Development and validation of a human bitemark severity and significance scale

Numerous efforts have been made to develop a consistent manner to describe bite injuries. Some have been related to the type of injury, others to the manner in which it was caused or simply its anatomical location. Bitemark severity is related to forensic significance and hence the ability to use a common means of injury description would be of benefit to odontologists and those who commission their services. A novel index, relating severity to forensic significance, was developed. A text version and accompanying visual index were produced and distributed (via the web) to three groups: odontologists, forensic pathologists, and police officers. A total of 35 bitemarks were assessed and rated using the new index. Weighted kappa analyses were used to determine the agreement data both between and within groups and individuals. kappa demonstrated a high level of intraoperator and interoperator reliability, particularly in the police officer group. The index shows promise as a universal means of describing bite injuries between professionals concerned with their detection and analysis.