EP 93 | Amber Riley | Forensic Odontology |

Join us for an exclusive interview with Amber Riley, an esteemed international speaker renowned for her expertise in forensic odontology and oral pathology. With a wealth of experience, Amber delivers comprehensive continuing education programs to dental and medical professionals worldwide. She serves as a Forensic Dental Consultant to the San Diego County Office of the Chief Medical Examiner and plays a crucial role in the U.S. Government disaster mortuary operational response team. Amber's contributions extend beyond her forensic work; she is an advisory Board Member to the Oral Cancer Foundation and a professional risk and liability consultant specializing in dental sciences. Her credentials include being the President of the American Society of Forensic Odontology, a Fellow of the American Academy of Forensic Sciences, and memberships in esteemed associations like the International Association of Coroners & Medical Examiners, the California Dental Hygienists’ Association, and the American Academy for Oral Systemic Health. 

Join us as we delve into compelling discussions on forensic odontology, pathology, and a myriad of related topics. Don't miss this opportunity to gain insights from a leader in the field!

Originally aired on: Dec 14, 2023

Transcript

00;00;00;00 - 00;00;29;29


00;00;29;29 - 00;00;48;25
Speaker
Hi everyone, it's Eugene here. And welcome to another edition of Forensics Talks. This is going to be episode 93. Yeah, definitely in the nineties, which is kind of cool. And my guest today is Amber Riley, and we're going to be talking about a whole bunch of different things in forensic dentistry. And so, I'm glad you can join us today.

00;00;48;25 - 00;01;18;28
Speaker
So, we're going to talk about Amber Riley. And Amber is an internationally recognized speaker, providing continuing education programs for dental and medical professionals covering oral and systemic pathologies, forensic ontology and the use and misuse of therapeutic and illicit substances. She's a forensic dental consultant to the San Diego County office of the chief Medical Examiner, federal safety and occupational health specialist and member of the Forensic Dental Unit of the US Government Disaster Mortuary Operational Response Team.

00;01;18;28 - 00;01;41;20
Speaker
I think that's DMORT an advisory board member to the Oral Cancer Foundation. And a professional risk and liability consultant and specializing in the dental sciences to national medical, dental, liability insurance brokerages and a certified medical cost projection specialist for civil litigation casework. She's the president of the American Society of Forensic Ontology. So, hey, we went right to the top here.

00;01;41;22 - 00;01;56;07
Speaker
And she's also a fellow of the American Academy of Forensic Sciences, member of the International Association of Coroners and Medical Examiners and other organizations. She does a lot of teaching. She's been online. She posts. In fact, I think that's where I first

00;01;56;07 - 00;02;01;05
Speaker
became aware of Amber Riley, and I think it was just from LinkedIn or something like that.

00;02;01;08 - 00;02;03;22
Speaker
And we've never actually met in person.

00;02;03;22 - 00;02;06;14
Speaker
But she was actually quite helpful in the past with

00;02;06;14 - 00;02;09;28
Speaker
recommending speakers and that sort of thing. So let me bring her in here right away.

00;02;09;28 - 00;02;11;04
Speaker
There she is, Hey

00;02;11;04 - 00;02;12;05
Speaker
Hi, Eugene.

00;02;12;05 - 00;02;23;29
Speaker
Hey, welcome, We finally... Well, I did speak to you, and I think it was well, it was early on when Forensics Talks started because you recommended there were a couple of people you recommended.

00;02;23;29 - 00;02;49;25
Speaker
I don't remember the other person, but it was definitely James Goodrich was one of them. Yeah. Jimbo, right. And I don't remember who the other person was. Colleen, Coleen Fitzpatrick, Genealogist. Yeah, the genealogist. Right, right, right. Yeah. So, thank you so much for recommending them. And you were long overdue, but we finally get you there. My pleasure. I mean, I like I've followed your channel for from almost the beginning.

00;02;49;25 - 00;02;54;05
Speaker
I think so I'm very humbled, actually to

00;02;54;05 - 00;03;12;17
Speaker
to be in the community of these individuals that I've considered are far more interesting and well than I am. But I'm happy to be here. Oh, great. Yeah. I mean, I mean, you post a lot of stuff. I mean, you post online every now and then and yeah, LinkedIn is the only social media that I use.

00;03;12;17 - 00;03;27;20
Speaker
I'm not. You wouldn't find me anywhere else. And so, but that and I do keep it very strict with professional but that's how we met Yeah for sure but you, but you post in many different areas, and I think that's going to be why we have plenty to talk to. I mean, yeah, talk about

00;03;27;20 - 00;03;29;08
Speaker
human trafficking,

00;03;29;08 - 00;03;30;23
Speaker
missing persons.

00;03;30;23 - 00;03;33;18
Speaker
You've talked about obviously, forensic or ontology.

00;03;33;18 - 00;03;35;06
Speaker
You talk about pathology.

00;03;35;06 - 00;03;51;16
Speaker
Yeah, just a lot of cool stuff. So. Well, let me begin by asking you about your beginnings. And I always I always I'm always curious about people when they were kids, like when they were young, you know, I don't know why. Oh, that part. Yeah. Like, I go way back, right?

00;03;51;16 - 00;04;19;22
Speaker
So, I, I don't know, like with me, I was always like, you know, geeky techie. I loved all the little, you know, games and things like that. Yeah. Were you, were you always, like, medically sort of inclined to think you were so Midwestern girl born and raised in Dayton, Ohio. And both of my undergrads for my undergrad in dental hygiene and my second undergrad is in psychology.

00;04;19;23 - 00;04;57;08
Speaker
And the I actually know I am very much a black sheep from my family. I am the only member of my family to have gone to college so then graduate school and raised and actually a of a small family that was more just very blue collar, salt of the earth, mom and dad. One sister and they I am a departure from that in that I went into health professions, I went into higher education.

00;04;57;10 - 00;05;27;19
Speaker
I've moved around the country. And so, although we have done the DNA, I am certain that my parents are my parents, and my sister is my sister. Other than that, I am a bit of an outlier. But I've always been bookish. I was always bookish and there is anything I could get my hands on. The library was definitely a good babysitter for me when I was growing up.

00;05;27;21 - 00;05;36;09
Speaker
It was a place where I could be dropped off and left alone. Yeah. Good, good. So, then I understand that

00;05;36;09 - 00;05;58;11
Speaker
you actually had a hygienist, that maybe it was your hygienist, your personal one. I don't know. But that never motivated you is that I would have to go into hygiene up thousand percent. My I was a teenager and this so this is the family practice, general dental family practice that my mom and dad still go to this day.

00;05;58;13 - 00;06;35;10
Speaker
And I was a patient there. And she was always just super bubbly and effervescent. And she was retrospectively I think she was then where I am now in years of practice. And she was just like, I am with my patients. What are you thinking about college, What's interesting to you and all that. And I thought that I was I had felt pulled to nursing definitely into health care, but I thought nursing and she said, well, have you ever thought about dental hygiene?

00;06;35;10 - 00;07;00;04
Speaker
And I hadn't. I it had never occurred to me to think about dental hygiene as my foundational profession of health care. And she was just sick as well. You know, the hours are great, the money is great, the environment's great. I've never had a patient die on me. You should come and spend the day with me and just, you know, hang out in the office.

00;07;00;04 - 00;07;22;19
Speaker
And of course, the dentist was super great with that. He's my family dentist, my family's family dentist. And I did. I went in and I shadowed her like a little bug on her shoulder. And she at that time, I had I was already enrolled in community college. And the community college that I went to have a nursing program.

00;07;22;21 - 00;07;45;21
Speaker
It had a hygiene program and it had physical therapy, but all of the core courses were exactly the same. All the anatomy and physiology, chemistry, pharmacology, all of those courses were exactly the same. And then you just branched off into your clinical domain of where you were going to specialize. And so, I just changed my major from nursing to dental hygiene.

00;07;45;21 - 00;08;11;24
Speaker
And I didn't lose a beat and I'm so glad I did. I think that had I stayed in nursing, I would have I'm sure I would have still taken that foundation and gone and in greater rings out of it like I have for hygiene. But I'm so I'm so thankful that she did that for me because I just fell in love with dentistry.

00;08;11;24 - 00;08;38;21
Speaker
Just the home has done is true. Love it. And so, I have tried to always be her to my patients. Coming up, young women and young men that ask them, what are you into? And have you thought about how to do that and that, you know, doing the same thing she did for me, which was like, Hey, why don't you just come in and spend half a day with me and, you know, see it from the clinician side instead of just the patient side.

00;08;38;24 - 00;09;27;08
Speaker
So, a dental hygienist, obviously, I don't know if it's like medicine or other areas, but there are their differences in different states and what you can do or what you can't do. Yeah, yeah. This scope of practice for a dental hygienist is different in in different states. I have three active vice insurers. I'm licensed in Ohio, Washington State and California, and even though I'm the same individual with the same training, education and experience, my scope of practice in each state is different when it comes to patient based care that they, in example, in the state of California and in the state of Washington, I may use a laser, a diode laser or an M.D. YAG

00;09;27;08 - 00;09;55;19
Speaker
laser, a soft tissue wavelength in the scope of practice of treating, arresting, intervening in periodontal disease. But in the state of Ohio, I cannot in the state of Washington, I can place a restoration in a prepared tooth and in the state of California and in the state of Washington or in the state of California, in Ohio, I mean, not thankful them.

00;09;55;23 - 00;10;23;08
Speaker
So, you have to know that you do have to know your scope where dentistry the scope is ubiquitous, but in dental hygiene, it is an okay and a yeah. So, a dental hygienist, you can administer drugs and things like that, like local anesthetic in all three states. As far as a drug, but definitely as a drug. But in that would be in a kind of practice setting.

00;10;23;13 - 00;10;36;19
Speaker
Yeah. Okay. And then that covered gave us some new legislation in California for the administration of vaccines. But, you know, it was it took literally an act of the state house to

00;10;36;19 - 00;10;40;20
Speaker
to recognize that Dennis and hygienist were going to be

00;10;40;20 - 00;11;10;16
Speaker
competent medical providers to increase the workforce for the delivery of vaccines. When we were in the beginning of that vaccine rollout, I mean, administering like an anesthetic in the mouth is like drinking urine hand much more significant nuance to take a, you know, a four-inch 27-gauge needle through a labyrinth of invisible space to deliver anesthetic accurately versus the deltoid.

00;11;10;23 - 00;11;38;10
Speaker
I know, but you're right. So, on a day-to-day basis, though, you have a practice, right? That's what you do. You have patients. I'm in a practice. I don't them in California, though again, states are different. In California, I hygienists actually can practice completely independently. We're self-governed in the state of California. Our licensure and discipline are a separate board away from the board of dentistry.

00;11;38;12 - 00;12;05;13
Speaker
But I am in in practice under practice is that are owned by dentists. Okay. Now you have sort of a unique position because, you know, there probably not a lot of hygienists that are doing like everything that you're doing right now. So, I'm wondering about what was it that got you sort of pushed into this forensic area like forensic dentistry and stuff?

00;12;05;13 - 00;12;31;10
Speaker
Like was there early training that you had? Like what? What, what was it? Yeah, yeah. Oh, for sure. So, well, both sides of it, because I have the civil side of forensics versus the, the clinical or I'd say more and more based side of forensics, forensic like to just the, the, the SAC term for all of my, my nerds, my Ozark.

00;12;31;10 - 00;13;18;23
Speaker
And I said, I said people, you know, Ozark just defines the word forensic is methods or techniques or processes that are related to the law or legal matter. So then taking the foundation of the dental professions, I, I took a so two things happened to be cut kind of close together earlier on in my career that's that was one was I took a very intro level forensic ontology course in in the state that was delivered by a forensic to ontologies and it was very light but it was just about the work and it as a service to community or county, multiple fatality situations.

00;13;18;23 - 00;13;41;08
Speaker
And it was just the first time that I had seen the use of my day-to-day antemortem record that I develop every single day or add to every single day that I treat patients being used in the application of this legal matter of identity. Identity. The name on the death certificate is very much a legal matter.

00;13;41;10 - 00;14;05;05
Speaker
And then so it piqued my interest just a little bit. But I, like so many others, just starting out, you know, you don't know who do I call, where do I look? And I had a wonderful patient that was an FBI agent. And so, I called him up and it's like, hey, this is Amber, I'm your hygienist. And he's thinking he's missed an appointment.

00;14;05;05 - 00;14;21;00
Speaker
And he's like, Oh my God. She goes, Am I supposed to be there? I'm so sorry. And I said, No, no, no, ma'am. But hey, do you know anybody that works for the McDermott County Coroner's Department? And that was the county that we were both in, in Dayton, Ohio at the time. And he's like, Yeah, I know everybody.

00;14;21;00 - 00;14;41;16
Speaker
Why? What did you do? Do you need someone gone? You need someone like, gone, gone? Because that's another call. It's going to take me a couple of days. Yes, he did. So, I just again, a wonderful personality and a willingness for mentorship. And he goes, it goes. Let me tell you what I can do. Let me introduce you to so-and-so.

00;14;41;16 - 00;15;13;18
Speaker
And she was she was a medicolegal death investigator for the county of the county coroner, but she was a nurse and she had left nursing to go into death investigation and medicolegal investigation. And he introduced me to her, and I set up an appointment with her. I go to the county, we sit down, get to know each other a little bit, and then they let me observe an autopsy from way far away across the room, you know, because they don't know me.

00;15;13;20 - 00;15;47;15
Speaker
And I've never been exposed to anything like this before. I might end up just being another body on the floor and 50 sec and state on that. But then what they did but what she did for me from there, again, the mentorship is so critically important is that she gave my information to the ontologies that that county used and allowed the ontologies then to make the decision to reach out to me, because this is some newbie you don't know about, but she's looking for mentorship.

00;15;47;17 - 00;16;29;14
Speaker
And he was willing and that was Dr. Frank Wright in Cincinnati, Ohio. And he was willing to you know, he gave me old casework. He gave me textbooks. He gave me he introduced me to the Asafo, which is the American Society of Forensic Ontology, which is an all-inclusive equal level, all welcome organization. And that those first couple of people that were just willing to mentor even though I wasn't the and again the naivety was probably an asset because I didn't know that there weren't a lot of high Janis or non dentists that participated in the work.

00;16;29;14 - 00;16;59;09
Speaker
And I think that naivete was an asset because I also wasn't distracted by, by someone that would say no, she's not exactly like me, she can't write. And I was just mentored and protected and nourished by people that didn't give any air to that kind of an attitude. And this was around what year that was 90. And that would have been 2000, early 2001.

00;16;59;09 - 00;17;32;23
Speaker
It was before 911. Okay. Okay. 911. And then after 911, I it was really, really deeply tattooed on me because at that point I was aware of several individuals, dentists and anthropologists and pathologists that were now responding to New York and to Pennsylvania and to Washington DC for that work. And it I was I was very, very motivated.

00;17;32;23 - 00;17;55;02
Speaker
And I really had my eyes open to the enormity of the mixed disciplines that were going to be involved to handle a fatality situation like that. Okay, let's get one. I wanted to ask you about. It was 2006, and I wasn't familiar with this, but it was called the Armed Forces Institute of Pathology. And it was. What can you tell me about there was some like training thing that way.

00;17;55;05 - 00;18;25;10
Speaker
Yeah, that was that was the first immersion course in forensic ontology that I took in, and it was the Armed Forces Institute of Pathology. And they had a week like about us. I feel like it was a six-day immersive class in ontology, intense so long days, nine, ten-hour days with homework every night, hands on multiple speakers from multiple disciplines.

00;18;25;13 - 00;19;01;13
Speaker
Definitely ontology, but also anthropology. Also, police, Federal, state, county level death investigation scene preserve Asian photography. I mean, it was like sipping water out of a firehose. And sadly, that that particular program has been retired. But there is other there are other immersion classes in the United States that I would I couldn't say that it takes the place of, but it fills a bit of the space.

00;19;01;15 - 00;19;28;03
Speaker
Okay. Okay. I gotcha. I was yeah, my patient, my FBI patient. He helped me get into that class, too. I don't know what back he scratched because there was me and 3 to 3 or four other hygienists and mostly dentists and medical doctors that were in that class and nurses of a maybe 150 people that had registered.

00;19;28;03 - 00;19;55;03
Speaker
And so, again, the not knowing until, you know, yeah, he provided a reference. I think, for me. So what is the what is the hierarchy like between or what is the relationship between like the hygienist, the dentist and the medical pathologist when you are working on if it's like the, the, the DeMarte, you know, or missing person case or forensic case, what's that sort of the great question.

00;19;55;03 - 00;20;31;03
Speaker
It's so it's different so I'll say from the county so like the county of San Diego I'm a I'm a contractor forensic consultant contractor to the county of San Diego's Department of the chief medical examiner. So, the chief medical examiner is the boss, period. And the chief medical examiner then will ask for independent consultations, forensic consultations in more nuanced area of specialty that could be or ontology anthropology if the case requires it.

00;20;31;10 - 00;20;59;01
Speaker
If they know that this is an individual that we don't have an identity for, maybe it's a decomposed set of remains or no fingerprints. It's a minor that doesn't have fingerprints in the system. Yet the body is destroyed or burned by fire. And the teeth are going to very likely still be in extraordinarily great condition, even in catastrophic fires.

00;20;59;01 - 00;21;35;20
Speaker
Often the teeth are in and in excellent condition. And so, the chief will contact my chief, who is Dr. Anthony Cardoza. He is the chief forensic ontologies for San Diego County. He's a diplomat of the American Board of Forensic Go and Ontology. And when we when that referral is made, then we will figure out when we he can get to the morgue, and I can get to the morgue because we live about equal distance away from the medical examiner's office in opposite directions.

00;21;35;20 - 00;22;03;18
Speaker
So, it's usually nights and weekends, Sunday mornings sometimes. These are really we call it like forensic Sunday or Sunday funday, because that's often when we can both get it into our schedules to get over there. We are more. It's always better to work in twos or even threes in individual case work, because then you do have a peer review that's happening right there and that's good practice.

00;22;03;21 - 00;22;32;18
Speaker
It's it has happened where he's been out of town and I'm the chief on call. If he's out of town. But we still with today's technology we have the ability to quickly peer review each other and I'm just he's again a great teacher, a great mentor. And he and I worked together there for over 14 years now.

00;22;32;21 - 00;23;07;00
Speaker
Can't believe it. But the chief the chief medical examiner is who signs that death certificate. It's not Rick and it's not me that that says this is Jane Doe, but we will write a report that our opinion is based on X, Y, Z, one, two, three, that this is Jane Doe. And then the medical examiner will take the opinion of their independent consultants and into their consideration and make their decision.

00;23;07;00 - 00;23;48;08
Speaker
But it's the medical examiner that or the coroner that assigns identity in the in the institution in the event of a DeMarte deployment, which that's federal the incident there's an incident commander. But ultimately the boss is always still the medical examiner or the coroner. They are the boss. This is it's their jurisdiction. The event, whether it's a natural disaster or an act of terrorism, wherever it has occurred, that the coroner or the medical examiner is the boss, everything goes up to them.

00;23;48;12 - 00;24;06;26
Speaker
I don't care who you are or what your role is, wherever your home territory is, you're a duck in a row, right? Right. Yeah, I get it. Well, I want to I want to come back to this because I got, I got to actually I want to spend most of the time on this particular area. But I have two of the things I want to get out of the way.

00;24;06;27 - 00;24;39;09
Speaker
One was you mentioned an SFO. So, in terms of organizations that if somebody is interested in forensic good ontology, they love this area, whatever. What are the primary organizations that they should be looking at? Well, I like the SFO, probably I am biased, but that that was my first home and that was my first network and family of mentors and friends and colleagues.

00;24;39;11 - 00;25;07;28
Speaker
And the SFO is open to all persons that the majority of our membership are Dennis and hygienists and dental assistants. But we have medical doctors, we have police, we have medicolegal investigators, we have FBI, we have anthropologists as well. And the unique thing about the SFO is that it is an inclusive membership. It's very low as far as just your annual dues go.

00;25;07;28 - 00;25;54;04
Speaker
And the entire mission of the institution is research, mentorship and inclusion. The eight F is the American Academy of Forensic Sciences and that in the United States is the is the umbrella of all of the forensic disciplines of which code ontology is one of the recognized forensic disciplines that is a in entry for there's there is professional affiliate which is brand new, but there's associate member, member and fellow and multiple sections and that is a place for there.

00;25;54;07 - 00;26;26;12
Speaker
There is a section like for students, like training affiliates, student affiliates, and that is that for membership as you promote from associate member to member to follow in that organization that is based on your participation and active participation in case for teaching research and that is it's I don't want to say it's exclusive because it isn't, but it's not a wide open door just for anyone.

00;26;26;15 - 00;26;53;15
Speaker
Okay. But what is the question? Is there an equivalent organization in Europe and what is the I saw something about like it's like an international symposium or something that happens on for. So, there's the International Association of Forensic Sciences. I think that's what you're referring to. Yes. I was just in Sydney two or three weeks ago. Sydney, Australia for you were there okay.

00;26;53;18 - 00;27;25;04
Speaker
Yes, I was. And they are so the International Association of Forensic Sciences, they have a meeting every three years and it's in different locations around the world. And that is so if the AFS is the umbrella for the United States, then the Air Force is under the international umbrella of the IFRS. We have so many acronyms. And so, we were just in Sydney in the end of November.

00;27;25;04 - 00;27;48;18
Speaker
It was over the Thanksgiving holiday of the United States. It was that week. Okay. Got it. And it's again, it's huge. And again, you're trying to just take all of these you're trying to run to all the different sections because this is interesting in pathology, and this is interesting in criminology, and this is interesting in odd ontology.

00;27;48;20 - 00;28;07;24
Speaker
And they ask me things are exactly like that, too. It's almost comical because, you know, you've got 15 or 20 minutes and you're you want to hear this talk and then you're busting out of the door to get across the convention center, because this is this is going on in criminalistics now. Yes, I guess I get it. Totally.

00;28;07;25 - 00;28;24;07
Speaker
Yeah, yeah, yeah. Running around. I went to the it was the International Association of ID Conference and it's the same thing. There’re three floors. It's a massive thing. Nobody's talking here. There's like three things I want to be at the same time. I run around going, Where the hell is this room? Where is this? I'm looking for something else.

00;28;24;09 - 00;28;46;05
Speaker
Yeah, I get it. Let me ask you about your civil work, because that's something that I think we need to cover because it's a real deal. Oh, yeah. Give me give me an example. When did you first sort of start looking into that side of things and what kind of cases do you do You do or. Yeah. Oh, oh, good question.

00;28;46;08 - 00;29;15;08
Speaker
So, the very beginning of the civil aspect of my forensic consulting, it happened actually a little close to when I was just kind of beginning my entry level volunteer ism and learning as a, as a little grasshopper in the clinical side about ontology. I had it then at that point relocated from Ohio to Washington State, and I was appointed to the dental board in the state of Washington.

00;29;15;08 - 00;29;42;11
Speaker
As there were, there was a subcommittee from the dental board that was the Dental Hygiene Examining committee, and we worked with the dental board and my responsibility on that in that role was the one of the responsibilities in that role was the investigation or the facilitation of the investigation of licenses under the board's jurisdiction, which were Dennis and hygienist.

00;29;42;14 - 00;30;24;24
Speaker
So if there was an investigation into a cause or a claim of negligence or incompetence or a violation of the practice Act in some capacity, then we were tasked with a along with if an investigator was assigned by the board to, you know, look into what's going on, who made that complaint was that an employee that's complaining? Is it being it another was it another department that has the responsibility of protecting the public, say, for instance, occupational safety or infectious control?

00;30;24;26 - 00;31;01;03
Speaker
Then and then you and so I began to see the exposures that my profession had in risk and liability. You begin to see the same mistakes happening over and over and over again. This it’s this if it was negligence or incompetence where a patient had been genuinely injured by care or the lack of that they received by a license provider in the state, then that was one examination.

00;31;01;05 - 00;31;30;09
Speaker
Or is it completely frivolous? And you just have a patient that's complaining, but there's not been there has not been a breach in the parameter of care. This is just the patients that's not satisfied. And in big eye opening, big eye opening. And then the other side of the civil for that was that I was also then tasked but it's never been a task to me.

00;31;30;09 - 00;32;13;09
Speaker
But I was I represent the state of Washington. I still represent the state of Washington as a board examiner. So, I am a clinical board examiner and captain and coordinator for entry level licensure all over the country, all over the United States, for hygienists and dentists that are entering into initial licensure. Oh, so is there is there a calibrated standard of clinical competency and critical thinking that has been met that that qualifies this individual for entry level licensure into the into the profession?

00;32;13;11 - 00;32;39;23
Speaker
And so, and I still don't have an almost 20 years now I love the state and that work follows me. Well, I'm going to I'm going to jump back now the like some of the work that you're doing with like missing persons and stuff like that. And so, it was actually really interesting because of the sort of the hygienist aspect, you had me thinking about certain things that I wasn't thinking about before.

00;32;40;00 - 00;33;09;29
Speaker
And so, one question here, well, okay, I'll back up here. So, you're geographically located in the San Diego area, and so you're close to the close to the Mexican border. And I know when I've interviewed other people, Dr. Laura Fulginiti, anthropologist from IS Right. Yeah. Maricopa, Arizona. Yes. So, she deals a lot with, you know, people who have crossed the border and then some unfortunate incident happens and then, you know, you're recovering a body and then trying to make an identification.

00;33;10;04 - 00;33;49;01
Speaker
Do you have the same sort of problems in in San Diego? We in in the border? Yeah, but we have so the county of San Diego and the county of Imperial, which is the county immediately east of San Diego, that is the entire Mexico, California border. And I would say compared to and I, I facilitated King County, which is on the Washington state British Columbia border, still a border, but definitely a much higher rate of John and Jane's in in my jurisdiction in San Diego County.

00;33;49;04 - 00;34;35;10
Speaker
And very often these are their skeleton ized or nearly skeletonized or very heavily decomposed individuals that that may not have any identification on them or the identification that is on them is suspected to be in authentic. And that that is often the case. I very recently we did with if the if the remains are on our side, we they are collected they are treated with dignity and respect that human remains deserve.

00;34;35;12 - 00;35;10;12
Speaker
And they will have an anthropological examination. They will have a medical examination or evaluation to the extent that is possible. And we will do a full dental evaluation if there is a skull or a mandible or both that are recovered and the remains even, and they'll have a case number assigned to them. And our investigators they will try every so often we do we do find we do make a match.

00;35;10;12 - 00;35;45;00
Speaker
We do get a name it just in the summer. I feel like it was maybe August or so. We had an individual that was skeletonized, and his remains were recovered, and the investigator had a high degree of confidence that the identification on this individual was authentic. And this was an individual that had migrated all the way from Guatemala and died in San Diego County.

00;35;45;02 - 00;36;15;07
Speaker
And despite all of the politics and all the noise that is that is focusing on our Southern border, to those of us actually quietly in the morgue, this is still a life. It's still somebody and somebody missed him, somebody all the way back home in Guatemala missed him. He should have checked in by now. Somebody in the United States or somebody is in the United States.

00;36;15;07 - 00;36;50;11
Speaker
We're expecting him and he wasn't there. And in our investigators tracked down a name, tracked down a lead, got photo of an upper dental model that this this that this individual had that was the totality of his dental record was an upper model, just a porcelain or stone model of only his upper teeth. And I have an individual in the in the we have individual in the morgue and his teeth were really, really unusual.

00;36;50;16 - 00;37;14;18
Speaker
They were at the 26 years of patient-based practice. I can tell you I've never seen teeth in an eruption pattern that he had and neither had Rick, my chief or in each other, like and then our investigator found that, and they sent a picture of the model. All we had was a picture of a picture.

00;37;14;21 - 00;37;40;27
Speaker
But the teeth were so unique. And the belief that the identity was authentic that he had on him, that his ID. Dr. Cardoza roped in another colleague from Santa Barbara, Dr. Ray Johansen, who is amazing with photography and Photoshop overlays. And I took an impression of the of the teeth of the gentleman that we have in the room in the morgue.

00;37;40;27 - 00;38;06;09
Speaker
And you have to think outside of the box. Sometimes you don't have a dome record, don't have radiographs. They don't have even a photo of teeth. I have a photo of a model. Yeah, we did it. We got it. We were we were very, very confident in our opinion that this was this was him and somebody in Guatemala, some family in Guatemala at least got an answer.

00;38;06;11 - 00;38;33;03
Speaker
Yeah. You raise a really interesting point, though, because the photographs are one and then radiograph. Yes. Yeah, well, those are we have them with physical casts and now even, you know, my dentist has an Intraoral 3D scanner. So, you have all these different things that you could potentially get. So, my question would be, how do you change the way you make the comparison based on what it is that you get?

00;38;33;06 - 00;39;06;22
Speaker
Well, the antemortem data that is available derives the methodology from the postmortem evaluation. If all I am given from the antemortem record is radiographs and they've not given me a therapy record, given me no photographs, they've given me no scans, no CTS, nothing of that is available then I have fortunately, we have the ability to do a C.T. in San Diego from the postmortem side.

00;39;06;25 - 00;39;44;01
Speaker
But wouldn’t that study provide any relevant information if I don't have an equivalent piece of data from the antemortem side? So, we also we think practically we think about is it going to help? It's great data to have, but is it going to help? What's the assignment if it's an A, you know, for the medical examiner and the forensic pathologist, the city is going to provide them a lot more information into their investigation, into the cause and manner of death of an individual.

00;39;44;03 - 00;40;19;10
Speaker
But that's not my assignment or our assignment. So, Europe is way ahead of us, in my opinion. When they go away to Intraoral scanning, patient based INTRAORAL scanning, it's their and then the postmortem utilization of that technology of intraoral scanning in postmortem research for Ruger patterns. Ruger are the little grooves that you can feel on the roof of your mouth behind your front teeth.

00;40;19;12 - 00;40;50;16
Speaker
They're not it's not a rubber stamp where everybody looks the same. There are differences. There’re patterns in those patterns. It's been shown to have a consistency throughout an individual's life. They don't change your model much. And so, the ASAFO has funded phenomenal research to many of our European members that are studying the stability of Ruger patterns, that setting the consistency.

00;40;50;17 - 00;41;18;25
Speaker
Can we use this as a secondary identifier in our ontology? How do they stand up in in a situation where the body begins to decompose or in fire or in water submersion, or as the body dehydrates, how well do they maintain their patterns? And so, yeah, the Euros are way ahead of us on that. That's super interesting. And actually, well I think there's other so fascinating.

00;41;18;25 - 00;41;38;13
Speaker
Yeah. The like it just the whole area of bite mark analysis or bite mark you know comparison and stuff. I always I always thought that there, there may be something beneficial to having a digital model of a person's dentition and then being able to do something with it maybe that we couldn't do with physical cas or with photographs.

00;41;38;15 - 00;42;07;07
Speaker
So, there could be something there to chair for sure. In the chair side, I love having a bite impression, but in my opinion, the application of that to a legal matter such as the oh gosh, the exclusion of identification of a bite mark is just so flawed. It should be nowhere, in my opinion, in in criminal courts, in not just the United States, but I'd love to see that overall.

00;42;07;07 - 00;42;34;00
Speaker
But as the clinician in me says, Hell yeah, man, I love that Intraoral scanner, right? To be able to manipulate in three dimensions the function novelty of an individual's dentition. Right. So, when we talked about or you mentioned decomposition, so I'm going to guess that, you know, if you find skeletonized remains, it's probably easier to work with than a, you know.

00;42;34;02 - 00;43;19;12
Speaker
Oh, yes. Been immersed in water or whatever. Oh, yeah, without a doubt. Okay. The it is I honestly anyone that's in clinical dentistry that that's on the call right now that also works possibly in post mortem that sometimes the living are the most difficult but yeah a skeletonized they're more fragile because they're desiccated and often if the periodontal ligament which is a ligament that is that envelops each two through throat and it's the connection factor between the socket that the tooth is in inside the jawbone.

00;43;19;15 - 00;43;46;17
Speaker
But that will dissipate and decompose with the rest of the body. And so, by the time a body is skeletonized or nearly skeletonized, the teeth often fall out. And so, it's exceptionally rare in my experience that if we're evaluating a set of skeletonized remains, that all the teeth are there, and you have empty sockets. So, I know when this individual died, that tooth was there.

00;43;46;19 - 00;44;09;08
Speaker
But it's not there now. Right? Right. Okay. There's actually a question about the teeth and DNA. And I'm gonna bring this up and I'm curious about I mean, the teeth are super robust. They're very strong. You mentioned fire that they resist fire and things like that. But what about like this fire, water? Like will that destroy the DNA or is it typically the internal components of the tooth which remain intact?

00;44;09;10 - 00;44;44;13
Speaker
Water generally? No. Assuming that the tooth has been recovered, fire can eventually it will eventually completely decimate a tooth to where the interior of the tooth, which is a vein and a nerve and the a pulp tissue vein artery and nervous tissue is the pulp that the soft, delicate tissue on the inside of the tooth. Yes. And that can be used for DNA extraction.

00;44;44;13 - 00;45;16;10
Speaker
I can't say I'm not a DNA expert to say that without exception, that a tooth can always be used for a source of DNA. But successfully a tooth in many times is a resource when the other more accessible resources that would have been gone to first, like bone marrow or blood or buccal tissue or something like that is all gone.

00;45;16;12 - 00;45;57;08
Speaker
We have had definitely in San Diego, we have had referrals where that was the identity of the individual was known, but they wanted DNA from the individual because now there was a greater investigation that this deceased individual was in fact connected to other violent crimes, namely rape. And so, you have multiple jurisdictions in the state now homing in on this body that we actually have custody of in San Diego that is decomposed and getting ready to be cremated.

00;45;57;11 - 00;46;26;15
Speaker
And they are like, stop everything. And we took his teeth. And ideally you want a tooth that is a virgin. We would say a virgin tooth, a tooth that has never been restored, a tooth that has never been decayed. And it would then have the highest degree of likelihood that that pulp will have usable substance for DNA analysis.

00;46;26;17 - 00;46;56;29
Speaker
I want to ask you about technology. I mean, you've been doing this for some time. So over the years, have you seen improvements or other things that have come in where it's really just hope and it could be could be hardware, could be technology, could be software like, or what kinds of things are at your disposal on which side on the like, For example, for an ID, you know, the fact that we have the Internet now, is there software for like missing persons or IDs?

00;46;57;02 - 00;47;41;05
Speaker
Yeah, I would say the digitalization of intraoral radiography, which was which was led from the antemortem side because digital radiography is it’s faster the images of a higher quality and slower radiation. So, all of that was a benefit to patient-based dentistry. And then we moved into postmortem evaluations as well for all of the same reasons, speed portability and the ability enlarge and enhance an image and be able to get the image within a fraction of a second versus dipping a film, drying a film, waiting.

00;47;41;07 - 00;48;09;26
Speaker
So that was an advantage. We do. I and again, I can speak for the state of California a little bit more perhaps than other states, but we have we have a really dedicated team in in Sacramento, California, the Department of Justice for the state. They are teams of full-time state employees working just on missing and unidentified. And they liaise between all of our counties.

00;48;09;28 - 00;48;35;11
Speaker
And when Dr. Cardoza and I have finished a dental examination on an unknown deceased individual, we don't have we don't even have a lead of who this individual is. All of our data is digitized. The radiographs, the photographs that we take, the odometer gram, which is the download chart, we create the report. It all goes in a file to Sacramento.

00;48;35;13 - 00;49;06;16
Speaker
And they and we those investigators will then work tirelessly to make reconciliations to us say it's a missing person that's in Fresno and that this missing person’s case has a lot of points of reconciliation with this unidentified individual that Cardoza and Riley have submitted casework on. So, is this missing person from Fresno County, the unidentified person in San Diego County?

00;49;06;18 - 00;49;38;00
Speaker
And so, and it's fun sometimes because it will get, we'll get casework. We'll see our familiar friends and names on a case from Northern California. And we'll see that name at the bottom of the chart. Most like, oh, this is Dr. So-and-so. And it is a that the digitization of all of the record keeping has been that speeds everything up that we can create a digital file that is instantly available to Sacramento.

00;49;38;05 - 00;50;14;21
Speaker
And it's not even that it's not even an overnight FedEx anymore. It's yeah and then and then nationally the where the where the public can come in. Name us name us. Dot gov is it’s a national database in the United States that has the law enforcement medical examiner forensic personnel side. But then there's a public side where members of the public can look at missing person cases and look at unidentified cases and look at unclaimed person cases.

00;50;14;23 - 00;51;07;14
Speaker
And the cyber sleuths and the online forums of people that just get together and solve puzzles and solve crimes, they can this database and really filter very tightly down to an area that they really want to look I use this I'm a forensic consultant for names from the medical legal side and like for the I have views that the general public wouldn't have but to just when I teach on this topic, I'm always really, really pressing in and almost begging the audience to look at these cases because this database exists for the public's help, for the public's input.

00;51;07;14 - 00;51;37;16
Speaker
You don't have to be a dentist or a hygienist or a police officer to go through these databases and look and see how many missing or unidentified or unclaimed there are in your state, in your city, and your zip code. And those cases are solved because the public cares enough to look and submit a tip or say, gosh, this missing person case here and this unidentified person case here, Wow.

00;51;37;16 - 00;52;07;17
Speaker
There's a lot in common here. In here. And they're just the natural puzzle solvers that are out there. It's incredible that the tips that the public provide to just the everyday folks that care. I want to ask you a question about and I sure I'm not going to have any problem convincing you this, but how important oral hygiene is and how it's related to other diseases or diseases in the body.

00;52;07;19 - 00;52;34;19
Speaker
Right. So how actually, I think you made a post once and I didn't know this either, and that about pneumonia and how it can originate. Oh, yeah, right from the morgue. Right. So, and this is an area that I teach as well in the it I teach in medical history and the oral pap, the oral systemic cycles of oral inflammatory diseases like gum disease and Indian disease.

00;52;34;21 - 00;53;26;16
Speaker
And then how that those inflammatory diseases, they exacerbate systemic inflammatory diseases like hypertension and insulin resistance. And it's the two aren't separate. They're related. And the oral disease inflames and exacerbates the systemic disease. So there are I mean, the CDC, you would be able to pull the data on oral infectious deaths every year like an individual developed an ammonia and when the sputum that they're hacking up is cultured to see to determine the what's the effective drug or drug category that we need.

00;53;26;16 - 00;53;57;26
Speaker
You know, your culturing so that you're treating the appropriate bacteria or virus and it's a periodontal pathogen it's or it's an end the ionic pathogen that has created a ferocious infection in this individual's long an individual that is in the throes of a heart attack and they're in the emergency room and the clot is clinically removed from the individual's coronary artery that's caused their infarct.

00;53;57;26 - 00;54;28;01
Speaker
And then they culture the clot, they culture the clot to see what's in there and their whole in the Dominic antigens whole into the ionic bacteria. Yeah. Oh, see that's something clearly you can see. I get very excited about it. That's, that's the patient education side of me to, to, to, to remove this distinction in a patient's mind that somehow their oral health or dentistry is separate from medicine.

00;54;28;04 - 00;54;52;06
Speaker
Thank you. Well, here's, here's my question. So, if you have postmortem, you're looking at, you know, a body or dentition or whatever it might be. Is there something have you ever seen it where you can see something about this individual's health postmortem? And, you know, is there some evidence or something in the mouth? Don't I mean, that says something about a disease that might have or some infection or something like that?

00;54;52;09 - 00;55;32;07
Speaker
I'm not sure. I would say not that I could speak to myself as a case that I have been immediately involved with where I felt or was asked to make an opinion or opine that a pair of Donal or an ended on a condition is contributing to the manner of death or cause of death. There are sometimes there's unusual internal findings like you know, there's a fentanyl patch that's stuck on the roof of an individual's mouth that has not been yet recognized in the physical examination postmortem.

00;55;32;09 - 00;56;07;00
Speaker
That might be a clue. Yeah, that's just me using my eyes that someone might want to look at that. You probably want to run a tox if you haven't already did say there, are we? But we. I can't not see clinically with my eyes when I'm doing a postmortem oral evaluation and that you know, clinically and confronted with profound oral disease that this individual died with oral disease died from it.

00;56;07;07 - 00;56;32;18
Speaker
That would not be my wheelhouse to make an opinion. Right. Right. But then, you know, we have an individual that, you know, as we began to see, there are times we have made identifications based on the progression of oral disease. We're having an individual who's antemortem radiographs have them. And I see I see all of the disease that's in this patient's mouth and then postmortem.

00;56;32;18 - 00;57;03;06
Speaker
We have an individual that we've exposed the same set of clinical diagnostic radiographs on. And instead of restorations or unique anatomical findings were actually continuing to chart the progression of pathology as being consistent as well. Okay, go backwards. There's a couple of questions here, and I'm going to pose one, but I'm afraid of it because it's probably it's not what we're talking about.

00;57;03;06 - 00;57;33;16
Speaker
But it's an interesting question, though. And if you use, you know, if the lips the technique and I, I know that people have done some work in that area but I'm. Yeah, yeah. Well, I know the person asking the question so don't be too afraid of it. No problem as an idea. So, Nicholas, you're asking the identification is a pretty discrete specific word.

00;57;33;18 - 00;58;29;01
Speaker
I would not use this as a primary identifier, and I'm speaking only for myself. But there is a growing area of qualified research into and let a prince. For those that are not familiar with the term as being something that is more unique to an individual, the suggestion is not that it's a primary identifier, like a fingerprint, but is there something, say like a palatal ruga pattern where if it is well documented in an antemortem record, could this be a usable metric in an in a post mortem examination or in you know, sometimes you still want to identify a person when they are alive as well.

00;58;29;03 - 00;58;57;29
Speaker
Yeah, but if he's asking me directly, then my answer would be no, I have not. Okay. Well, he's Nicholas has got a second question and it's something we haven't discussed either. And that has to do with he's got several questions here, but maybe you can talk in general about like how many how many qualified forensic or ontologies exist around the world, a world how many board certified it is if all members exist, And what are the requirements to become a board certified as a full member?

00;58;58;01 - 00;59;48;00
Speaker
So, I think that he's conflating two organizations. The SFO is the American Society of Forensic Ontology and that is so that's the organization that I'm currently the president of. And that is not a certifying organization. That is not an organization that that credentials a member as an expert or as a qualified consultant. The that I believe what he's referring to is a PFO and that is the American board of Forensic code ontology and that is the single and only board certifying credentialing institution in the United States, specifically for dentists only.

00;59;48;03 - 01;00;32;06
Speaker
That's the AP f o and I haven't counted recently, but I feel I would feel comfortable that there are about a hundred, maybe 115 currently certified ab f o od ontologies in really in in the entire organization. And to say in the United States would be inaccurate because there are Canadian diplomats to the ABO, and we have we have a colleague that is from Spain, and she is she is a dentist and an anthropologist, and she is an ABF a diplomat.

01;00;32;06 - 01;00;58;21
Speaker
So, it's not unique just to the United States, but the organization is founded and headquartered in the United States. Okay. Yes. I mean a lot of credentials to be qualified to even challenge the board of the ABF, though chiefly being a dental degree. Yeah, well, and degree and you said like the American Society of Forensic Good Ontology is a good place to go meet people to learn and things like that.

01;00;58;24 - 01;01;45;11
Speaker
And, and you also teach though, like you, you also have courses that you teach on, you know, some basic forensic courses. You talk about you; you have a bunch of it. Yeah, yeah. Oh yeah, yeah. Yes. We talk to the folks to talk to me about some of the courses you're doing. So, in forensics. So I do teach very entry level forensic ontology 1 to 1 and mostly the audience is usually and hygienist, but sometimes I get investigator ers and nurses or attorneys that sometimes will come in, and that is both sides of it, both from my work and my experience in risk and liability mitigation, from being on the dental board and working for

01;01;45;11 - 01;02;11;05
Speaker
insurance companies that are insurer professional licensors like dentists and hygienist. I work from it from that side. And then I also teach the importance of the fidelity and completeness of the medical record, the dental record when we all go back to work on Monday. That's your medical record that you have on this patient. What is a complete record?

01;02;11;05 - 01;02;50;29
Speaker
What is a record that I can use to protect you in a matter of civil litigation? If you have a patient that is making a claim against you and it's unfounded, it's frivolous. It's just it's unfounded. So, if I have a good dental record and then I teach dentists and hygienist how to lower their risk of litigation for, you know, privacy exposures and oh my gosh, social media and Yelp and Google and oh, there's such a slippery slope there.

01;02;51;04 - 01;03;51;17
Speaker
But then I also and then I get, you know, proper radiographic technique, proper diagnosis. The things that I do see legitimately go into litigation against providers outside of legitimate negligence or incompetence. It's things that they don't do often more than things that they did in a they didn't get informed consent. The delay of diagnosis missed the and so I teach that I teach more for from the clinical aspect though in oral pathology and pathophysiology medical history review the of prescribing or treating a patient that is on multiple farm or patients that are using or abusing substances that are illegal or recreational.

01;03;51;17 - 01;04;21;03
Speaker
How to mitigate those risks. You know you have a patient that dropped an edible 60 minutes before their dental appointment and that kicks in after you're already started with the patient. You've delivered an anesthetic. You know, those are the these are scenarios that happen to us now and so I love it. I love teaching. I love my I love my domain family of dentistry and dental hygiene.

01;04;21;03 - 01;04;45;09
Speaker
So, there's you can see I've taken it in a lot of different directions, but that's still the home. That's the metal. Let me ask you a question about what you see as maybe not some of the difficulties, but what areas right now do you see are important for research in your area right now? Like what? What areas need a lot of attention in?

01;04;45;12 - 01;05;21;17
Speaker
I really would love to see the United States step way up on scanning on INTRAORAL scanning and CTE. Well definitely in again everything for me first is patient doing what's right for the patient but giving the just the increasing the diagnostic competency and scope to those that are making diagnosis the to so because it is in the best interest of the patient.

01;05;21;19 - 01;05;51;23
Speaker
I would love to see so in California and it's not the same in every state but in California if I if we have an unknown individual, a genre. Jane, we have no direction as to who this individual is before the body is buried or cremate it, we take the jaws, it's in it's in the practice that we're under, which is actually under the medical code for ontology.

01;05;51;23 - 01;06;19;02
Speaker
When we're being supervised by medical examiners, it says the jaws are retained. And what I would love to be able to do would be able to start scanning all of these John and Jane's just so that I have an immediate access to a three dimensional, a three-dimensional case of that jaw that I actually still have that is frozen.

01;06;19;05 - 01;06;52;27
Speaker
So that again, just the ease of access I've got radiographs, I've got photographs, and now I have a three-dimensional model of exactly what was retained. So, if anything, just to speed up their area of clinical examination as far as research goes, I love I love the interest in gaze because that it is in cases where I'll have, I mean the individual is absolutely completely consumed by fire.

01;06;53;00 - 01;07;19;08
Speaker
They're not viewable. Fingerprints are gone. The body is completely charred inside the mouth, the teeth, more times than not, are in great condition, but so is the palate. And so, the rigor is there. And then I'll get a tattoo up there, like someone has an internal tattoo on the roof of their mouth. And again, I, I preach the fidelity of the antemortem record.

01;07;19;10 - 01;07;41;20
Speaker
If you have patient with or intraoral jewelry, jewelry, you have a patient with a lip tattoo on the inside or something on the roof of their mouth, document it, take a photo of it, because it matters. It matters to us. On the other side, the SFO funds research we have, we have entirely different grant money set aside for research.

01;07;41;20 - 01;08;07;29
Speaker
So, if there's anybody that's in the like in the chat now or you know that that's going to listen to this or pop it up later, reach out to the SFO. If you have research ideas that's in the wheelhouse about ontology, we would we just that's the whole mission is to support the growth in the contribution of literature and the mentorship and network of us that do this work.

01;08;08;01 - 01;08;31;25
Speaker
Okay. Well, I know we're getting on in time. There’re just a few questions. Okay. Well, if you want to give some short answers to these, you can we can rapidly fire these off and get them. Okay. So first one, how can I get on the Debord? Oh, that's a common question. So, the demo is a federal job, so I'm I am a full-time federal employee on an intermittent basis.

01;08;31;25 - 01;09;10;00
Speaker
That's how that works. So basically, it means if I'm called up or I'm put on alert or orders, you kind of drop everything and, and now I'm a full-time federal employee. USA jobs dot gov is the website that any put any potential future federal employee has to start there so you create a user profile you put your information and then the and when I position on D more which is all positions of forensic science, it's not just old ontology, it's path anthro and fingerprints.

01;09;10;00 - 01;09;57;29
Speaker
It's everybody. If that if that job posting were to come up, then you would make you would apply for that job. Because it is a federal job. It's different now from when I first came onto DeMarte, which was in oh five, right as Katrina was rolling out. But when I've promoted from the forensic dental team and I'm now a safety officer for Region ten, which is in a position of leadership, I'm an officer now, even though I was being promoted already as an employee, I still had to go through USAA jobs dot gov and, you know, make an application for that job even though, you know, it had come to me from my

01;09;57;29 - 01;10;24;20
Speaker
chain of command. But that's how to start. Okay, here next one. This is a good question. Actually, discuss some future talent challenges about artificial intelligence applications as any then discuss that at the SFO or talking about maybe it could be used for I don't know. I don't know. Matching. Yeah, it's interesting. I haven't. Nicholas. That sounds like a good research project right up, up and center my research committee.

01;10;24;22 - 01;10;53;01
Speaker
But right here's, here's another one. Just two more and this will be the second last one I think are. Yeah. Are regular citizens able to take your courses? Absolutely. 100%. All right. Good ones answered. And this is another easy one, but it is a with your clinical hygiene. Now, I probably work it's more like a couple of days a month because of because of all the other consulting that I do.

01;10;53;04 - 01;11;18;11
Speaker
The morgue based the county-based work that I do is not every day that is if the if there is a case that requires that ontology, then Dr. Cardoza and I receive a referral. Otherwise, he goes on his fault. He's a full-time general dentist in San Diego County. And that's just nights and weekends when we can do it outside of it.

01;11;18;11 - 01;11;46;05
Speaker
In exceptional case, which may be something like a homicide or high profile or child or something. My civil side is the civil litigation work and working as a consultant or a cost projection specialist. I do that and teach more than I actually sit next to a patient anymore for money. Anyway, I do volunteer for patient based. I still do that one few times a quarter, I would say.

01;11;46;05 - 01;12;13;29
Speaker
But yeah. Jessica Not as much. I'd say a couple days a month and I float where I can, and I love Perio. So that's Perio is my, my favorite working as a clinician. So. Well, look, we're going to we're going to wrap this up soon. But I guess my last question to you would be, I mean, you're obviously well seasoned and I thank you for liking all this information you got.

01;12;13;29 - 01;12;59;00
Speaker
You're just an explosion of stuff. You get a whole bunch of things going on. Is what's it. Yeah, for sure. But what is it? What is it that you want to do next at this point of your career? And like, you know what? What looking forward Like what? What do you want to do? I prefer fortunately, I really am really enjoying how much my forensic consulting is growing in matters of civil litigation because it is I have found it to be another way that if my Northstar has always been to do what is right for the patient, to always do what is right for the patient, and the truth is always the truth, no matter

01;12;59;00 - 01;13;27;15
Speaker
who is asking you, the truth will always be the truth. So as my shoulder and my hip does dictate the fact that I am doing less chair side clinical dental hygiene, I have found that this is another way that I can continue to serve my serve patients by being involved in matters that affect an individual that has been injured or harm.

01;13;27;17 - 01;14;07;26
Speaker
And I can continue to serve and protect my professions of dentistry and dental hygiene that I love by working in ways to protect my ethical, hardworking providers from unnecessary headaches and from risk or liability that they don't see in front of them. If I if I see an ethical dentist or a hygienist walking right towards a manhole that doesn't have a cover on it, I want to be able to put the cover on it so that they don't have reputational harm or practice harm, that that is unwarranted and.

01;14;07;26 - 01;14;41;13
Speaker
So that's the civil side of my forensic consulting is where my eyes are more focused. But I will always serve my county until I am just physically unable to do it. And I will continue to serve our organized forensic communities as a member, as active participant. And I want to be the mentor to others behind me, like those have mentored me, that it's it is about the work.

01;14;41;13 - 01;15;12;22
Speaker
It is not about it is not about celebrity. It is not about recognition. It is not about exclusion. It is about that the I am a more exceptional career, but that is because of the people that have mentored me. That's it. It's because of people that have mentored me that I have been able to recognize and seize opportunities that I have.

01;15;12;22 - 01;15;34;10
Speaker
And I my future is that I want to give that back now to those that are coming in after me, that their pathway is easier. And if somebody wants to reach out to you, I'm going to I've got your website up here, but you've got obviously a contact form here that they can fill in. Oh, yeah. Now you're and you're also on are you only on a LinkedIn?

01;15;34;15 - 01;15;54;27
Speaker
I'm only on LinkedIn. Okay. So, if yeah, they can always, I guess reload social media. Otherwise, I well look, and I want to thank you so much. I really appreciate it. And as long as it's over, long overdue. But it's okay. We got it done and I'm glad to you. And I hope one day we'll meet in person and get to shake hands and.

01;15;55;04 - 01;16;01;27
Speaker
Yeah, thank you so much for everything. Keep doing what you're doing. I think it's wonderful. I can tell you're passionate about what you're doing, which is fantastic.

01;16;01;27 - 01;16;12;09
Speaker
You know, just Yeah, SFO, the things you're doing there and getting involved. So, look. Yeah. Thank you. Hang back for a second and I'll come back and chat with you. Thank you so much.

01;16;12;09 - 01;16;12;26
Speaker
Okay.

01;16;13;10 - 01;16;16;29
Speaker
Really appreciate everyone's questions, everyone's comments and everything else.

01;16;16;29 - 01;16;17;18
Speaker
So

01;16;17;18 - 01;16;34;05
Speaker
we will be back soon. It's the holiday season, so I'm going to try and do what I can over this time and into the new year. There's a lot going on. The forensic photography symposium courses and conferences are going to be ramping up again in like January, February. So, look, have a great Thursday, everyone, and we will see you soon.

01;16;34;08 - 01;16;34;29
Speaker
Bye.