|Year : 2014 | Volume
| Issue : 3 | Page : 220-224
Dermatoglyphics: A genetic marker of early childhood caries
C Anitha, Sapna Konde, N Sunil Raj, NC Kumar, Preetha Peethamber
Department of Pedodontics and Preventive Dentistry, AECS Maaruti College of Dental Sciences, Bengaluru, Karnataka, India
|Date of Web Publication||2-Jul-2014|
Department of Pedodontics and Preventive Dentistry, AECS Maaruti College of Dental Sciences, Bengaluru, Karnataka
Source of Support: None, Conflict of Interest: None
| Abstract|| |
Background: It is an accepted fact that genetics plays an important role in determination of palmar dermatoglyphic patterns. Since caries is a multifactorial disease with the influence of genetic pattern, this study was undertaken to explore the possibility of dermatoglyphics as a noninvasive and early predictor of dental caries in children, so as to initiate preventive oral health measures at an early age. Materials and Methods: The study group comprised of 200 children aged between 4 and 5 years. The dmfs score was evaluated. The experimental group (Group 1), comprised of 100 children with early childhood caries (ECC) with dmfs >5. The control group (Group 2) comprised of 100 children with dmfs score of 0. Results: An increased frequency of ulnar loops in caries-free children and whorls in children with ECC was observed. Low mean atd angle and low mean. Total ridge count was observed in the ECC group. Conclusion: There is definite variation in dermatoglyphics between the ECC and caries-free group, indicating that dermatoglyphic patterns can be used as a predictive tool for children with ECC.
Keywords: Atd angle, dermatoglyphics, early childhood caries, genetics, total ridge count
|How to cite this article:|
Anitha C, Konde S, Raj N S, Kumar N C, Peethamber P. Dermatoglyphics: A genetic marker of early childhood caries. J Indian Soc Pedod Prev Dent 2014;32:220-4
|How to cite this URL:|
Anitha C, Konde S, Raj N S, Kumar N C, Peethamber P. Dermatoglyphics: A genetic marker of early childhood caries. J Indian Soc Pedod Prev Dent [serial online] 2014 [cited 2019 Aug 21];32:220-4. Available from: http://www.jisppd.com/text.asp?2014/32/3/220/135828
| Introduction|| |
Lines on the human hands have since long been a subject of interest. The skin of palm and sole has ridges, unique to every individual and has been used for personal identification. "Dermatoglyphics" as coined by Cummins and Midlo  refers to the study of the intricate dermal ridge configurations on the skin covering the palmar and plantar surfaces of hand and feet and has been investigated extensively by many researchers. Etymologically this term is a harmonious blend of two words derma, i.e., skin; and glyphe, i.e., carve, giving the impression that something has been carved out of the skin. The dermal patterns once formed remain constant throughout life. 
Through decades of scientific research, the hand has been recognized as a powerful tool in the diagnosis of psychological, medical and genetic conditions. It has proved to be a helpful adjunct to other diagnostic methods in identifying specific syndromes of genetic origin.  Dermatoglyphics is considered as a window of congenital abnormalities and is a sensitive indicator of intrauterine anomalies and known to be one of the best available diagnostic tools in genetic disorders. 
Dental caries is the most prevalent chronic disease seen in children worldwide, and despite advancements in oral healthcare, many adults, and children are still affected. The etiology of dental caries is complex and multi factorial, including environmental and genetic factors. The magnitude of each of these factors contributing to caries can vary significantly on an individual basis. 
There are various methods to diagnose early childhood caries (ECC). However, so far, there is no method to predict ECC. The basis of considering dermatoglyphic pattern as genetic marker for dental caries is that the epithelium of finger buds as well as enamel which is the most susceptible dental tissue to dental caries have ectodermal origin and both develop at the same time of IU life.  Several studies have shown that dermatoglyphic patterns are genetically determined. ,,, So any problem at this particular period will have its effect on both enamel as well as on the dermatoglyphic patterns. 
The present study was undertaken to establish a correlation between dermatoglypic patterns and ECC, to identify the susceptible children so as to enable early prediction and protection from dental caries.
| Materials and Methods|| |
The study sample consisted of 200 children aged between 4 and 5 years, divided into two groups of 100 children each. The dmfs score was evaluated to select the experimental group and control group. The experimental group (Group 1), comprised of 100 children with ECC with dmfs >5. The control group (Group 2) comprised of 100 children with dmfs score of 0. The study design, objectives, and methodology were explained to the selected children and their parents. Written consent was obtained prior to the study from the parents.
Dermatoglyphic pattern recording and interpretation
Finger and palm prints were recorded using the ink method described by Cummins and Midlo.  The hands of the children included in the study were washed with soap and water to remove dirt and oil from the ridged skin and blot dried to improve the quality of the prints.
The finger prints (right and left) of all the subjects were recorded for the study by using black duplicating ink, which was applied on the fingers with cotton swab. The digits were guided and pressed firmly against the white bond paper clipped on to a board.
The palm prints (right and left) of all the subjects were recorded using black duplicating ink, which was smeared on the palms and pressed on a sheet of recording paper which was kept firm. A sponge pack was placed beneath the paper, to record the hollow of the palms so as to eliminate any incorrect interpretation of the epidermal ridge pattern.
The handprints obtained were checked for their clarity with a magnifying glass (×2) and coded. The presence of core and the triradii of the dermatoglyphic pattern was checked thoroughly to include the handprint in the study. A total of 2000 digital prints and 400 palmar prints were obtained.
| Method of Reading Handprints|| |
The handprints were observed in a sequential manner under a magnifying glass with ×2 power, from the left hand 4 th digit until the thumb followed by the thumb of right hand until the 4 th digit. Dermatoglyphic analysis included the following: Qualitative analysis that includes fingertip patterns and Quantitative analysis that includes finger ridge count, total finger ridge count, and distal deviation of axial triradius or atd angle.
| Qualitative Dermatoglyphic Analysis|| |
Type of dermatoglyphic pattern
The frequency of true patterns of loops, whorls, and arches was counted on the fingertips of all the 10 digits of children with ECC and caries-free children. They were assessed for increase or decrease in mean frequencies.
A loop [Figure 1] is recognized as a series of ridges that enter the pattern area on one side of digit, recurves abruptly and leaves the pattern area on the same side. A single triradius is present, which is located laterally on the fingertip, where the loop is closed. If the ridge opens on ulnar side it is called as ulnar loop and if it opens toward the radial side it is called as radial loop.
A whorl [Figure 2] differs from the loop in the aspect of concentric arrangement of ridges, with two or more triradii in the latter. A whorl may be spiral, symmetrical, double looped, central-pocketed or accidental, depending upon the internal structure of the whorl pattern.
In all the dermatoglyphic patterns seen, arches [Figure 3] show the simplest ridge pattern, which is formed by the succession of one or more parallel ridges, which cross the finger from one side to the other without recurving. These patterns usually do not show the presence of triradii, except when the tented arch is present that will have a triradii point near its midline.
| Quantitative Dermatoglyphic Analysis|| |
Total ridge count
A ridge count [Figure 4] is made by drawing a line (blue line) from the triradius (green dot) to the center (red dot) of the pattern (core) and determining the number of intersected ridges between these two points. Arches score zero because they have no triradii and thus there are no ridges to count. A loop has one triradius. In whorls, which have two triradii, counts are made from each triradii and the larger one is used. A total ridge count (TRC) is the summation of the ridge count for all 10 fingers. It was assessed for increase or decrease in mean frequencies between the groups.
A feature of the palm that captures the relative position of three triradii-a and d, usually located on distal palm just inferior to the 2 nd and 5 th fingers, respectively and t whose location can vary on the proximal palm from just distal to the wrist, up to the center of the palm. Atd angles [Figure 5] were measured for each palm print by drawing two straight lines through the "a" and "t" triradii and the "d" and "t" triradii and measuring the resulting angle. The atd angles were compared and assessed for increase or decrease in mean frequencies between the groups.
The obtained data was calculated using relevant statistical tools such as Mann-Whitney test with level of significance: α = 0.05. The decision criterion was to compare the P value with the level of significance.
| Results|| |
The evaluation and comparison of patterns in children with ECC and caries-free children in both right and left hands [Table 1] showed a statistically significant (P < 0.001) increase in the number of loops in control group when compared to ECC group. Higher number of whorls was found in ECC group as compared to control group in both hands, which was statistically significant (P < 0.001). The number of arches in control group was marginally higher as compared to ECC group in both hands. However, this was not statistically significant. The mean atd angle [Table 2] was found to be higher in control group when compared to ECC group in both hands, which was statistically significant (P < 0.001).
|Table 1: Evaluation and comparison of patterns in children with ECC and caries-free children|
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|Table 2: Evaluation and comparison of atd angle in children with ECC and caries-free children in both right and left hands|
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Higher TRC [Table 3] of 144.23 + 23.60 was found in the control group as compared to 133.96 + 8.28 in the ECC group which was statistically significant (P < 0.001).
| Discussion|| |
Widespread interest in epidermal ridges developed only in the last several decades when it became apparent that many patients with chromosomal aberrations had unusual ridge formations.  Dermatoglyphic patterns make good material for genetic studies, because unlike stature, intelligence, and body weight, they are not significantly influenced by age or by postnatal environmental factors. Dermatoglyphics have the advantage of remaining stable throughout life and therefore can be compared among individuals of different ages. A good print makes a permanent and complete record providing both qualitative and quantitative data. 
Dermal ridge differentiation takes place early in fetal development. The finger and palm prints are formed during the first 6-7 weeks of the embryonic period and are completed after 10-20 weeks of gestation. , Abnormalities in these areas are influenced by a combination of hereditary and environmental factors, but only when the a combined factors exceed a certain level, can these abnormalities be expected to appear. This threshold theory advanced by the studies of Carter (1969) and Matsunaga (1977) is now generally accepted. ,
The basis of considering dermatoglyphic pattern as genetic marker for dental caries is that the epithelium of finger buds as well as enamel which is the most susceptible dental tissue to dental caries have ectodermal origin and both develop at the same time of IU life. Several studies have shown that dermatoglyphic patterns are genetically determined. Any disturbance at this particular period affect both enamel as well as the dermatoglyphic patterns.  Studies have established a strong correlation between dermatoglyphics and dental caries. ,,
Dermatoglyphic interpretation of patterns in the digits of caries-free children in this study showed maximum loops followed by whorls and arches in both right and left hands, whereas the ECC group showed maximum occurrence of whorls followed by loops and arches. Among the two types of loops, ulnar loops were the most common pattern seen and radial loops were the least common in both groups. These findings are in accordance with studies done by Atasu, Sharma and Somani, Madan et al., and Ahmed et al. ,,, who found an increased frequency of ulnar loops in caries-free children and an increased frequency of whorls in children with dental caries. The majority of whorl patterns in the control group were spiral while the ECC group showed spiral, central pocket and double loop. Similar results were shown in a study by Ahmed et al.  Arches were the least common patterns in both groups.
The axial t triradius was wider in the control group (>56°) than in ECC group (between 45° and 56°); this is in agreement with Atasu,  where the caries-free children had more t triradii than that of the children with extensive caries. Ahmed et al.  studied the correlation between dermatoglyphics and dental caries and found that the atd angle was >56° in the control group while in the experimental group it was between 45° and 56°.
The ridge count for each finger of an individual was found and the total ridge was count obtained by adding the values for all 10 fingers. The quantitative analysis of the TRC in caries-free was higher when compared to the ECC group. Similar findings were reported by Atasu, Madan et al. and Ahmed et al. ,,
In the present study, we found that the children with dental caries showed an increase in the whorl patterns on the distal phalanges of the ten fingers, a decrease in the atd angle and TRCs as compared to the normal children which indicates the degree of developmental instability of the study group. A definite correlation in the dermatoglyphic patterns between children with ECC and caries-free children can be seen in this study. Thus, recording the dermatoglyphic patterns of children at an early age, during their first dental visit will be handy in predicting whether the child belongs to the high risk group or the low risk group and thereby can aid in planning a definitive preventive and treatment strategy.
| Conclusion|| |
Caries is a multifactorial disease with the influence of genetic pattern. The present study shows a definite variation in dermatoglyphics between the ECC and caries-free group indicating a correlation between dermatoglyphics and dental caries. Dermatoglyphics can prove to be an extremely useful, noninvasive and cost-effective tool for preliminary investigations into conditions with a suspected genetic base. Early detection can aid the clinician to anticipate oral health problems in the susceptible children and initiate preventive oral health measures at a very young age. This study opens a new arena for dermatoglyphics as a genetic marker of ECC. However, further large scale observations should be undertaken to evaluate the significance of these variations in the dermatoglyphic pattern in children with ECC.
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[Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5]
[Table 1], [Table 2], [Table 3]