Unique Denture Identification System for All Indian Nationals.

Marking dental prosthesis has always been considered an important part of forensic dentistry. Denture identification systems are important not only for patients in health-care facilities, old-age homes, and hospitals but also in medico-legal cases. In India, no standardized method is being followed for labeling of the dentures. This article proposes a technique of denture marking that gives permanent, unique, and global identification to all the Indian nationals using Aadhaar - a universally accepted identity for Indian nationals. The information on the card can be printed on a piece of paper or a plastic card and the Aadhaar card quick read code/number can be easily and cost-effectively used for marking all the newly constructed or existing prosthetic devices.

Introduction

Denture marking is the recommended procedure recognized by forensic odontologists and most International Dental Associations.[12] However, in a developing country like India, very little is known about denture marking, its advantages, and its necessity. Most of the techniques are too expensive, time-consuming, may not be esthetic, and do not permit the incorporation of a large amount of information.[34]

The technique described in this article proposes - unique, reliable, least expensive, quick, and easy method of denture marking using Aadhaar card quick read (QR) code and number.

Unique Identification Authority of India (UIDAI) Aadhaar card project gives each Indian citizen a unique 12 digit identification number, along with recording their biometrics such as iris scan and fingerprints on a UIDAI database and the card is being rolled out to all eligible citizens.[5]

As the possession of Aadhaar card has been made mandatory for all the Indian nationals, it can easily be used as an identification method in forensic odontology for the Indian natives.

Three key characteristics of Aadhaar number are as follows:[5]

Permanency (Aadhaar number remains same during the lifetime of a resident)

Uniqueness (one resident has one identity [ID], and no two residents have the same ID)

Global (same identifier can be used across applications and domains).

Aadhaar card is used as proof of identity (ID), proof of address as well as proof of age when an individual is applying for jobs in public and private sectors. In this way, it is a very versatile card, as it can be used for all government-related services and programs. Aadhaar can be downloaded onto any device and displayed when required. The central government has issued a notice making it mandatory to link existing Aadhaar numbers with Permanent Account Number of taxpayers with effect from July 1, 2017. Thus, it would not be wrong to say that Aadhaar is the single most important government-issued document an Indian individual should possess.[5]

The Aadhaar card number/QR code/barcode when scanned even on an ordinary smartphone gives authenticated complete information about the individual in a very concise form.

Technique

A completely edentulous patient was randomly selected and explained about the complete procedure and advantages of marking a denture

With the written consent of the patient, his Aadhaar card number and QR code was received, for incorporation into the denture

A photo of the patient's Aadhaar card QR code was clicked using ordinary cell phone camera (13 Megapixel) and printed on photographic paper (similar in size of the Aadhaar QR Code)

Standard procedure for the fabrication of a conventional complete denture was followed, and the denture was finished and polished

On the polished surface of the posterior palatal region of the maxillary denture, a slot 1.8 cm × 1.8 cm in dimensions and 1.5 mm in depth was made using acrylic trimming bur to accommodate the Aadhaar card QR code [Figure 1]

Figure 1

Slot to accommodate Aadhaar quick read code

Same way on the polished surface of the distolingual flange of the mandibular denture base, a slot of dimensions 3.5 cm × 0.5 cm and 1.5 mm deep was made to accommodate the Aadhaar card number [Figure 2]

Figure 2

Slot to accommodate Aadhaar number

The photographic paper with the QR code print (dimensions - 1.7 cm × 1.7 cm) was laminated with cellophane sheet to protect the ink from coming in direct contact with the monomer particles

The laminated QR code was precisely placed in the slot prepared without any fold in the denture base and clear self-polymerizing acrylic resin (DPI-RR Cold Cure, DPI Products and Services Ltd., Mumbai, India) was mixed following manufacturer's instructions and placed over QR Code to fill the slot and was allowed to set [Figure 3]

Figure 3

Barcode incorporated into denture

The denture was again polished for enhanced clarity of the embedded QR code [Figure 4]

Figure 4

Polished denture with embedded quick read code

The same procedure was followed for the incorporation of laminated photographic paper with the Aadhaar card number in the mandibular denture base

The Aadhaar QR code was scanned using an ordinary scanner of the smartphone or by scanning through any downloaded QR scanner app on mobile phone and complete information such as name, father's name, age, sex, and address was easily retrieved [Figures 5–8].

Figure 5

Cellphone scanner to decode the quick read code

Figure 8

Postoperative view showing maxillary denture with embedded Aadhaar quick read code and mandibular denture with embedded Aadhaar number

The quick read code decrypted

Complete information retrieved by scanning Aadhaar quick read code

Discussion

In the United Kingdom, a bonus is offered by the National Health Service to the dentists who label the dentures of the patients, who are in “house” care. In the US, the social security number of the individual is marked on the denture, but this marking is mandatory only in 21 states.[1] Australia uses tax file numbers of the individuals, while in Sweden, the patient's unique personal ID is marked on a metal band and incorporated in the denture.[3678] Unfortunately, in India, prosthesis/denture marking is neither taught nor practiced.

The denture marking systems are advantageous as they help in patient identification in natural and mass disasters, prosthesis identification in geriatric institutions, regeneration of dental records in cases of emergencies such as accidents, diagnostic, and decision support in medico-legal cases. Furthermore, labeling a denture makes recording and storage of patient's details on an easily accessible system.[9]

The two methods of denture marking that have been followed are the surface marking methods and the inclusion methods.[24510] The surface method is relatively inexpensive and easy to apply. There is no requirement of skilled personnel, but the disadvantage is that they wear off very easily. The inclusion method is relatively more permanent and provides a more predictable result, but it could create porosity, thus leading to weakening of the denture. Another disadvantage is that it is more expensive and is usually made by trained personnel in dental laboratories.[11]

In India, we need a method that is cost-effective and could be easily identified by all the people of the society. The Aadhaar card QR code/number serves just the above-mentioned purpose.

Most countries have unique identification numbers for its individuals.[81213] In India, the Aadhaar card number issued by the UIDAI can be used as denture labels. The UIDAI provides an Aadhaar card, i.e., a unique number issued to every citizen in India and is a centralized and universal identification number. The Aadhaar card is a biometric card that stores an individual's personal details in a government database. It provides a national platform for ID authentication and can be used to deliver services effectively to residents across the country.

The most suitable placement for dental marking is the posterior palatal surface of the maxillary prosthesis and distolingual surface of the mandibular prosthesis because these areas are easily accessible for reading, the esthetics of the prosthesis are least affected, and there is a sufficient thickness acrylic resin for making slot and marking placement.[9]

Conclusion

Aadhaar is the world's largest biometric ID system, with over 1.133 billion enrolled members as of March 31, 2017. As of this date, over 99% of Indians aged 18 years and above had been enrolled in Aadhaar.[3] An Aadhaar card gives you an official identification as an Indian citizen. Dentures with Aadhaar QR codes can be easily recognized with the help of a mobile camera. The importance of denture marking using Aadhaar card QR code/number should be emphasized by all law enforcing authorities and should be promoted among all dentists, toward making it a compulsory routine dental procedure throughout the country.[14]

Financial support and sponsorship

This study was supported by Sudha Rustagi College of Dental Sciences and Research, Faridabad, Haryana, India.

Conflicts of interest

There are no conflicts of interest.