Summary
While the phenomenon of pink teeth has been known since 1829, when it was first described by Bell, its application in forensic medicine has been limited. Recently, however, attention was again focused on pink teeth in legal cases. The medico-legal implication was the use of pink teeth as a possible means of evaluating the cause of death. Pink teeth can occur during life and postmortem. Except for very few and poorly documented exceptions, they develop earliest after 1 to 2 weeks postmortem. Their chemical analogy is seepage of hemoglobin or it's derivates into the dentinal tubules. Prerequisites are hyperemia/congestion and erythrocyte extravasation of the pulp capillaries, furthermore autolysis and a humid milieu. Therefore, they are most often associated with water immersion. The intensity of characteristics varies between different cases and also between different teeth in an individual case. Since the ante-mortem prerequisites are non-specific and can be replaced by certain postmortem conditions, there exist until now no specific correlation to the cause of death. The phenomenon is very often seen in victims of drowning where the head usually lies in a head-down position. From this it can be assumed that pink teeth even if not identical to postmortem lividity can, at least to some extent, be considered as analogous. Since, there is no obvious connection between the occurrence of pink teeth and the cause of death, it may be concluded that pink teeth are not pathognomonic for a specific cause of death and this is therefore an unspecific phenomenon.
Zusammenfassung
Das zuerst 1829 von Bell beschriebene Pink Teeth-Phänomen hat seither wiederholt bei der Untersuchung von Tötungsdelikten eine Rolle gespielt. Die postmortale Pinkfärbung der Zähne ist in der Regel frühestens 1–2 Wochen nach dem Tod zu beobachten. Dem Phänomen liegt das Einsickern von Hämoglobin oder von Hämoglobinderivaten in die Dentinkanälchen zugrunde. Voraussetzungen sind Hyperämie bzw. Stauungszustände, eine Erythrozytenextravasation aus den Pulpakapillaren, ferner Autolyse und feuchtes Milieu. Das Phänomen ist daher meist bei Wasserleichen beobachtet worden. Die Intensität der Verfärbung variiert von Fall zu Fall und, innerhalb eines Falls unter Umständen von Zahn zu Zahn. Eine spezifische Assoziation des Phänomens mit bestimmten Todesursachen ist nicht nachweisbar. Postmortale Bedingungen spielen für die Entstehung der Pinkfärbung eine wesentliche Rolle. Nicht selten ist sie bei mit abhängendem Kopf treibenden Wasserleichen zu beobachten. Insofern ist Analogie zur postmortalen Hypostase naheliegend. Da das Phänomen in Verbindung mit ganz unterschiedlichen Todesursachen (Ertrinken, Verbrennen, CO-Intoxikation, Strangulation u.a.) beobachtet wurde, kann es keinesfalls als pathognomonisch für eine spezielle Todesursache angesehen werden.
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Borrman, H., Du Chesne, A. & Brinkmann, B. Medico-legal aspects of postmortem pink teeth. Int J Leg Med 106, 225–231 (1994). https://doi.org/10.1007/BF01225410
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DOI: https://doi.org/10.1007/BF01225410