programming algorithm to process the image. If the 
digital camera does not allow native black-and-white 
image creation, color images can be desaturated by edit-
ing software such as Adobe® Photoshop®. It is impor-
tant to realize that, although it is acceptable to create 
a monochromatic black-and-white image from a color 
image, this is a manipulation of the color image data file. 
Therefore, it is best to capture the image with a camera 
setting for black and white.
7.6.1 visible imaging Technique
Although it is not recommended, many bitemark cases 
may have traditional visible-light photography only. 
Realistically, even forensic photographers may not have 
access to or expertise in specialized techniques such as 
ALI or nonvisible light. This places an additional burden 
on the photographer and technique to do it right the first 
time. There is no maximum number of images that should 
be created. One should take as many as is necessary and 
as circumstances dictate for that particular case.
Evidence collection in the living and deceased using 
visible-light digital photography begins with orientation 
photographs that demonstrate the location of the injury 
or injuries. Typically, only color images are created for 
the orientation views of the bitemarks. Sequential images 
of the bitemark, with and without the scale, are followed 
by macrophotography, which requires the use of a macro-
lens and/or a macrosetting on the digital camera with a 
synchronized detachable flash. If the bitemark has three-
 dimensional characteristics, additional macro images are 
produced with a flash detached from the camera body 
and positioned at various angles to highlight detail. 
Using a detached flash unit may require that the camera 
be mounted on a tripod. All images should be reviewed 
when they are created and retaken if they are unaccept-
able. It might be important to execute serial images at 
different intervals to observe changes in the bitemarks, 
whether the bitemark recipient is alive or dead.
Proper lens, scale, and bitemark orientation are 
imperative to capture bitemark images accurately. The 
injury, the lens, and the scale all need to be parallel to 
one another, according to Krauss [6]. Accomplishing 
each of these requirements ensures accurate capture of 
size and orientationof the bitemark. Lack of parallelism 
will create photographic distortion and complicate bite-
mark assessment. There are digital techniques for the 
correction of distortion, but proper parallel orientation 
of scale, lens, and bitemark minimizes this concern.
7.7 Digital image Acquisition
The explosion in digital imaging has led to significant 
enhancements in image capture and quality and elimi-
nates chemical processing. Manufacturers continue 
to refine the camera with improved and more sensi-
tive photodiodes, more precise sensors with a greater 
number of pixels, and better processing algorithms, 
thus providing an increase in the density of the digital 
image. Depending upon which of these characteristics 
the manufacturer includes in the camera, the cost and 
utility of these features can impact the overall quality of 
the bitemark images.
It is suggested that the photographer spend time 
learning the current state of digital imaging, the associ-
ated costs of the latest enhancements and features, and 
photography 83
the versatility of a given camera system for such things as 
macrophotography, low-light image handling, the inclu-
sion of detachable flash units, interchangeable lenses, the 
properties of the image capture sensors, image creation 
and quality, the density of the pixels after image capture, 
and the properties of how the lens, flash, and image cap-
ture sensor work to create the image. Usually, as price 
increases, so do the more desirable camera features.
7.7.1 image Capture Sensors
The two main digital image sensors used today are the 
charged coupled device (CCD) and complementary 
metal oxide semiconductor (CMOS) (Figure 7.9). These 
electronic components were invented in the late 1960s 
and early 1970s. CCD sensors are made of silicon and are 
quite expensive to produce. Their size and quality have 
a direct effect on the price of the camera. These devices 
are located behind the lens, where the light energy is 
captured, processed, and transferred to the image stor-
age media in the camera. Image capture devices are 
composed of arrays of tiny photodiodes that record 
light energy and then send it to a voltage converter as 
an analog signal. The software drives the image sensor’s 
algorithm and thereby converts the electronic data to a 
digital image. How that process occurs is vastly different 
in CCD sensors and CMOS sensors.
CCD sensors capture the light with the filtered pho-
todiodes and process it “into electronic signals at output 
nodes where … it is converted to voltage, buffered and 
sent off-chip as an analog signal. All of the pixels can 
be devoted to light capture and the output’s uniformity 
(a key factor in image quality) is high” [7]. Because all the 
energy of the photodiodes on the CCD chip is dedicated 
to image capture, CCD image quality is more uniform 
(better) than CMOS. One trade-off is that CCD image 
processing takes more energy to create the image than 
does CMOS; this slows the image capture, in images per 
second, when compared to CMOS. This difference in 
burst rate can be a problem when multiple images are 
made in a continuous image capture mode.
Some modified cameras use three separate CCDs—
one each for red, blue, and green light—to capture the 
light energy that composes the image. “Light coming 
into the camera lens is split by a trichroic prism assembly, 
which directs the appropriate wavelength ranges of light 
to their respective CCDs” [8]. Because these cameras 
use a separate CCD for each of the red, blue, and green 
lights, there is no Bayer filter, and they achieve much 
better precision than single CCD cameras [8]. These 
cameras are referred to as three-CCD or 3CCD cameras 
and are more expensive than single-CCD cameras.
CMOS sensors capture light in the same manner as 
CCD sensors but with one major difference. Each pixel 
on the CMOS chip “has its own charge-to-voltage con-
version, and the sensor often also includes amplifiers, 
noise correction, and digitization circuits, so that the 
chip outputs digital bits. … With each pixel doing its 
own conversion, uniformity is lower” when all the pixels 
are assembled to create the image. However, when com-
pared to CCD images, CMOS image quality is not as 
good. Generally, CMOS-based cameras use less energy 
and are less expensive than comparable CCD cameras. 
The image quality difference means that most camera 
manufacturers make CCD-based cameras, although the 
CMOS cameras are closing the gap.
7.7.2 Pixels and Color
Image capture sensors in digital cameras are the equiva-
lent to old photographic film, but that is where the com-
parison to film ends. Digital imaging has greater latitude 
in image creation, virtually no wasted time waiting for 
film processing, no cost, and immediate image viewing. 
The silver halide emulsions on photographic film cap-
tured the light energy after exposure. Then the film had 
to be rolled back into the canister, processed, and the 
subsequent printed images created before the results 
could be seen. Problems anywhere along this process 
required another photographic shoot, loss of time, and 
no guarantee of better results.
In contrast with photographic film, digital capture 
elements (sensors) are produced in varying sizes. The 
size of the sensor dictates the cost of the camera, color 
accuracy, speed (ISO equivalence), light-gathering capa-
bility, zoom factor of the lens, and the magnification of 
the image. Sensors have microfilters that interpolate a 
monochrome image (256 levels of gray) into an accurate Figure 7.9 capture elements. (courtesy of kodak.)
84 Bitemark evidence: a color atlas and text, 2nd edition
color image. These microfilters make up the basic com-
ponents in a sensor and are referred to as “pixels.” 
Digital images are created using tiny building blocks of 
arranged and color-filtered photodiodes (pixels).
In its simplest form, think of a pixel as a grain of 
emulsion on a strip of film. Pixels can interpolate the 
color several ways, depending on the manufacturing pro-
cess. The two most common are red–green–blue (RGB) 
and cyan–yellow–magenta (CYM). Still others capture 
YC (chrominance and luminance) values indirectly 
from the sensor. A typical RGB sensor (Figure 7.10, left) 
has several thousand clusters of four-element pixels per 
each color cell. The more pixels per image, the greater 
the versatility of the image to be enlarged or otherwise 
enhanced without losing critical image detail.
In image sensors, the light energy is captured by 
the photodiodes through a color filter array called a 
Bayer filter. This filter was invented by Bryce E. Bayer of 
Eastman Kodak and is arranged so that each square grid 
of photodiodes (pixels) is composed of two green, one 
red, and one blue filter elements. The predominant light 
energy detected by each square grid (red, green, or blue) 
is passed along the image creation processing pathway 
that, when combined with all the other pixels’ dominant 
color detection and algorithmic interpolation, creates 
the image. Bayer used twice as many green elements as 
red or blue to mimic the human eye’s greater resolving 
power with green light [9]. Typical Bayer filter pixels only 
capture about one-third of the color information for each 
pixel, with the other two-thirds of the color interpolated 
by the camera’s image processing algorithm.
Recent advancements by Kodak and others in the 
Bayer filter model include the addition of white or 
transparent filters with the green, red, and blue filters 
that change the basic Bayer filter of a square-gridded 
four-element filter to larger six- or more gridded filters 
(Figure 7.10, right). These modified filters increase the 
sensitivity of the image sensor by creating a sensor sen-
sitive to all wavelengths of light (white light) and collect 
a larger amount of the light striking the sensor [9].
There is an inherent problem with this type of filter-
ing system, particularly when the frequency of informa-
tionis greater than the frequency of the filter groups, 
leading to an effect called “aliasing.” Aliasing can appear 
as a white area in a particularly detailed area of the 
image, surrounded by red-, green-, and blue- colored 
pixels. Two methods for correcting aliasing include 
optical correction, usually by using quartz filters on the 
CCD, and software correction. The use of the quartz fil-
ter can directly and significantly affect the cost of the 
imaging system.
7.7.3 Aspect ratio
Most still cameras create images with aspect ratios (width 
by height) of 4:3, 3:2, or, more recently, even 16:9, which 
previously had been available only on high-end profes-
sional cameras. Printing enlarged images will become 
sized in multiples of the same aspect ratio as a 3:2 sensor: 
6 × 4, 12 × 8, 24 × 16, etc. This feature can become prob-
lematic if a printed presentation is going to be formatted 
in traditional film dimensions. For example, a typical 
film enlargement can be printed as 8 × 10 in. without 
peripheral loss. A digital camera will create a file whose 
aspect ratio prefers enlargement to 8 × 12-in. size, but it 
may get printed as 8 × 10 in. during commercial enlarge-
ment. Hopefully, any crucial information contained in 
the image is not located at the edge that will be cropped 
during the enlargement and printing process.
7.7.4 resolution and Compression
Digital cameras are able to save files (images) in sev-
eral formats. Some images are saved with compres-
sion, a method that squeezes the data into a smaller file. 
Resolution represents the quality of an image printed at a 
specific size. Both resolution and compression are impor-
tant components of the image and will determine to what 
size it can be enlarged. It is possible to determine from 
the size of the print what file size and resolution are 
needed for the saved image by using the mathematical 
equation: height (in.) × width (in.) × pixels/inch × 1,000 
file size (megabytes). For example, at 300 pixels per inch, 
an 8 in. × 10 in. × 300 pixels/inch image yields a file of 
24,000 bytes or 24 megabytes (MB).
One may also derive the file size by the actual pixels. 
This is usually a ratio of 1:3. For example, an RGB.tif 
file with no compression and a raw image of 1.2 million 
pixels will result in a 3.6-MB file. These terms must be 
Conventional Red Green
Blue “Bayer Pattern”
Sensor Array
New Kodak High Sensitivity
Sensor Array with Panchromatic
“Clear” Sensors in the grid.
Figure 7.10 typical array of RGB pixels (left). (courtesy of 
linear Systems inc.) Super ccD (right). (courtesy of kodak.)
photography 85
understood before an intelligent choice can be made on 
fulfilling the photographer’s needs if the digital image 
needs to be printed.
7.7.5 iSo Equivalence
The ISO setting on a digital camera is nothing more than 
an emulation of film properties. Digital cameras have an 
advantage in that some can shoot images at incredibly 
high ISO equivalence settings. For example, a digital cam-
era that has the capacity to capture an image at 6400 ISO 
can be set to shoot one stop faster than film rated at the 
same ISO, thereby increasing the digital ISO to 12,800. 
Moreover, some digital cameras have the capability to 
pull or push the images up to two additional full stops, 
resulting in a virtual ISO of 50,000. These images can be 
either monochrome or color. The greater the ISO is, the 
more “dark current noise” is introduced into the image 
(Figure 7.11). This is equivalent to an increased graini-
ness associated with high-ISO-rated traditional film.
Some cameras can eliminate dark current noise 
by the application of a filter inside the camera. Other 
cameras eliminate the noise by applying a filter inside 
the software. Even more sophisticated, some cameras 
eliminate the noise by acquiring two separate images 
during the exposure (one with the shutter closed) [10]. 
Employing the application of a noise subtraction algo-
rithm, the software eliminates the dark current noise.
As with film-based photography, the higher the ISO 
setting is, the less light it will take to capture the image. 
Conversely, the lower the ISO setting is, the more 
light will be required to capture the image accurately. It 
will take some experimentation with any given digital 
camera to fine-tune the ISO setting for the amount of 
ambient light available for image capture. With digital 
cameras, correcting for under- or overexposure is sim-
ple: Change the camera setting and immediately retake 
the photo.
7.7.6 lens magnification
If the sensor size is physically smaller than the actual 
film size for which the camera body was designed (i.e., 
traditional 35-mm-film-based cameras), this decreased 
size will magnify the image from the lens (Figure 7.12). 
The 35-mm camera frame is 36 mm × 24 mm. Typical 
digital camera sensors meas ure 4.8 mm × 3.6 mm (small 
sensor) to 6.4 mm × 4.8 mm (medium sensor) to 8.8 mm 
× 6.6 mm (larger sensor), yielding equivalent image cap-
ture areas from approximately 8:1 for the small sensor 
to 4:1 for the large sensor. The chip set in the sensor will 
interpolate the captured image to yield the equivalent 
35-mm base image size. Magnification in sensors with a 
given lens is typically a factor of 1.2:1 or 1.7:1. To under-
stand the effect of magnification on image, a 50-mm 
lens gives a magnification 1.5:1. The image equivalent 
will be of a 75-mm lens. Similarly, a 100-mm lens will 
give an equivalent digital image of a 150-mm lens. This 
presents an advantage during long-range surveillance 
and close-up photography since there is no loss of light 
in magnification.
Figure 7.11 increasing iSo increases current noise. (courtesy of kodak.)
86 Bitemark evidence: a color atlas and text, 2nd edition
7.7.7 Storage Devices
The initial digital image storage occurs at the camera level 
or, via Bluetooth or other wireless technologies, directly 
from the camera to a connected computer. From there, 
the images can be viewed and either stored or deleted. At 
the camera level, removable memory storage cards will 
record the images as they are created. Most digital cam-
eras have small, built-in LCD screens so that the images 
can be immediately viewed for acceptability. Typical 
intracamera body storage cards range from larger-sized 
CF removable storage cards to the more popular smaller 
SD cards to the micro-SD cards and range in storage 
size from 256 k to more than 10 gigabytes. Often, the 
photographer will carry extra removable storage cards 
that can easily be exchanged—a full card for a fresh, 
blank, formatted card—making it possible to collect a 
nearly infinite number of images for only the cost of the 
memory cards.
Once the images have been uploaded or imported 
into the computer, storage, authentication, and viewing 
of the images can occur. At this point, depending on the 
intended use of the images, storage can go in several dif-
ferent directions, including long-term physical storage.
Increasingly, larger digital storage media have accom-
panied the move to digital photography. A collection of 
several hundred 10-megapixel images can easily reach 
multiple gigabyte quantities for a given case. For this 
reason, there has been significant improvement in 
storing digital image files. Whereas in the past, burn-
ing images to a CD or DVD was convenient, today’s 
larger image sizes have rendered CD and DVD storage 
obsolete. Removable and portable USB drives of up to 
64 gigabytes, external hard drives with 500 gig capac-
ity, or storage to multiterabyte hard drives is now used 
for storing digital images. These devices can easily be 
backed up for protection and security purposes. In addi-
tion, their portability makes them very user friendly, 
not only for file storage but also for moving them to and 
from authorized users.
The future of digital image storage will likely rest on 
the use of additional secure online storage sites, such as 
those currently offered by proprietors such as Google®or 
Dell®, potentially allowing access to the images from any-
where in the world where an authorized user would have 
Internet access. For a fee, these secure sites will allow sig-
nificantly large-volume storage that protects against the 
catastrophic loss of images in a hardware crash or mal-
ware virus contamination. Having both local and online 
secure storage provides the best of both worlds.
For jurisdictions completely immersed in the digital 
imaging world, local area networks (LANs), synched with 
huge data servers and hardware storage through such 
systems as RAID, arrayed multiple hard drives tiered 
servers to huge multiterabyte (or more) “data farms,” will 
be used for image collection, storage, and preservation. 
These storage tech nologies are supported by redundant, 
frequent data backup to protect against the loss of the 
digital images.
7.7.8 Saving Digital images
A RAW file is an image saved directly from the camera’s 
imaging sensor and contains the most information of 
all file types; it is the largest of all files sizes for digital 
images. Usually, it is a secure file format that prohibits 
modification in imaging software applications. The RAW 
file also offers the ability of postexposure compensation 
and color correction, usually using an image editing/
enhancement digital software program such as Adobe 
Photoshop. A JPEG file is one that has been compressed 
from the RAW data into a smaller size for storage maxi-
mization and saved with a JPG file extension. JPG files 
are not secure and the user cannot change the values for 
exposure or color from the RAW data via image editing. 
Most quality digital still cameras produce either a RAW 
or JPG file; some produce both files simultaneously.
The secure file format is a source for debate among 
forensic scientists, the legal community, and investigative 
Figure 7.12 actual sensor size (left). effect of magnification by sensors (right). (courtesy of linear Systems inc.)
photography 87
agencies alike. Although it is a “loss-less compression” type 
of file, a secure file is one-directional and can be viewed, 
edited, and modified in a software program. When it 
is edited, it cannot be written back to a secure file format. 
If the software does save the file under the same name and 
extension, the image was not an original to begin with.
Secure file formats contain more information than 
any other file type. The information can include time of 
day, date, serial number of the camera, exposure num-
ber, and camera settings for each exposure. Working in 
a secure file format minimizes chain of custody issues 
because the authenticity of the image is provable. The 
most advantageous feature of a secure file format is that it 
becomes insurance against challenges of authenticity—
an issue that could be raised in judicial proceedings. The 
only major drawback is the large file sizes.
In some instances, it is not possible to create images 
in a secure RAW format. Under circumstances when 
secure images are not created, it can become necessary 
to encrypt the images digitally with information that can 
authenticate the file and associated information. There 
are several ways the images can be digitally encrypted; 
the easiest is the incorporation of a digital watermark. 
There are many ways to add digital watermarks, which 
can become quite useful if the nonsecurely formatted 
image should need to be verified as the pristine origi-
nal image in chain of custody issues or in an associated 
legal proceeding.
The question of when to use a secure file format is 
based on a number of considerations. Who will be get-
ting access to the files? Where are they? How are they 
handled, where, and when? To whom will they be dis-
tributed? Who has access to the originals? These ques-
tions are important when the exchange of files (evidence) 
will occur inside law enforcement agencies and forensic 
labs and among experts, lawyers, and/or the courts. The 
same problems are encountered if the defense produces 
digital information in judicial proceedings.
7.7.9 Digital Scanners
One way of converting analog images to digital data is 
by scanner. There are optical scanners that are designed 
specifically for reading film, slides, printed material, 
radiographs, or all of the above. In the typical flatbed 
scanner, the scanned material is placed on a glass platen. 
An optical sensor under the glass moves past the object 
and records it as a digital image. The sensor reads the 
object very much like a photocopier; however, in this 
case, instead of producing a print on paper, the software 
creates an image file that can be stored and managed.
The optical sensor in the scanner works much like 
the sensor in a digital camera. Photodiodes with filters 
capture the light created by the sensor of the scanner in 
either color or black-and-white image formats. The elec-
tronic image is then processed by the algorithms in the 
scanner’s chip set to create the digital image, converting 
the analog scan to a digital image.
Several important scanner applications are relevant 
to bitemark investigation. Dental study models (casts) 
of suspects’ teeth can be imported as image files using 
a flatbed scanner (Figure 7.13). Many odontologists use 
the image of scanned study models to create hollow vol-
ume and/or compound overlays for comparison to life-
size bitemark digital images or standard photographs. 
Images of a pattern injury can also be imported into an 
imaging software program such as Adobe Photoshop via 
scanned film, color print enlargement, or digital files. 
Once digitized, the image can be corrected for rota-
tion, size, and photographic distortion [11]. The entire 
bitemark comparison and analysis can then be printed, 
demonstrated on computer, or projected via a laptop 
computer connected to an LCD projector.
7.8 Considerations for Digital Photography 
in order of importance
While many considerations enter into digital image cre-
ation, the first is output. If the main intent is to print the 
images, how big the actual prints are going to be will 
Figure 7.13 casts of teeth digitized from a flatbed scanner.
88 Bitemark evidence: a color atlas and text, 2nd edition
determine file size, camera capabilities, and printer fea-
tures. Larger prints of digital images require larger files 
with more resolution, which means more sophistication 
and advanced features in the camera. Are the images 
going to be subject to electronic distribution? If so, will 
it be through a network, server, or Internet e-mail? The 
larger the file size is, the more time is required for image 
transfer. Many Internet service providers limit the max-
imum file size they will accept. Some RAW image files 
may be too large to send via electronic distribution. 
RAW images will also require a plug-in software file that 
interpolates the digital information when importing it 
to an image software program.
The second consideration is storage. Will the images 
be stored temporarily on a flash card, online, with a hard 
drive or RAID array, or near line via a network server or 
DVD jukebox (Figure 7.14, left)? Flash card capacity has 
been steadily increasing and is well affordable, even in 
multigigabyte sizes. Will proprietary software such as 
DIMS [12] be required for image protection and non-
overwriting security?
The file size and number of files to be stored will 
dictate the requirements for storage hardware. For per-
sonal usage, an external hard drive may be more than 
adequate; however, for long-term storage and security, 
one should consider an outside source where files are 
encrypted and uploaded to a professional storage and 
backup online service such as Carbonite®. A major 
metropolitan law enforcement agency may accumulate 
thousands of images daily. For this situation, a multiuser 
access drive with multiterabyte capacity may be neces-
sary for storage (Figure 7.14, right).
The third consideration is retrieval. Who is going 
to maintain thesoftware to download the images? Will 
it be one person or several people on a LAN? Will that 
software be the same as the one that is used to find the 
image and work with it? How will the files be indexed, 
sorted, named, and saved? These questions are critical 
for multiuser input settings and must be answered before 
digital imagery is integrated into forensic applications.
The fourth consideration is hardware requirements. 
The type of computer one uses for viewing and creat-
ing images and graphics must be adequate to fulfill the 
requirements of the job. The components should include 
a large amount of RAM (2–4 gigabytes), a hard drive 
with a minimum of 300 gigabytes, a fast processor, DVD 
reader/writer, and flashcard ports or Firewire® for faster 
downloading of images. Some additional considerations 
might include wireless connectivity, battery operation in 
case of power failure, and, last but not least, a contingency 
plan in case there is a general failure of digital imaging. 
The remote but possible failure of an application of digital 
imaging in a specific case reinforces the suggested redun-
dancy by the authors of incorporating multiple digital 
cameras in one’s armamentaria as well as multiple, sepa-
rate, secure image-storage devices and sites.
The final consideration involves decisions to be 
made regarding the type and capabilities of the camera. 
Will a secure file format be necessary? How big a file 
will be needed and what size enlargement for working 
cases? What applications are available from the manu-
facturer for downloading and working with the images? 
How are images to be stored? Downloading and storing 
RAW images that are 30–50 MB in size on a home PC 
under these circumstances might create more problems 
than anticipated.
Software selection is critical. What are the needs of 
the investigator? Eventually one can count on outgrowing 
Figure 7.14 DvD/cD storage system (left). (courtesy of Rimage.) Megaterabyte storage array (right). (courtesy of 
plasmon.)
photography 89
the next release of any imaging software package. Will 
it be upgradeable and appropriate to other applications? 
The worst-case scenario would be changing record man-
agement systems and/or operating systems. The user will 
need to know if the software is compatible with subse-
quent releases of operating systems such as Windows or 
Mac OS.
Another important aspect of software consider-
ation is the ability to manipulate or enhance the images 
rendered. As previously mentioned, Adobe Photoshop 
is one of many very powerful image management sys-
tems. This multipurpose imaging software suite has 
algorithmic options that offer total control over how the 
image is presented. Digital enhancement can frequently 
improve the appearance of bitemark images. Figure 7.15 
(left) was scanned from a color slide and represents the 
maxillary arch on the sole of a child’s foot. Using Adobe 
Photoshop, the image was converted to gray scale and 
the bite isolated using the marquee tool. Enhancement 
of the bite pattern by altering levels of contrast and 
brightness resulted in Figure 7.15 (right).
Another impressive enhancement software man-
ager is LucisPro® [13]. This program was developed for a 
variety of medical and scientific applications and offers 
a simple user-friendly system for bringing out details 
of bruises in bitemarks by means of two separate cur-
sor algorithms. The latest version (6.0) has been adapted 
as a plug-in feature to Adobe Photoshop. Figure 7.16 
(left) is a scanned color slide of the right calf of a female 
child-abuse victim. Figure 7.16 (right) is the same photo 
enhanced with LucisPro software with the large cursor 
set at 57 and the small cursor at 11. Note the improved 
visibility of the dental arches even though this bite was 
partially inflicted through the child’s clothing, as is evi-
dent by the elastic band imprint.
In summary, before digital equipment is purchased, 
the authors suggest consulting with an experienced ven-
dor that can integrate all components of a digital system 
and provide technical support when it is needed. Sooner 
or later that support will be needed—guaranteed!
7.8.1 Alternate light imaging
Alternate light imaging, fluorescent photography, foren-
sic light source photography, and narrow-band illumi-
nation are all synonymous for the process of recording 
a photographic image with the aid of a monochromatic 
light and a blocking filter. The technique of ALI is 
Figure 7.15 unretouched color image scanned from a slide (left). (courtesy of ontario police Dept.) enhanced photoshop 
image (right).
Figure 7.16 Scanned from original color slide with no modifications (left). (courtesy of upland police Dept.) Same photo 
after enhancement with lucispro (right).
90 Bitemark evidence: a color atlas and text, 2nd edition
founded upon a phenomenon entitled the “Stokes shift” 
after Professor G. G. Stokes [14], who discovered that the 
remitted wavelength of light is of a different frequency 
from the illuminating source (Figure 7.17). Part of the 
energy of light at a particular frequency (meas ured in 
nanometers) is absorbed by the subject matter it strikes. 
Once that energy, in the form of electrons, is absorbed, it 
creates a molecular excitation that seeks to return to its 
unexcited state. The return of the electrons to their rest-
ing state releases that energy as fluorescence. The remit-
ted light (fluorescence) is of a higher frequency and lower 
intensity and cannot be seen in ambient conditions. 
However, it can be observed by using filters that pass the 
remitted light and block the incident light.
The equipment requirements for ALI are similar to 
those for other forms of macrophotography with the excep-
tion that one must employ a forensic light source for the 
incident light and a blocking filter over the lens to capture 
the fluorescent image. Tripod-mounted 35-mm camera 
and macrolenses are part of the standard armamentaria.
Figure 7.18 shows a schematic drawing of the ALI 
technique and how fluorescent images are captured 
photographically. There are many types of forensic 
light sources. These include lasers, tunable lights, and 
PRIMARY LINES
ABSORPTION
STOKES SHIFT
LASER LINES
CVL
Ar
400 nm 500 nm 700 nm600 nm
Ar
CVL
Ar
Ar
Ar
514.5 nm
510 nm
488 nm
496.5 nm
476.5 nm
(Line height
proportional to %
visible output)
EMISSION
Figure 7.17 Remitted wavelength of light is of a different frequency from the illuminating source. (courtesy of linear 
Systems inc.)
Forensic Light
Source
(Emits Narrow Band
Wavlength)
Camera
FILM
# 15 yellow barrier filter
blocks 450 nm light
Transmits shifted light
Fluorescing
Subject
Fluorescent Photography
Figure 7.18 Fluorescent protocol.
photography 91
personal-sized light-emitting diodes (LEDs). Figure 7.19 
(left) is of an LED ring flash that screws onto the fil-
ter already attached to the lens. A tunable light source 
(Figure 7.19, right) has several selectable internal filters 
for varying frequencies of light illumination. Plexiglas 
goggles are used for the observer to detect latent evi-
dence and view enhanced fluorescent objects at differ-
ing frequencies. The color of source light and shade of 
goggles used depends on the subject matter being illu-
minated and photographed.
Alternate light imaging is firmly anchored in numer-
ous applications of forensic investigation. Crime scene 
analysts and forensic photographers learn to utilize the 
appropriate light wavelengths to illuminate blood spat-
ter, illicit drugs, fibers, fingerprints, and body fluids 
including semen, vaginal secretions, and saliva [2].
Virtually any organic compound found in nature 
can be made to fluoresce. The peak level of excitation that 
a compound exhibits when illuminated depends on the 
wavelength of the illuminating light and the chemical 
components of the substance [15]. Early research on the 
bioluminescence of human skin detected a peak excita-
tion at 430–450 nm [16,17].This range of visible light 
is coincidentally very near the long UVA range, but it is 
actually in the deep blue color of the visible spectrum. 
Illuminating tissue with the ALI technique provides a 
distinctive advantage when bruises, pattern injuries, 
and bitemarks on skin are photographed. When the ALI 
technique is utilized, the net overall effect of obtaining 
the fluorescent image of a bitemark is to enhance the vis-
ibility of the injury [18].
The biochemical explanation of how this image 
enhancement occurs is revealed in the differences 
between normal and abnormal (injured) tissue sub-
stances. Certain organic components, such as collagen, 
keratin, and subcutaneous fat in the layers of the skin 
(dermis and epidermis), are bioluminescent and readily 
transmit light [19]. Other components, such as biliru-
bin, hemoglobin, and melanin, absorb light. Uninjured 
epidermis, rich in keratin, is highly bioluminescent. 
Contrasting blood components of hemoglobin and 
melanin that have collected in the injured areas of the 
bitemark are seen as dark areas of contusion. This differ-
ence in light absorption due to blood products and high 
light remittance of uninjured tissue is what creates the 
enhanced appearance of the bitemark.
Figure 7.20 (upper left) is a postautopsy digital pho-
tograph, taken with visible lighting by strobe flash, of 
a bitemark on the right lateral thorax area of a female 
homicide victim. Figure 7.20 (upper right) is a close-up 
of the same bitemark taken with 455-nm blue LED light 
and filtered with a Tiffen no. 15 yellow filter. Differences 
in the injured and uninjured tissue are more visible in 
the ALI photo. Figure 7.20 (lower left) is a digital IR 
image of the same bitemark, while Figure 7.20 (lower 
right) was created with digital UV.
Alternate light imaging is most useful in situations 
when there is minimal visible bruise pattern informa-
tion present on the surface of the tissue, but below the 
epidermis there is significant bruising.
ISO equivalence and exposure factors vary depend-
ing upon the individual situation. Unlike UVA photog-
raphy, ALI must be achieved in total darkness with the 
exception of the forensic light source. Any ambient light 
will interfere with the image capture, particularly when 
the higher ISO settings are used.
7.8.2 Digital Ali Technique 
for Bitemark Photography
A photographer should routinely be able to capture an 
adequate digital image with a minimum setting of 200 
ISO equivalence. Exposure times can vary depending 
on several factors that will be discussed here. At 200 
Figure 7.19 Blue ring flash (left). (courtesy of Rc Forensic.) turnable forensic light source (right). (courtesy of Rofin 
polilight®.)
92 Bitemark evidence: a color atlas and text, 2nd edition
ISO and with an adequately powered light source, typi-
cal exposures range between 1/4 second and 2 seconds 
at f-stop settings of f/4 to f/5.6 aperture. The light source 
and camera ideally should be placed at distances of 
12–18 in. from the subject. Before exposure, the camera 
should be mounted on a tripod with the camera’s back 
surface and the ABFO no. 2 scale positioned parallel to 
the injury. It is advisable to prepare the shot and focus 
prior to turning out the overhead lights.
With the camera set in manual mode, the light meter 
readings are taken through the electronic TTL viewfinder 
with the no. 15 yellow filter mounted to the lens, while 
illuminating the subject with the tuned blue light source 
in an otherwise dark room. The forensic light source 
should be set at or near 450-nm monochromatic light. 
Liquid light guides and fiber optic cables coming from the 
light source may be mounted on a tripod or handheld. If 
a personal LED or ring light is used, it is typically already 
fixed to the camera lens. Exposures should be bracketed 
by increasing and decreasing shutter speed. Bracketing 
with f-stops tends to reduce focal depth of field. The pho-
tographer should attempt to capture images at the small-
est f aperture to maintain best focal depth.
With a little practice, one may discover that, with 
ALI, slightly underexposed images may contain more 
information than normal or overexposed images. Most 
internal light meters are typically not designed for read-
ing monochromatic light. The result is that the meter mis-
reads the intensity of 450-nm illumination and adjusts 
by allowing more light than is necessary for an accurate 
exposure. This problem can be corrected by changing 
the aperture setting and/or the exposure time.
Many variables affect exposure factor. A person 
with a dark complexion (more melanin) will require 
increased exposure times due to more absorption and 
less reflection of light. Forensic light units come with 
different output strengths and bulb wattages. The con-
veyance of light, whether it is through a fiber optic cable, 
liquid light guide, or LED, determines how much lumi-
nance is transferred from the source.
Photographing living bite victims presents some inter-
esting problems since motion must be limited with the long 
exposure times that are sometimes required. Consequently, 
higher ISO equivalences are chosen. Typically, 400–1600 
ISO is needed for capturing bitemarks with ALI in the 
conscious living, and absolute darkness is required. Any 
ambient light results in image contamination.
As a rule, photographers attempting fluorescent 
photography should become familiar with their camera 
equipment, its capabilities, and the appropriate exposure 
Figure 7.20 Digital color photo of bitemark (upper left), canon eoS 10D, 50-mm canon macrolens, iSo 100, f/4, 
1/60 second, sRGB, syncronized flash; ali digital photo (upper right), canon eoS 10D, 50-mm macrolens, iSo 800, f/5.6, 
1/8 second, sRGB, Rc Forensic Super R-lite at 475 nm, #15 tiffen filter; monochrome digital iR (lower left), Fujifilm 
Finepix S3pro, nikon quartz uv 105-mm lens, iSo 200, f/27, 1/60 second, synched flash, #87 filter; digital uv (lower 
right), Fujifilm Finepix S3pro, nikon quartz uv 105-mm lens, iSo 800, f/4.5, 1/90 second, nikon SB 140 full flash with 
uv filter, Baader venus u filter.
photography 93
settings prior to actual casework. Pretesting equipment 
under controlled conditions is highly recommended.
Case Presentation 7.1
A 34-year-old Hispanic male received multiple stab 
wounds during a gang-related homicide. A bitemark on 
the dorsum of the right hand was observed and photo-
graphed (see Figure 7.21).
Case Presentation 7.2
A 3-year-old male Hispanic was brought to the emer-
gency room with obvious signs of felony child abuse 
and multiple bitemarks. The child subsequently died; 
the cause of death was attributed to blunt force abdomi-
nal trauma. The images demonstrate one of the more 
distinctive bites sustained on the child’s abdomen (see 
Figure 7.22).
Figure 7.21 color bitemark photograph on right hand of a homicide victim taken postautopsy (upper left), canon eoS 
10D, 50-mm macrolens, iSo 100, f/4, 1/60 second, sRGB, synched flash; ali (upper right), canon eoS 10D, canon 50-mm 
lens at f/5.6, 1/3 second at iSo 800, sRGB, Rc Forensic Super R-lite at 475 nm, tiffen #15 filter; color iR image (center 
left), Fujifilm Finepix iS-1, sRGB, #87 filter, f/5.6, 1/60 second, iSo 200, synched flash; monochrome iR image desaturated 
in photoshop (center right); color uv image (lower left), FujiFilm Finepix S3-pro, nikon quartz uv 105 lens, sRGB, f/4, 
1/90 second, iSo 800, Baader venus u filter, kodak SB 140 flash set to maximum output; monochrome uv image (lower 
right) desaturated in photoshop.
94 Bitemark evidence: a color atlas and text, 2nd edition
7.9 nonvisible light Photography: 
infrared Technique
Infrared light possesses special properties when directed 
on injured skin. It is possible to capture extravasation 
of blood beneath the skin surface, when it is present, 
using IR digital photography. While the patterns may 
not appear as sharply focused in IR as in visible or UV 
images, they canprovide yet another source of digital 
imaging of bitemark documentation.
Subdermal hemorrhage can occur when teeth 
or other objects crush tissues. The IR technique takes 
advantage of light absorption in areas of bruising that 
consequently appear black in the resultant image. 
Frequently, the individual groupings of blood patterns 
recorded in the IR images may record the biter’s dental 
signature in a bitemark.
The appearance of the IR photographs is different 
from those of UV, ALI, and visible light images. Because 
the focus point of IR images is up to 3 mm below the sur-
face of the skin, the IR photographs often appear grainy 
and/or blurry as compared to those taken in other light 
media [4,20]. Failure of a bitemark to appear in an IR 
photograph may not be the result of poor technique. The 
more likely cause is the lack of bleeding below the skin 
surface [2].
In a living victim, IR photography is best utilized 
within the first 72 hours after the injury, with the sub-
dermal healing beginning soon after the injury occurs. 
In a deceased victim, the subdermal changes also begin 
Figure 7.22 Bitemark on the right abdominal area (upper left), nikon D80 62-mm lens at f/4.5, 1/60 second, iSo 100, 
ring flash; ali (upper right), canon eoS 10D, 50-mm canon macrolens, f/3.3, 1/60 second, iSo 1600, #15 yellow filter, 
Rc Forensic flex-arm ring light, 455 nm; iR digital color (lower left), Fujifilm Finepix iS-1, f/3.6, iSo 200, 1/80 second, #87 
iR filter, synched flash; uv digital protocol (lower right), Fujifilm Finepix iS pro, nikon quartz uv 105-mm macrolens, 
color sRGB, f/4, 1/60 second, iSo 3200, Baader venus u filter, kodak SB 140 flash set to maximum output.
photography 95
to occur rapidly after death; however, depending on the 
environmental disposition of the body, it may be pos-
sible to capture IR images in an interval greater than 
72 hours. Because the unaided human eye cannot see 
details of the bitemark captured in IR photography, it 
is recommended that this type of photography be uti-
lized whenever possible in the collection of bitemark 
evidence [6].
7.9.1 Armamentarium for Digital 
infrared Photography
An IR photograph requires the use of special equip-
ment, including a tripod, a 35-mm digital TTL SLR 
camera body capable of capturing infrared light, a lens 
that passes infrared light, an infrared light source, and 
an infrared band pass filter such as the no. 87 Kodak 
Wratten gel filter (Figure 7.23, left) or the Baader IR glass 
band pass filter (Figure 7.23, right).
Some off-the-shelf 35-mm digital camera bod-
ies have been found to work well for IR photography. 
While the published spectrum of light sensitivity for 
many of these unmodified cameras may not indicate it, 
they are capable of capturing IR light. Fuji® once man-
ufactured several UV/IR full-spectrum 35-mm digital 
cameras, but it no longer does. At this time, there are 
no camera manufacturers making full-spectrum digi-
tal cameras. However, several after-market companies 
will take most of the medium to higher quality 35-mm 
digital cameras from the major manufacturers and 
convert them to a full-spectrum digital camera.
There are many commercial lenses that pass IR light. 
However, the Nikon Nikkor UV105 lens has been the 
gold standard because it was specifically designed for 
passing both visible and nonvisible light. Unfortunately, 
as with the Fuji UV-IR camera, this lens is no longer 
produced. Readily available commercial lenses are made 
with a fluorite coating on the lenses that acts as a filter 
and allows only visible light to pass. It may be possible 
that a given commercial lens, designed for only visible 
light photography, will pass amounts of IR light suffi-
cient to create an image as long as the camera sensor can 
capture IR light. To fill the need for UV and IR, several 
manufacturers do make full-spectrum quartz lenses that 
work beautifully for IR photography. Often, an Internet 
search will list companies that offer these full-spectrum 
silicon-based lenses.
Finally, an IR-emitting light source must be used to 
create IR photographic images. Some commercial flash 
units will emit IR light, as do tungsten lamps, quartz-
halogen lamps, special LED infrared light sources, and 
special full-spectrum commercial flash units, such as 
the unfiltered model of the Quantum® flash.
Once all of the necessary equipment for IR photog-
raphy has been gathered, it is critical to experiment with 
the entire setup by taking practice IR digital images to 
learn the camera system’s proper settings and capabili-
ties. Multiple trial images should be created with widely 
bracketed settings and then compared to identify both 
the best IR technique and optimal camera system set-
tings. In this way, confident that the optimal IR tech-
nique will be achieved, the photographer will be ready 
to document a bitemark case.
7.9.2 infrared Photography Technique
IR photography normally requires the use of a tripod 
with the camera. Because the IR light penetrates below 
the surface of the skin, the camera is set to increase 
depth of field with an aperture of f/16 or f/22, and a 
bracketed exposure from 1/250 of a second to 1 second 
for each f-stop used. This will ensure that by slightly 
Figure 7.23 kodak wratten no. 87 gel iR filter (left); Baader iR glass filter (right).
96 Bitemark evidence: a color atlas and text, 2nd edition
underexposing the images (1/250 second) to slightly 
overexposing (1 second) them, the bitemark details pres-
ent using IR light will be captured.
The camera is positioned so that the front of the 
lens, film, scale, and bitemark are all in the same parallel 
plane. If a strobe flash is used, the camera’s ISO should 
be set to 25 or 100. Using the TTL viewing properties of 
the camera, the visible focus is established, the IR focus 
shift applied, and the IR band pass filter placed in front 
of the lens. To specify the exact wavelengths of light that 
are passed through the lens to the sensor, a band pass 
filter is required in IR photography. There are numerous 
inexpensive glass and gel IR filters. The Kodak Wratten 
no. 87 gel filter and the Baader IR glass band pass filters 
are specifically manufactured for passing only infra-
red light. The filter is placed tight against the lens after 
focusing. Using an IR-emitting light source, the image is 
created on the camera’s full-spectrum digital sensor and 
stored as a digital image.
7.9.3 Focus Shift
Most commercially available lenses are manufactured to 
perform optimally within the visible spectrum of light, 
the range for which the focusing properties of the lens 
are calibrated. Additionally, the manufacturers place 
fluorite coatings on the lenses that specifically block 
transmission of nonvisible light. When photographing 
outside the visible light spectrum, it may be necessary 
to make small adjustments to the focus point to account 
for the nonvisible light [21]. The process of refocusing 
after establishing the visible focus is referred to as the 
“focus shift” (Figure 7.24).
As previously mentioned, the focus for IR pho-
tography is up to 3 mm below the surface of the skin. 
Therefore, IR photography must account for the change 
in the visible focus by moving the lens slightly away 
from the object [4,20]. Many lenses have a small dot on 
the focus ring located to the right of the visible focus 
point that marks the infrared focus shift point. A focus 
shift is required for IR photographic images.
In contrast to IR photography, UV photography 
highlights the surface details of the bitemark. Thus, the 
focus point in UV is closer to the front of the lens than 
the visible focus; if a focus shift is required, the lens is 
moved slightly toward the object being photographed. 
While others have championed the need for a focus 
shift of the same amount as infrared but in the oppo-
site direction when taking UV photographs, the authors 
have found that no focus shift is necessary with UV pho-
tographywhen a quartz lens is used (Figure 7.25, left).
Practically speaking, once the photographer has 
the necessary equipment to begin UV and IR pho-
tography, it will take several photographic sessions of 
experimentation to determine the specific needs and 
techniques that will be required for optimal nonvisible 
light photography.
7.10 reflective ultraviolet 
Digital Photography
If a bite inflicted to skin shows signs of damage on its 
surface (epidermis), the use of electromagnetic radiation 
in the UV range will often photographically depict the 
surface damage. For most organic materials, the rule of 
Figure 7.24 iR focus mark on nikon nikkor uv 105 lens (left). the large black dot in the top picture represents the vis-
ible focus. the small dot to the right of the visible focus highlighted in the bottom photograph represents the iR focus. 
(photograph courtesy of nikon, inc.) close-up of iR focus shift point on nikon nikkor uv 105 lens (right).
photography 97
thumb is that the shorter the wavelength of the incident 
light, the more the absorption will be and the shallower 
the depth of penetration. Disruption of the normal skin 
surface where the teeth touch during biting creates a 
physiological difference between the damaged areas and 
the undamaged adjacent skin. That part of the injury on 
the surface of the skin may have a potentially different 
UV appearance than in visible light.
Under these conditions, the preferred photographic 
technique to capture surface disruptions employs the 
shorter-waved UV’s tendency to scatter off surface 
anomalies. This requires utilization of both UV light 
and the special armamentarium for taking UV photo-
graphs. The net effect is an observed enhancement in the 
appearance of the injury pattern [22]. Ultraviolet pho-
tography captures these subtle differences that cannot 
be seen with the unaided human eye.
There is some controversy in the literature regard-
ing the optimum timing for the use of UV photogra-
phy. Suffice it to say that there is a wide variation in 
results from serial photos of the same injury over peri-
ods of 1–6 months. It is the authors’ observation that the 
best results have occurred between 7 and 9 days after 
trauma [23].
If one chooses to perform UV serial documentation 
over time, there is no need to retake orientation photo-
graphs since they should have been taken in the original 
series. Only close-up exposures with the scale in place 
should be taken during a subsequent UV series. The over-
all size (gross characteristics) and pattern (individualiz-
ing characteristics) of the injury are what is important.
7.10.1 ultraviolet Digital Photography 
Armamentarium
Ultraviolet digital photography requires the use of 
specialized photographic equipment and techniques. 
Levels of ultraviolet light range from the near ultraviolet 
to deep ultraviolet, and the armamentaria will depend 
upon which area of the UV band is to be captured. For 
this discussion, the basic requirements for capturing 
images in the 360- to 400-nm range will predominate. 
The equipment for digital UV photography starts with 
a pro-sumer class 35-mm DSLR camera with software 
and internal filtering system that have been converted to 
capture the nonvisible extremities of the light spectrum. 
The modification can be provided by the manufacturer, 
as in the Fuji UV/IR series (Figure 7.25, right), or by con-
version of a standard camera by a market vendor.
Unfortunately, Fujifilm North America discontin-
ued production of its UV/IR line of cameras in 2008. 
That fact should not discourage the novice photogra-
pher, since most basic 35-mm format digital cameras 
can be converted to “see” the UV range. One only has 
to seek a reputable and knowledgeable outsource ven-
dor. The modification involves removal of the “hot mir-
ror” filter in front of the electronic sensor and should 
be accomplished by a qualified technician. Modifying 
an older-model digital camera is more advisable than a 
brand new one since the modification would void any 
existing factory warranty.
The next consideration is to acquire a lens that trans-
mits UV light. Silicon-fused (quartz) lenses transmit 
Figure 7.25 the quartz uv nikkor 105 lens (left); Fuji iS-pro uv/iR DSlR camera (right). (courtesy of Fujifilm.)
98 Bitemark evidence: a color atlas and text, 2nd edition
75–80% of UV light and require no focal shift; however, 
they are scarce and very expensive. Nikon Corporation 
discontinued production of the UV105 quartz lens several 
years ago. To fill the demand, Universe Kogaku America 
[24] and Jenoptic Inc. [25] have developed a line of UV 
quartz lenses. Numerous less expensive, nonquartz, 
regular glass lenses are functional for UV imaging and 
transmit up to 50% of the UV. However, one must make 
certain that the glass surface is not fluorite coated and 
that no UV light will be transmitted. Consult the manu-
facturer’s specifications before purchasing the lens.
A UV light source is also required. Direct sunlight, gas 
discharge lamps, YAG lasers, and ultraviolet-tuned LEDs 
are the most common sources of illumination. Although 
very inexpensive, sunlight does not produce the level of 
intensity required for capturing images indoors or in mac-
rophotographic applications. Fortunately, several types of 
UV light sources are on the market, ranging from typical 
flash units modified to emit UV light to specially designed 
UV LED light sources. Recently, UV LEDs based on gal-
lium nitride semiconductor alloys have become popular; 
they have several advantages over gas discharge lamps, 
especially in their spectral purity. For bitemark documen-
tation, the preferred choice of illumination would be a 
very strong strobe flash, such as the Nikon SB 140, which 
was produced specifically for UV photography. Short of 
finding the unit, any programmable flash with a high 
guide value (50+), such as the Quantum® series flashes, 
should provide adequate light for digital UV imaging at 
high ISO equivalence (800–1600).
In addition to the previous items, a UV-specific 
band pass filter must be in front of the lens in order to 
allow only UV light to strike the electronic sensor. The 
traditional Kodak Wratten 18A glass UV filter cannot 
be used in digital UV photography because of a small IR 
transmission spike that allows just enough IR radiation 
to leak through and contaminate the image. The digital 
camera’s sensor cannot differentiate between UV and IR 
radiation. Therefore, the 18A filter, which set the gold 
standard for film-based photography, is inappropriate 
for digital UV. The Baader® Venus U filter has become 
the accepted filter of choice for UV digital photography. 
It has a peak transmission at 360 nm and less than 0.1% 
red leak.
7.10.2 Digital ultraviolet Protocol
The UV/IR-capable digital camera should first be 
mounted on a tripod with the appropriate lens attached 
and proper filter holder positioned over the lens. The 
camera mode function should be set to manual with 
a starting ISO equivalence of at least 400 and a shut-
ter speed of 1/60 to 1/90 second. Exposures should be 
bracketed using multiple f-stops. If a programmable 
electronic flash unit is used, it should be set to maxi-
mum output.
Camera distance to the bitemark may vary with the 
length of the lens. The injury and ABFO no. 2 scale should 
be included in the electronic viewfinder and focusing 
should be at the actual visible focus point if a quartz 
lens is used. If a glass lens is used, a slight adjustment 
in focus may be necessary. The ruler must be positioned 
adjacent to the injury and parallel to the back plane of 
the camera to minimize angular distortion. Once focus 
is established in ambient light, the Baader Venus U filter 
is positioned in front of the lens. Ultraviolet photography 
using a strobe-type flash can be accomplished in ambi-
ent room light illumination. If a gas tube or LED source 
is used, the room should be totally darkened except for 
the illuminating lightsource. Under these conditions, 
protective eyewear should also be worn by all present.
Once the photographer acquires the essential equip-
ment, predictable, reliable, and accurate UV photo-
graphs will be obtained through experimentation. It is 
imperative that the photographer be familiar with the 
UV technique before the advent of a real bitemark case. 
Failure to collect all the available evidence in the bite-
mark case could otherwise result. The recommenda-
tion that UV photography be used does not imply that 
it is compulsory in a bitemark case. However, it is the 
responsibility of the investigator to attempt to collect all 
available evidence when possible, and UV photography 
does represent one additional venue in evidence collec-
tion (Figure 7.26).
7.11 Application of Photographic 
Techniques other Than for Bitemarks
The techniques described in this chapter can be applied 
in other areas of forensic investigation. Documentation 
of tattoos, scratches, or tool marks on decomposed tis-
sue is an applicable venue for IR. Similarly, UV and IR 
techniques can be applied to tattoos, scratches, gunshot 
injuries, stab wounds, ligature restraints, hanging or 
suspension injuries, and many other types of patterned 
injuries. The ALI technique is applicable for examina-
tion of bruises associated with ongoing abuse or assaults 
or in instances where a history of aging injuries needs to 
be documented (see Figures 7.27 through 7.34).
photography 99
Figure 7.26 child-abuse victim with bitemarks on the back; photo taken by child protective services 2 days after the 
attack (left); same bitemark injuries taken in Raw digital uv almost 2 months after the attack (upper right), Fuji pro S3 
uv-iR camera, iSo 100, f/5.6, 1/125 second, nikon nikkor uv105 lens, nikon SB140 synched flash, Baader venus uv 
band pass filter; desaturated and enhanced in adobe photoshop (lower right).
Figure 7.27 color photograph of homicide victim with bullet hole in the left side of the neck (left); uv without signifi-
cant change in the appearance wound compared to color (center); iR of the wound showing the entrance wound without 
apparent hemorrhage. the blood is still there but the camera focus is below the surface of the skin, making it seem to 
magically disappear.
100 Bitemark evidence: a color atlas and text, 2nd edition
Figure 7.29 iR photograph of neck ligature pattern in the skin of homicide victim (left); uv photograph of same ligature 
(right). note the detail of the electric cord used for the strangulation.
Figure 7.30 Black-and-white photograph of knife puncture wound on homicide victim (left); iR (center) and uv of same 
injury.
Figure 7.28 color image of mummified back skin of homicide victim with tattoo; yellow box shows area of interest 
(left); iR photograph of same mummified skin with the details of the tattoo in the highlighted box.
photography 101
Figure 7.31 child-abuse victim with ligature marks on neck (left); iR (center) and uv of same ligature marks.
Figure 7.32 Multiple series of tattoos on back of female (left); iR of same tattoos (right). (courtesy of Miami Metro-Dade 
M.e. imaging Bureau.)
Figure 7.33 tattoo on face of homicide victim (left); iR of same tattoo (right).
102 Bitemark evidence: a color atlas and text, 2nd edition
references
 1. Wright, F. D. 1998. Photography in bite mark and pat-
terned injury documentation—Part I. Journal of Forensic 
Sciences 43 (4): 877–879.
 2. Wright, F. D., and G. Golden. 1997. Forensic photogra-
phy. In Forensic dentistry, ed. P. Stimson and C. Mertz, 
102–106, 123, 132. Boca Raton, FL: CRC Press..
 3. Bachem, A., and C. I. Reed. 1930. The penetration of 
light through human skin. Publication of the University 
of Illinois, College of Medicine, Chicago.
 4. Kodak infrared films. Kodak publication no. N-17, p. 4.
 5. Ultraviolet and fluorescence photography. Kodak publi-
cation no. M-27.
 6. Krauss, T. 1984. Photographic techniques of concern in 
metric bite mark analysis. Journal of Forensic Sciences 29 
(2): 636.
 7. CCD vs. CMOS: Dalsa.com; www.dalsa.com/markets/
CCD_vs_CMOS.aspx
 8. Three CCD. http://en.wikipedia.org/wiki/3CCD (redi-
rected from 3CCD).
 9. Bayer filter. http://en.wikipedia.org/wiki/Bayer_filter
 10. Canon U.S.A. Inc. 2003. EOS 10D digital camera bro-
chure, p. 12.
 11. Johansen, R., and C. M. Bowers. 2000. Digital analysis 
of bite mark evidence using Adobe Photoshop. Forensic 
Imaging Services, Santa Barbara, CA, pp. 17–44.
 12. Digital information management solution. Linear 
Systems Corp., Rancho Cucamonga, CA.
 13. LucisPro software, Image Content Technology LLC. PMB 
#203, 430 Franklin Village Drive, Franklin, MA 02038-
4007, http://www.lucispro.com, http://www.lucisart.com
 14. Stokes, G. G. 1853. On the change of refrangibility of 
light. Philosophical Transactions of the Royal Society of 
London 143:385–396.
 15. Guilbault, G. 1973. Practical fluorescence. New York: 
Marcel Dekker.
 16. Devore, D. 1974. Ultraviolet absorption and fluorescence 
phenomena associated with wound healing. Thesis for 
doctor of philosophy, University of London, Dept. of 
Oral Pathology.
 17. Dawson, J. B. 1980. A theoretical and experimental study 
of light absorption and scattering by in vivo skin. Physics 
in Medicine and Biology 25 (4): 695.
 18. Golden, G. 1994. Use of alternate light source illumi-
nation in bite mark photography. Journal of Forensic 
Sciences 39 (3): 1560–1567.
 19. Regan, J. D., and J. A. Parrish. 1982. The science of pho-
tomedicine. In Optical properties of human skin. New 
York: Plenum Press.
 20. Medical infrared photography. Kodak publication no. 
N-1, p. 26.
 21. Nieuwenhuis, G. 1991. Lens focus shift required for 
reflected ultraviolet and infrared photography. Journal of 
Biological Photography 59 (1): 17–20.
 22. Krauss, T. C., and S. C. Warlen. 1985. The forensic sci-
ence use of reflective ultraviolet photography. Journal of 
Forensic Sciences 30 (1): 264–265. Henderson, J. W. 1993. 
Infrared photography revisited. Journal of Audiovisual 
Media in Medicine 16:161.
 23. Wright, F. D. 1998. Photography in bite mark and pat-
terned injury documentation—Part 2: A case study. 
Journal of Forensic Sciences 43 (4): 881–887.
 24. http://www.ukaoptics.com
 25. http://www.jenoptik-inc.com
Figure 7.34 Black-and-white image of avulsed areola thought to be bitemark (left); uv of same avulsed tissue defini-
tively showing the injury is not a bitemark (right).
www.dalsa.com/markets/CCD_vs_CMOS.aspx
www.dalsa.com/markets/CCD_vs_CMOS.aspx
103
8
8.1 introduction
Just a few years ago film was the product of choice for 
forensic photography; today, digital is the standard. 
This is particularly true for bitemarks since this type 
of evidence lends itself to color, infrared (IR), ultravio-
let (UV), and alternate light imaging (ALI). What was 
a very long process with film now takes seconds with 
instant results.
Good results in IR and UV photography can be 
obtained using a good single lens reflex (SLR) digital 
camera. But because in normal color photography IR 
and UV will greatly affect the results in a negative way, 
many cameras have built-in IR and UV filters. These fil-
ters greatly reduce the sensitivity of the charged coupled 
device (CCD) or complementary metal oxide semicon-
ductor (CMOS) sensor, making it more difficult to cap-
ture IR and UV pictures. Longer exposure is required, 
as is adjustment for the focus shift. IR and UV filters are 
very opaque, and thus it is impossible to focus properly 
by looking through the lens. Mandatory manual adjust-
ment of the focus is essential, followed by filter installa-
tion and picture taking. Finally, the use of bracketing for 
a clear image is critical in order to compensate for the 
focus shift.
Experimenting with the Fuji IS PRO UV IR dem-
onstrated that this particular camera is well suited to IR 
and UV photography. The filters are not installed by the 
manufacturer, thus allowing for those wavelengths to 
be capturedeasily by the internal CCD sensor. Besides 
being a lot more sensitive to IR and UV, the live view 
feature on this camera allows the user to see potential 
results before the picture is taken; this greatly reduces 
the time of exposure and solves the focus shift problem. 
The camera can also be used as a normal digital camera, 
but needs a filter, such as the PECA 916 purchase option, 
to block IR and UV light. For the ALI technique, using 
a normal digital camera with the no. 15 yellow filter is 
suggested (see Figures 8.1 and 8.2).
The use of a computer (preferably a laptop for conve-
nience) and the software provided by the camera manu-
facturer such as the Nikon Capture—or, in the case of 
the Fuji IS PRO UV IR, the Hyper Utility 3—is recom-
mended. This will allow the user to control the cam-
era remotely on a tripod for immediate photographic 
results. It will be a lot easier to acquire a high-quality 
focused picture looking at the computer screen rather 
than looking through the camera viewer.
Different types of light sources will provide IR and 
UV light. For example, most electronic flashes emit IR 
and UV light, but when the Fuji IS PRO UV IR is used 
in live view mode, it is very useful to use a steady-beam 
light source such as the Polilight Flare® from Rofin, 
which permits proper focus before picture capture (see 
Figures 8.3–8.5).
8.2 infrared Photography
Infrared photography enables one to capture lesions 
within deeper layers of skin. The principle is based 
on the fact that blood absorbs IR light, which appears 
darker than the surrounding tissue. Most CCD and 
CMOS sensors are a lot more sensitive to infrared light 
than to UV light, so short exposure and small aperture 
will normally give very good results. As with UV, the 
focus point could be off by a few millimeters due to a 
focus shift when a normal digital camera is used. This 
type of photography is very easy using the Fuji IS PRO 
UV IR; because it is very sensitive to IR light, this new 
Practical Tips in Forensic 
Bitemark Photography
luc GaGnon
Contents
8.1 Introduction 103
8.2 Infrared Photography 103
8.3 Ultraviolet Photography 104
8.4 Alternate Light Imaging Photography 107
8.5 Summary 110
Reference 110
104 Bitemark evidence: a color atlas and text, 2nd edition
camera facilitates infrared photography to the point that 
results can be seen before capturing the image. One of 
the light sources used is the new Polilight PL500 with 
infrared lighting.
Three examples of the different filters available 
are the Hayo 72, the PECA 910, and Kodak’s Wratten 
87C. The latter blocks all visible light other than infra-
red light. Depending on the distance and the infrared 
source used, it is easy to overexpose (especially with the 
Fuji IS PRO UV IR), so a very small aperture such as 
f/22 or even smaller is recommended. Good results have 
been obtained with f/27 at 1/125 second, depending 
largely on the strength and distance of the light source. 
Because each forensic case is different, a trial-and-error 
technique is suggested. Recommendations include:
The use of a tripod (mandatory to facilitate •	
manual focus)
The use of an ABFO no. 2 scale and its place-•	
ment parallel to both the surface photographed 
and to the camera lens
Installation of a good infrared filter in front of •	
the lens (the Kodak 87C blocks all visible light 
and lets in only infrared)
As for UV, normally, IR photographs do not have 
to be taken in total darkness since the filter is very 
opaque to visible light. To make sure, simply take a 
picture with just the ambient light on, using a long 
exposure; if the photo is black, there should not be any 
contamination. The use of soft ambient light greatly 
facilitates picture taking.
The focus shift for infrared will give a focus point 
away from the lens. One of the great advantages of IR 
photography is to show tattoos that would usually be 
hard to see under normal lighting due to burned or 
decomposed skin. For bitemark photography, infrared 
can be a useful tool, but UV and ALI often give better 
results [1] (see Figures 8.6–8.8).
8.3 ultraviolet Photography
In odontology, ultraviolet photography is particularly 
useful in order to accentuate the details on the under-
surface of the damaged skin. UV photography has the 
advantage of being able to show details that would not 
normally be visible to the naked eye or in normal pho-
tography. Even though literature on the subject is quite 
0.1%
89B 88A 87 87C
Wratten Filter Numbers
1%
10%
% 
Tr
an
sm
itt
an
ce
D
iff
us
e D
en
sit
y
100% 0
1
2
3
600 700 800
Wavelength (Nanometres)
900 1000 1100
Figure 8.2 the spectral transmission curves for the kodak 
wratten series of infrared transmission filters. notice that 
the 87c filter blocks light less than 800 nm (http://msp.
rmit.edu.au/article_03/02c.html). (photo courtesy of Mit.)
0.1%
1%
10%% 
Tr
an
sm
itt
an
ce
100% 0
200 300 400 500
Wavelength (Nanometres)
600 700 800 900
D
iff
us
e D
en
sit
y
3
2
1
Figure 8.1 this graphic illustrates the spectral transmission curve for the kodak wratten 18a filter. this ultraviolet 
filter allows some infrared penetration in the 700- to 800-nm range (http://msp.rmit.edu.au/article_01/06.html). (photo 
courtesy of Mit.)
http://msp.rmit.edu.au/
http://msp.rmit.edu.au/
http://msp.rmit.edu.au/
practical tips in Forensic Bitemark photography 105
meager, the best results were obtained after the bitemark 
is no longer visible.
For UV photography, as for IR photography, many 
types of digital cameras could give decent results when 
using the proper light source and filter. However, it was 
found that the Fuji IS PRO UVIR is well worth the invest-
ment if UV and IR photographs are taken on a regular 
basis. This particular camera is a lot more sensitive to 
those wavelengths than other digital cameras, and the 
live view is a great advantage over other cameras. Because 
Figure 8.3 uv and iR light source, the polilight pl 500 (left), a laptop computer (center), and the Fuji iS pRo uv iR 
digital camera mounted on a tripod (right).
Figure 8.4 a laptop screen showing the hyper utility 3 software package included with the Fuji iS pRo uv iR camera 
shows results before and after picture taking, making it a lot easier to get a good picture every time.
106 Bitemark evidence: a color atlas and text, 2nd edition
Figure 8.5 Rofin polilight Flare kit (left), vector 7® uv light (center), and ivona® uv light (right).
Figure 8.6 this infrared photograph shows the peripheral circulatory system of the arm.
Figure 8.7 a bitemark photographed in iR.
practical tips in Forensic Bitemark photography 107
of the latter factor, an appropriate focus is obtained every 
time, thus removing the guesswork from picture taking. 
However, even with this camera, the exposure time will 
be a lot longer than for infrared (see Figures 8.9–8.11).
The technique of photographing a bitemark in UV is 
summarized as follows:
 1. Install the camera Fuji PRO UV IR on the tripod.
 2. Remove the UV filter on the lens if one is pres-
ent. The filter is often used to protect the lens.
 3. Install the UV 18A or a similar filter.
 4. Set the camera to manual mode. The filter is 
so opaque to visible light that the TTL and the 
autofocus are useless. For example, using the 
Fuji IS PRO UV IR, good exposures have been 
obtained at 1 second, aperture f/10, with the 
beam of Polilight at approximately 30 cm from 
and 45° to the bitemark.
On a live subject, it is important to keep the expo-
sure as brief as possible since UV light has the potential 
to damage skin. The total exposure should not exceed 
12 minutes per day and 4 minutes of continuous expo-
sure with the Polilight PL500, making sure that the 
exposure is adjusted according to the UV source used 
and the manufacturer’s instruction.
Depending on the UV source used, different results 
can be obtained. It is very important to know that the 
Kodak Wratten 18A filter also lets infrared lightthrough 
(Figures 8.1 and 8.2). It is therefore possible to obtain 
photographs with more red depending upon infrared 
contamination, or more blue due to the UV source used. 
Ideally, the UV light source should emit no IR whatso-
ever. The source of UV light coming from LEDs seems to 
emit much less infrared. The Polilight Flare from Rofin 
is a good example and gives excellent results.
As for infrared, normally, UV photographs do not 
have to be taken in total darkness since the filter is very 
opaque to visible light. Simply take a picture in ambient 
light with a long exposure; if the photo is black, there 
should not be any contamination. The use of soft ambi-
ent light greatly facilitates picture taking. Remember 
that the Kodak Wratten 18A will let in a good portion of 
infrared light depending on how much the light source 
emits in the infrared wavelength.
Ultraviolet light gives a focus shift of a few millime-
ters closer to the lens. Again, the use of the Fuji IS PRO 
UV IR live view mode eliminates this problem; other-
wise, adjusting focus by looking at the photograph and 
using the bracketing technique will be time-consuming. 
Notice the difference in color in Figure 8.11. All pho-
tographs were taken with the Fuji IS PRO UV IR and 
Kodak’s Wratten 18A filter with a variable UV light 
source. Some are contaminated to different degrees by 
the infrared light emitted, as seen by the different tints 
of red. The Polilight and the Polilight Flare seem to pro-
duce the best UV light source, emitting less IR and thus 
giving better detail.
8.4 Alternate light imaging Photography
Alternate light imaging photography uses a yellow filter 
no. 15 and a 450-nm light source for photographing bite-
marks. Figure 8.12 illustrates the differences between 
no. 8, no. 12, and no. 15 filter photographs. Visually, 
filters no. 12 and no. 15 are indistinguishable and can 
easily be mixed up, although the photographs produced 
are perceptively different. The light source used in this 
figure was the Polilight PL500 from Rofin at 450 nm. A 
digital camera—preferably one sensitive to light (high 
ISO)—is ideal with an ABFO no. 2 scale. The technique 
Figure 8.8 two pictures taken with the Fuji iS pRo uv iR camera with the peca 916 filter (right) and without filter (left). 
the uv and iR are not being blocked.
108 Bitemark evidence: a color atlas and text, 2nd edition
is particularly well suited for bitemark photography and 
other types of wounds or bruises that have a distinctive 
pattern. The ultimate goal is quite simply to improve the 
visibility and the contrast of the wound. The ALI method 
is remarkably effective when few visible details are pres-
ent on the skin surface. (Figure 8.13 highlights a color 
and an ALI yellow no. 15 filter bitemark photograph.)
The Nikon D700, for example, has a very high light 
sensitivity (ISO) and gives a very good quality photo-
graph at ISO 6400 with almost no dark current noise. 
This allows picture taking without a tripod—a very 
useful tool when photographing bitemarks on a young, 
restless victim. A high-sensitivity camera will also allow 
for the use of smaller aperture settings in order to have 
a better depth of field. Very good results have been 
obtained with a shutter speed of 1/60 second at f/9. Do 
not rely on the internal light meter because the yellow 
filter and the 450-nm wavelength give a false reading.
The technique is as follows:
 1. Make sure that the anti-UV filter, often used to 
protect the lens, is removed and then install the 
Figure 8.9 three photographs of a tattoo in color with ambient light (upper); iR with the nikon D2X (center). notice 
that it is out of focus due to the focus shift. the Fuji iS pRo uv iR was used for the bottom photograph. Both iR pictures 
were taken using the same polilight and the kodak wratten 87c filter.
practical tips in Forensic Bitemark photography 109
no. 15 yellow filter. For this technique, the auto-
focus should work fine.
 2. Protective glasses (yellow color) must be worn. 
Be aware that wearing these glasses may skew 
the vision, producing different results from what 
is anticipated. For this reason, one should moni-
tor picture taking through the camera lens.
 3. Use a no. 2 ABFO scale placed parallel to the 
bitemark and camera lens.
 4. There should be no ambient light other than the 
Polilight set at 450 nm. The light source can be 
moved to different distances and directions to 
maximize bitemark photographic detail. Trial 
and error is in order. Looking through the cam-
era lens while experimenting with light distance 
and position produces the best results.
 5. Finally, it might be necessary to use a tripod, 
depending on the camera’s sensitivity to light.
Figure 8.10 two pictures taken in uv; one with the polilight (left) and the other with the polilight Flare (right) using the 
same Fuji camera and wratten 18a filter. this shows that results can differ when different light sources are used.
Figure 8.11 Four photos taken with the same camera and filter but with different uv light sources: polilight Flare 
(upper left), polilight pl500 (upper right), with the nikon SB 800 flash (lower left) and a black light (lower right). notice 
the different result, which is mainly due to infrared contamination.
110 Bitemark evidence: a color atlas and text, 2nd edition
8.5 Summary
The vast majority of SLR digital cameras can be used 
to take UV and IR pictures with good results. However, 
because using the Fuji IS PRO UV IR will greatly facili-
tate the process by removing quite a bit of the guesswork, 
it is highly recommended. It is important to remember 
that different light sources and filters can give different 
results, so it is recommended to experiment to obtain 
the best results.
reference
 1. Dorion, R. B. J. 2010. Bite mark profiling based upon 
color, UV, and ALI photographic interpretation. 
Proceedings of the 62nd annual meeting of the American 
Academy of Forensic Sciences, Feb. 22–27, 2010, Seattle, 
WA. Colorado Springs, CO: American Academy of 
Forensic Sciences.
Figure 8.13 color (left) and ali yellow no. 15 (right) filter bitemark photographs.
Figure 8.12 three pictures using the ali technique with three different filters: yellow no. 8 (left), no. 12 (center), and no. 
15 (right). this shows the importance of having the proper filter for ali—namely, the yellow no. 15.
111
9
9.1 introduction
Technological advances in the past few years have given 
us powerful, inexpensive tools for modifying images. 
What was traditionally the domain of specialized 
technical professionals is now available to the general 
practitioner. Image processing has become ubiquitous. 
It is so integrated into how one acquires and views imag-
ery that it often cannot be separated from the act of tak-
ing pictures or looking at them. Modern digital cameras 
include multiple processing steps as part of the formation 
of a photograph. They allow the user to do tasks such as 
sharpening, image averaging, edge enhancement, color 
balancing, and even high dynamic range imaging within 
the camera. Modern displays offer similar functions. For 
instance, a common graphics card used in consumer 
laptop computers at the time of this writing allows the 
user to modify gamma, brightness, contrast, color bal-
ance, anti-aliasing, filtering, compositing effects, and 
resizing. Common consumer-level image processing 
image Processing and Analysis 
for Evidentiary Purposes
williaM R. oliveR
Contents
9.1 Introduction 111
9.2 Image Processing and Analysis 112
9.2.1 Image Processing 112
9.2.1.1 Definitions 112
9.2.1.2 Image Enhancement and Restoration 112
9.2.1.3 Substantive versus Demonstrative Image Processing 113
9.2.2 Image Analysis 115
9.2.3 Literature Review 116
9.3 Standards 116
9.4 The Digital Work Flow Pipeline 117
9.4.1 Images as Evidence 117
9.4.2 Image Acquisition and Archival 117
9.4.2.1 Storage Format 117
9.4.2.2 Primary, Original, and Working Images 119
9.4.2.3 Image Integrityand Archival 120
9.4.2.4 Format and Media Obsolescence 120
9.4.2.5 Image Authenticity 121
9.4.2.6 Image Retention 121
9.4.3 Image Enhancement Documentation 121
9.4.4 Report Preparation 123
9.5 Software Resources 123
9.5.1 Applicability 124
9.5.2 Single Application or Enterprise Solution 124
9.5.3 Validation and Algorithm Description 124
9.5.4 Graphical Interface and Ease of Use 124
9.5.5 Programming Requirements 125
9.5.6 Metaphor 125
9.5.7 Data Representation 125
9.5.8 Audit Trails 125
9.5.9 Third-Party Support 126
9.5.10 Open Source versus Proprietary 126
References 127
112 Bitemark evidence: a color atlas and text, 2nd edition
software packages provide access to hundreds of algo-
rithms in dizzying numbers of combinations.
The evaluation of bitemark evidence has taken 
advantage of this, particularly in the areas of image 
enhancement, digital overlay production, and image-
based meas ure ment. It is necessary, then, for those who 
use digital imaging to become conversant with the tech-
niques employed. This chapter discusses considerations 
that may be important in image processing and analysis 
for bitemark interpretation from an evidentiary point of 
view. It is not meant to be a tutorial on image processing. 
That is a topic well beyond the scope of a single chapter; 
readers are encouraged to turn to any of the many good 
textbooks on the subject.
9.2 image Processing and Analysis
9.2.1 image Processing
9.2.1.1 Definitions
Since the manipulation of imagery has become integral 
to its acquisition, storage, viewing, and analysis, it may 
be useful to think about what image processing is. One 
convenient model considers what kinds of data one is 
putting into a process and what kinds of data one is get-
ting out of it. Basically, one can have either an image or 
some sort of descriptive data as input, and one can have 
an image or some sort of descriptive data as output, as 
shown in Figure 9.1. In computer graphics, one provides 
a mathematical description of what one would like to 
see—a model of an object, a list of color and reflectance 
properties, a description of lighting, etc.—and the output 
is an image. In computer vision and image analysis, one 
uses imagery as input and attempts to derive some sort 
of description as an output (e.g. “there is an enemy tank 
behind a tree”).
Generally, if a machine does the analysis, it is called 
“computer vision”; if analysis is done by a human, it is 
called “image analysis.” If one supplies a representa-
tion and receives a different representation, then one is 
performing any of a number of file-based tasks (such as 
format manipulation or compression) that generally fall 
under the classification of picture archiving and com-
munications systems (PACS) in medical imaging. If one 
supplies an image and receives a modified image, then 
one is performing image processing [1].
Definitions of image processing vary a little between 
disciplines. In the world of forensic science in the United 
States, Canada, and Great Britain, definitions tend to 
be similar to those defined by the U.S. Federal Bureau 
of Investigation (FBI) Scientific Working Group on 
Imaging Technology (SWGIT). There, image process-
ing is defined simply as “any activity that transforms 
an input image into an output image” [2]. The National 
Policing Improvement Agency of the United Kingdom 
states: “Processing images generally involves adjusting 
the technical properties of the image and modifying the 
actual content to improve or change some quality of 
the image” [3]. The Canadian Royal Mounted Police 
generally refers to the SWGIT guidelines for definitions, 
but expands on comments regarding image enhance-
ment for analysis (vide infra).
9.2.1.2 Image Enhancement and Restoration
Forensic image processing is usually directed toward a 
few specific tasks. These tasks, in turn, can generally be 
categorized as image enhancement and image restora-
tion. Image restoration is the process of reversing some 
degradation of an image due to acquisition technology 
or some environmental effect. The process often involves 
modeling the degradation process, creating a process 
that acts as its inverse, and then applying that inverse.
A classic example in medical imaging is the res-
toration of conventional light microscopy images. In 
microscopy, the light traveling through the microscope 
from the light bulb is almost never uniform. Instead, it 
is brighter in the middle and darker at the edges of the 
field. There are almost always small bits of dust on the 
mirrors and lenses that cause dark spots. This is called 
“nonisotropic illumination.” Because the lenses are small 
and curved, different wavelengths of light are refracted 
differently, so red and blue portions of the image are no 
longer aligned at the edges. This is called “chromatic 
aberration.” In addition, because the lens is not a per-
fect sphere, light going through the edge of the lens will 
focus at a different spot than light that goes through 
the center. This is called “spherical aberration.” All of 
Computer
Vision
Image
Processing
PACS
D
es
cr
ip
tio
n
Im
ag
e
O
ut
pu
t
ImageDescription
Input
Computer
Graphics
Figure 9.1 categorizing image manipulation on the basis 
of input and output.
image processing and analysis for evidentiary purposes 113
these can be partially alleviated by better engineering 
and maintenance, but they will almost all still remain 
to some degree.
Each of these can be modeled, however. For instance, 
an image is mathematically the multiplicative product 
of the illumination and the reflectance properties of the 
resulting image. Thus, one can normalize for uneven 
lighting simply by dividing the image by an image of the 
illumination (i.e., a picture taken without a microscope 
slide but with the lamp on). In contrast, light added by 
random currents in the sensor is additive, so it may be 
subtracted. To correct an image, then, one can subtract 
an image taken with the camera turned on but the light 
turned off (the “darkfield” image) and divide the image 
with the specimen by an image taken without the 
specimen (the “brightfield” image). The process is dia-
grammed in Figures 9.2 and 9.3.
Similarly, one can take the blur out of out-of-focus 
images by modeling the blurring function and per-
forming the inverse—either directly by a process called 
deconvolution or by using iterative methods. While 
there are methods of “blind” de-blurring that do not 
require a good model of the blurring function, the more 
efficient and better performing methods rely on a good 
mathematical model of how the blurring occurred.
Image enhancement is the relative increase or 
decrease of specific features in an image to make it more 
interpretable or, as defined by SWGIT, “any process 
intended to improve the visual appearance of an image or 
specific features within an image” [2]. Examples include 
the removal of distracting periodic patterns such as stria-
tions in concrete obscuring a shoe print or textile pattern 
in cloth obscuring a fingerprint, contrast enhancement 
to make faint features more obvious, and separation of 
color channels (Figures 9.4 and 9.5). The Canadian Royal 
Mounted Police guidelines for image enhancement for 
analysis say [4]: “Enhancements are intended to improve 
the overall appearance of an image or to extract hidden 
details within the image. Enhancements are not to hide 
anything from the courts and should only be performed 
on a copy of the original.”
9.2.1.3 Substantive versus Demonstrative 
Image Processing
As described later in this chapter, there are a number of 
guidelines for the handling, documentation, and evalu-
ation of image processing in forensic imaging. In large 
part, the degree to which these apply depends on how 
the image will be used. The primary distinction, partic-
ularly with regard to the courts in the United States and 
similar countries, is whether the processed image will be 
used simply to demonstratefindings derived elsewhere 
or if it is the basis for the interpretation. If one is going 
to enter an overlay of teeth on a bitemark into court, it 
–
Anisotropic Illumination
Correction
–
=
Figure 9.2 correcting for anisotropic illumination.
Figure 9.3 Before and after illumination correction.
114 Bitemark evidence: a color atlas and text, 2nd edition
matters whether the overlay is the basis for the conclu-
sion that there is or is not a match or if it is to be used 
merely to show the jury what the investigator has deter-
mined using some other technique. Of course, one must 
know the rules of evidence for one’s particular jurisdic-
tion. However, demonstrative imagery often must sim-
ply be stated by affirmation to be useful to demonstrate 
the point being made, be accurate in its representation 
of the point being made, be pertinent to the testimony, 
and not be prejudicial.
While it is not described in the forensic odontol-
ogy literature, in areas of investigation such as foren-
sic pathology, image processing is often not the basis 
of the analysis but is instead used to create a collection 
or “space” of images that are processed using multiple 
methods and varying parameterizations [5]. These in 
turn are used to increase the likelihood that the observer 
will notice a feature pertinent to diagnosis. Recent stud-
ies in the cognitive science literature explain why this 
can be useful.
In studies of visual response to motion, research-
ers found that the brain creates potential futures out 
of remembered scenes and uses them to predict what 
one will see. This is modified when there is a signifi-
cant discordance between what is predicted and what 
is actually viewed [6]. Interestingly, this kind of tactic 
was developed independently to speed up processing in 
computers, where it is called “speculative execution” [7]. 
This predictive process has advantages in terms of time 
and effort, but these findings suggest it may be a source 
of visual confirmation bias. The use of image process-
ing to create a number of images with differing relative 
strengths of features may thus be used to force the visual 
cognitive system out of its expectations and allow the 
observer to notice features or relationships that he or 
she would otherwise have overlooked.
However, since these newly observed features might 
be artifacts of the processing method, the analyst would 
be well advised to return to the original image and use 
it as the basis of his or her conclusions, except in certain 
Figure 9.4 Removal of background linear swept pattern in concrete to help view shoe print pattern.
Figure 9.5 contrast enhancement of bitemark. original image (left) and contrast-enhanced image (right).
image processing and analysis for evidentiary purposes 115
circumstances. The image processing is thus used to 
increase sensitivity, but any analysis based on the pro-
cessed images alone would also have a much lower 
specificity [5]. Image processing, particularly contrast 
enhancement, has been studied extensively in the diag-
nostic radiology literature, where it has been shown to 
increase sensitivity, decrease specificity, and decrease 
time to diagnosis, depending on the task [8]. In mam-
mograms, it increases the likelihood of detection of 
microcalcification, but not soft tissue mass detection 
[9]. It has also been used to evaluate drusen in retinal 
images [10].
As noted before, in certain circumstances the pro-
cessed image is the basis for the conclusion. Measure-
ments of tooth position or area of injury may be 
derived from a processed image and form the basis for 
a statistical match. In these cases, it will usually be nec-
essary to demonstrate the scientific basis for the conclu-
sion, the error of the meas ure ments, and the validity of 
the processing method. In the United States, the two 
primary tests for court admissibility are based on the 
U.S. Supreme Court decisions Frye v. United States and 
Daubert v. Merrill Dow [11,12]. The latter applies in 
federal court and many states and sets forth multiple 
criteria for determining the admissibility of scientific 
evidence. The former requires primarily that the method 
be generally accepted by the scientific community and it 
is still used in many states. In either case, any person 
using image processing in a substantive manner should 
have sufficient knowledge of the process to explain and 
defend its use.
9.2.2 image Analysis
While image processing focuses on modifying an image, 
image analysis focuses on extracting data and drawing 
conclusions from one. The SWGIT describes it as “the 
application of image science and domain expertise to 
interpret the content of an image and/or the image itself 
in legal matters. Major subdisciplines of forensic image 
analysis with law enforcement applications include: 
photogrammetry, photographic comparison, content 
analysis, and image authentication” [13].
Image processing may make it easier to see the edge 
of a bitemark. Determining the distance between teeth 
or the classification of marks is image analysis. Like 
medical diagnosis, it is a cognitive function that com-
bines both art and science. In the United States, the 
criteria for admission of this kind of evidence was deter-
mined in Daubert jurisdictions by the Supreme Court in 
Kumho Tire Co. v. Carmichael, which decided that the 
courts had Daubert-like responsibilities in determining 
the admissibility of technical but nonscientific evi-
dence [14]. In general, this has led to the evaluation of 
the certification, proficiency, and training of the exam-
iner in addition to examination of the validity of the 
methods applied. Thus, image analysis requires knowl-
edge of image science in order to understand and use 
imaging tools and demonstrate the scientific validity of 
the techniques.
However, the analyst must also have knowledge of 
a domain of expertise in order to recognize and inter-
pret important image features. A forensic odontologist 
may not be allowed to testify about conclusions based 
on a processed image if he or she cannot demonstrate 
an understanding of the processing method and how it 
affects the features he or she uses in analysis. An expert 
on image processing may not be allowed to testify about 
the meaning of the contents of a processed bitemark 
image if he or she cannot demonstrate competence in 
forensic odontology.
In general, image-based analysis of bitemark evi-
dence involves all of the tasks within the general area of 
image analysis, including photogrammetry, image com-
parison, and authentication. As defined by the American 
Society for Photogrammetry and Remote Sensing, pho-
togrammetry in the general sense is “obtaining reliable 
information about physical objects and the environ-
ment through the processes of recording, meas ur ing, 
and interpreting photographic images and patterns of 
electromagnetic radiant energy and other phenomena” 
[15]. The most common photogrammetric application is 
taking meas ure ments from images to determine tooth 
size, tooth distances, and other geometric information. 
As such, it is incumbent upon the analyst to know the 
sources and solutions for errors of perspective, projec-
tion, and such, as well as issues of camera attributes.
Forensic odontologists commonly do image com-
parison through overlays and other methods of compar-
ison. As noted in the SWGIT image analysis document, 
“photographic comparison is an assessment of the cor-
respondence between features in images and known 
objects for the purpose of rendering an expert opinion 
regarding identification or elimination (as opposed to 
a demonstrative exhibit)” [16]. Domain expertise is of 
critical importance in recognizing critical features for 
comparison, knowing artifacts, and interpreting results. 
Integral within this is content analysis, the drawing of 
conclusions from an image.
Image authentication is “verification that the infor-
mation content of the analyzed material isan accurate 
rendition of the original data by some defined criteria. 
The forensic odontologist must be able to distinguish 
between “real” features of bitemarks as opposed to issues 
116 Bitemark evidence: a color atlas and text, 2nd edition
of compression, image degradation, image acquisition, 
and such.
It should be clear from the preceding discussion 
that bitemark analysis involves both objective statistical 
and cognitive analytical issues. These should not be con-
flated. As noted by the SWGIT [17]:
Some conclusions can be based on statistical criteria, 
while other conclusions are based on subjective criteria. 
Conclusions derived from photogrammetric analyses 
can often be reported in terms of statistical criteria. In 
contrast, many conclusions derived from image content 
analyses are based on subjective criteria. The basis for, 
and uncertainty of, any conclusion should be reflected 
in the reporting.
Regardless of the image processing or analysis 
method employed, the investigator should have suffi-
cient practical and theoretical knowledge of any algo-
rithm used to know what artifacts can be created, how 
changes in parameterization can be expected to change 
the image, and potential sources of error. It may not be 
necessary to have a complete knowledge of the math-
ematics involved (though that would be optimal), but at 
least the practitioner should know enough to describe 
the underlying principles and pitfalls. It is not enough to 
go to court and merely claim that one hit the “improve” 
button in a piece of software and then magic happened. 
Not all forensic odontologists can or should master 
all algorithms, and not all computer scientists should 
pretend to know odontology. However, that does not 
remove the analyst’s responsibility to become sufficiently 
conversant with the principles of the algorithm and 
implementation to demonstrate competence to apply it 
intelligently and to interpret the results correctly.
9.2.3 literature review
There is currently some debate about the uniqueness and 
interpretation of bitemarks. This literature review is not 
intended to address these issues, but rather to demon-
strate some of the applications of image processing and 
image analysis in the discipline. Image enhancement 
has been shown to be of some use in clinical dentistry. 
For instance, one method of contrast enhancement has 
resulted in a small increase in the diagnosis of caries in 
intraoral radiographs [18,19]. The use of filtering, par-
ticularly embossing filters, has been of some value [20].
The most common use of image processing in bite-
mark evaluation is the creation of overlay images and 
image mixing and overlay [21–23]. It has become a com-
mon method of comparison and, at least under in vitro 
conditions, can be used to compare impressions with a 
high reliability, though cadaver studies have not been 
as encouraging [24,25]. In one recent article, three-
dimensional models were created by the use of laser 
scanners of casts and impressions, although the com-
parison was done using two-dimensional projections 
and overlays [26].
A great deal of work has also been done in trying to 
determine what photogrammetric meas ure ments from 
images can be used to distinguish bitemarks. Some 
early attempts were made to use computer vision tech-
niques to create a “similarity index” between dentition 
and bitemarks, with mild success [27,28]. More recently, 
Kieser et al. found encouraging results when they used 
the amount of deformational energy necessary to warp 
images of scans of casts to match candidate images [29]. 
Another approach has been to meas ure the relationship 
of features to a medial axis [30]. Simple Procrustes dis-
tances have been found to have limited value [25].
Contrast enhancement methods have been pro-
posed to increase the visibility of dental features, but 
without statistical evaluation [31]. Comparisons have 
been attempted using pseudo three-dimensional eleva-
tion maps from grayscale images, again without formal 
meas ures of validity [32].
9.3 Standards
There are no specific standards for image processing 
in forensic odontology; in fact, there are few such 
 discipline-wide imaging standards within forensic sci-
ence in general at the time of this writing. Some disci-
plines have specific historical standards. For instance, 
in the United States, the fingerprint analysis commu-
nity subscribes to a resolution standard of 1000 ppi for 
scanned latent prints and 500 ppi for 10-print cards. 
These standards are derived from transmission require-
ments for the national fingerprint comparison and data-
base system rather than from a scientific determination 
of comparison criteria. Only afterward were studies 
published demonstrating the degree of detail to which 
this actually corresponded [33].
To fill this need, the FBI established scientific work-
ing groups (SWGs), of which the previously referenced 
Scientific Working Group on Imaging Technology is 
one [34]. The SWGIT has proposed general guidelines 
for the handling and processing of images for foren-
sic purposes. Over the past few years, these guidelines 
have been used numerous times in courts in the United 
States to aid in determining the admissibility of digital 
evidence. The remainder of this chapter will address the 
image processing and analysis for evidentiary purposes 117
application of these guidelines with an eye to digital bite-
mark imaging. Similar organizations have responded 
to these needs in the UK through the Home Office, in 
Australia, and in Canada.
9.4 The Digital Work Flow Pipeline
Most digital image processing and analysis tasks fall 
within a predictable work flow. While there are many 
variations, it is most simply viewed as consisting of four 
steps. Images are acquired or received, processed, ana-
lyzed, and then a report is generated. Each of these, in turn, 
consists of substeps—each with specific guidelines.
9.4.1 images as Evidence
Whether or not a given image requires formal evidence-
handling processes is a matter of local jurisdictional 
requirements. In general, primary images (defined later) 
almost always require careful handling that preserves 
chain of evidence. In contrast, working images often do 
not. Whatever the circumstance for a particular juris-
diction, standard operating procedures (SOPs) should 
be in place to formalize the handling of images for evi-
dence. SOPs must, of course, conform to the require-
ments of individual jurisdictions. Most formal SOPs 
include a statement of the name, date, scope, and pur-
pose. Commonly, they delineate the equipment used, the 
methods of calibration and standardization, known lim-
itations of the method, steps in performing the task, ref-
erences to the method, and ancillary information [35].
9.4.2 image Acquisition and Archival
Often, forensic odontologists do not have the opportunity 
to photograph injuries, but instead receive the images 
from an outside authority or consultant. In other cases, 
the odontologist may take the photographs. Proper pho-
tographic techniques are addressed in other chapters. Of 
importance to image processing is the recognition that 
all methods of digitization involve inherent digital image 
processing, whether it is the scanning of a photographic 
print or the use of a digital camera, for instance. This sec-
tion will concern itself primarily with digital photogra-
phy. Other acquisition methods have analogous issues.
Digital processing is inherent in the conversion 
from camera sensor signals to pixels forming image 
data. The basic camera and optional in-camera pro-
cessing influence the image appearance and may affect 
interpretability. These settings are often recorded in 
metadata contained in the image header, as well as other 
data such as time and date stamps and even GPS data 
[36,37]. But, however they are recorded, they should be 
noted. It should also be noted that some image process-
ing programs modify or remove metadata;if header data 
are used as a documentation technique, care should be 
taken to make sure that they are not lost.
9.4.2.1 Storage Format
Storage format is also important. The format must be 
able to store the data that are acquired. For instance, 
images may be in pixels with separate red, green, and 
blue values. The number of colors that can be repre-
sented in this representation is a function of the number 
of bits allocated for each color. Thus, a 24-bit image that 
stores 8 bits in red, 8 bits in green, and 8 bits in blue can 
store 28 × 28 × 28 = 255 × 255 × 255 = 16,581,375 col-
ors. Some devices can store 48-bit images. In contrast, 
some formats can store only a very limited number of 
colors. For instance, graphics interchange format (GIF) 
images traditionally store only 255 colors in a “palette” 
and all pixels in an image use one of those colors [38]. A 
traditional format developed by the Joint Photographic 
Experts Group (JPEG) can store a maximum of 24 bits, 
and common variants of the tagged image file format 
(TIFF) can store up to 16 bits per color for a total of 
48 bits [39,40]. It is important to make sure that the for-
mat can represent the data.
Most file formats also include some sort of compres-
sion algorithm and many allow a choice of compression 
methods. Some algorithms allow complete reconstruc-
tion of the original image data and are called “loss-
less” algorithms. Some make decisions about what is 
important data and discard the data considered unim-
portant; these methods are called “lossy.” Lossy meth-
ods usually achieve much greater compression, but at 
the loss of information.
As an example, consider a simple method of com-
pression called “run-length encoding.” In this method, 
the compression algorithm replaces repeated values by 
the value and the number of repetitions. Consider the 
following series:
101 101 101 101 101 100 100 100 101 101 102 102 
102 102 102
This series has 15 values and 45 digits. There are five 
instances of 101 followed by three instances of 100 fol-
lowed by two instances of 101 and then five instances 
of 102. If one replaces the original data by a run-length 
encoding, one gets:
101 5 100 3 101 2 102 5
118 Bitemark evidence: a color atlas and text, 2nd edition
This provides a total of eight values and 16 digits—47% 
compression in terms of numbers and 65% in terms of 
digits. It is possible to reconstruct the original data from 
this encoding and it is thus “lossless.”
There are a number of lossless compression algo-
rithms, a discussion of which is beyond the scope of 
this chapter. The most common in use at the moment 
is TIFF. It should be noted that the TIFF format, 
often presented exclusively as a lossless format, does 
allow lossy JPEG compression (described later) in 
some implementations. Practitioners who use pro-
grams that allow JPEG compression in TIFF formats 
should take care that they are not inadvertently los-
ing data. In contrast, if one makes the assumption 
that any change of one unit or less is irrelevant, one 
can replace all the values with 101 in the preceding 
example, perform run-length encoding, and get the 
following result:
101 15
This provides a total of two values and five digits—87% 
compression in terms of values and 89% in terms of dig-
its. However, it is impossible to reconstruct the original 
data from this encoding. Because data are lost, this is 
called lossy compression.
Of course, practical lossy compression methods are 
more complex and sophisticated than this simple exam-
ple, but the effects are still noticeable. A popular com-
pression method is defined by the Joint Photographic 
Experts Group and is incorporated into two formats: 
Exif (exchangeable image file format) and JFIF (JPEG 
file interchange format), both of which are commonly 
known as “JPEG” formats. JPEG/Exif is more commonly 
used in digital cameras, though it is not supported by 
the newer JPEG2000 standard [41]. JPEG compression 
segments the image into 8 × 8 pixel squares and a lossy 
compression algorithm is applied to each square. The 
user often selects a quality parameter that dictates how 
much data is discarded. In many cases, the data loss is 
visually unapparent at higher quality settings, but can 
still become obvious when the image is enlarged or 
contrast enhancement methods are applied. As shown 
in Figures 9.6–9.8, lossy JPEG compression results in a 
visually similar image when viewed without enlarge-
ment (Figures 9.6 and 9.7); however, the small squares 
used for compression become obvious upon contrast 
enhancement and enlargement (Figure 9.8).
Most guidelines suggest that images to be used for 
analysis should be stored using only lossless compres-
sion [42]. Most also recognize, however, that the qual-
ity requirements of an image are dictated by its use and 
purpose. For instance, the UK Home Office notes that 
“the format is not relevant to the admission of the evi-
dence, only that the quality is fit for purpose” [43]. The 
SWGIT recommends that “the decision to use lossy or 
lossless compression will be dictated by the intended use 
of the image” [44]. A photograph used merely for docu-
menting who is at a crime scene, for instance, often does 
not need to have the same quality as an image acquired 
for careful analysis of fine detail. Thus, a documentation 
photograph used merely to show where on the body a 
bitemark is may not need to be saved in a lossless man-
ner, but a photograph that will be used for performing 
analysis would be best saved in a lossless format.
To avoid the effects of both in-camera processing 
and compression artifact, some cameras allow the storage 
of images in an uncompressed, so-called “RAW” format 
that often stores the actual sensor data and information 
required to reconstruct a conventional format file. It can 
also include a low-resolution JPEG format image as part 
of the file. RAW formats have the advantage of saving data 
Figure 9.6 Same bitemark, saved using lossless compression (left) and lossy JpeG compression (right), which are visually 
similar.
image processing and analysis for evidentiary purposes 119
before most, and in some cases all, of the in- camera image 
processing. It provides the best access to the basic data.
The disadvantages of RAW format are twofold. 
Most important, many RAW formats are proprietary 
and many require proprietary format for construction 
of a useful image format file. This may result in format 
obsolescence and loss of the ability to retrieve the image 
data if the company goes out of business or decides to 
discontinue support of the format. Thus, some guide-
lines suggest the use of RAW format only as an ancil-
lary format or only if it is an open format. For instance, 
the combined SGIT and Scientific Working Group on 
Digital Evidence (SWGDE) document on archiving dig-
ital and multimedia evidence (DME) notes that “propri-
etary formats are formats that are primarily supported 
by the company producing them. These formats may not 
be supported as new applications become available and 
as technology improves. When possible, DME should be 
retained in its original format and in a nonproprietary 
format” [45].
The second drawback is more practical. High-
resolution RAW images use more disk space and take 
longer to save in some cameras. This may have an 
impact on work throughput. This second issue may or 
may not be of significant impact in any particular situa-
tion and will likely be obviated as technology continues 
to improve.
9.4.2.2 Primary, Original, 
and Working Images
For digital photography, the data produced by the cam-
era are usually stored on some temporary medium such 
as a magnetic card, though a few cameras can write 
directly to small optical media. In either case, this is 
Figure 9.7 the images in Figure 9.6 subjected to contrast enhancement.
Figure 9.8 a close-up of a portion of each of the images in Figure 9.7 taken at the edge of the ruler extending downward 
from the