Assessing socioeconomic status through dental and associated tissue characteristics: A cross-sectional study for human identification

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Additionally, analyzing a person’s teeth can provide insights into their socioeconomic status, which may assist in the process of identification. Our study aimed to assess the correlation between dental health status and SES among individuals, with a focus on identifying predictors of SES based on dental health indicators Methods A cross-sectional study was conducted to evaluate the correlation between dental health status and socioeconomic status among 135 individuals. who had visited the Department of Oral Medicine for various forms of dental care. SES was measured according to a modified Kuppuswamy scale. The associations between SES and dental health indicators were analyzed using chi-square tests for categorical variables and t-tests for continuous variables. Results Dental caries is more common in lower SES groups, attributed to factors like poor nutrition and hygiene. Partial and complete edentulism are also more prevalent in lower SES populations, often due to financial constraints and lack of awareness, leading to extractions rather than restorations. However, urban populations, regardless of SES, show greater utilization of dental restorations, likely due to the concentration of dentists in cities and access to community-based dental camps offering low-cost treatments. Periodontal diseases further reflect SES disparities. Studies show that individuals from lower SES backgrounds report more severe periodontal issues, such as gingival swelling, while higher SES groups report milder symptoms like gingival bleeding, indicating earlier intervention. Conclusion SES plays a vital role in shaping health and lifestyle outcomes. The findings in our study demonstrate the value of incorporating SES indicators, such as education, occupation, marital status, and residence, into forensic investigations to enhance the precision of identification processes. 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F1000Research 2025, 14 :220 ( https://doi.org/10.12688/f1000research.161533.3 ) NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article. Close Copy Citation Details Export Export Citation Sciwheel EndNote Ref. Manager Bibtex ProCite Sente EXPORT Select a format first Track Share ▬ ✚ Research Article Revised Assessing socioeconomic status through dental and associated tissue characteristics: A cross-sectional study for human identification [version 3; peer review: 2 approved] CEENA DENNY https://orcid.org/0000-0001-9908-6753 1 , Srikant Natarajan https://orcid.org/0000-0002-2686-0397 2 , Jasmine Jophy 1 , Nandita KP 2 , Amita Juanita Lewis 2 , Shwetha Yellapurkar https://orcid.org/0000-0003-1998-820X 2 CEENA DENNY https://orcid.org/0000-0001-9908-6753 1 , Srikant Natarajan https://orcid.org/0000-0002-2686-0397 2 , [...] Jasmine Jophy 1 , Nandita KP 2 , Amita Juanita Lewis 2 , Shwetha Yellapurkar https://orcid.org/0000-0003-1998-820X 2 PUBLISHED 18 Mar 2025 Author details Author details 1 Department of Oral Medicine Radiology, Manipal College of Dental Sciences, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India 2 Department of Oral Pathology and Microbiology, Manipal College of Dental Sciences, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India CEENA DENNY Roles: Conceptualization, Data Curation, Formal Analysis, Investigation, Methodology, Writing – Original Draft Preparation Srikant Natarajan Roles: Conceptualization, Data Curation, Formal Analysis, Supervision, Writing – Review & Editing Jasmine Jophy Roles: Data Curation, Investigation, Writing – Review & Editing Nandita KP Roles: Data Curation, Methodology, Writing – Review & Editing Amita Juanita Lewis Roles: Data Curation, Methodology, Writing – Review & Editing Shwetha Yellapurkar Roles: Data Curation, Writing – Review & Editing OPEN PEER REVIEW DETAILS REVIEWER STATUS This article is included in the Manipal Academy of Higher Education gateway. Abstract Abstract Background Dental identification methods are employed to determine a person’s identity in forensic odontology. Additionally, analyzing a person’s teeth can provide insights into their socioeconomic status, which may assist in the process of identification. Our study aimed to assess the correlation between dental health status and SES among individuals, with a focus on identifying predictors of SES based on dental health indicators Methods A cross-sectional study was conducted to evaluate the correlation between dental health status and socioeconomic status among 135 individuals. who had visited the Department of Oral Medicine for various forms of dental care. SES was measured according to a modified Kuppuswamy scale. The associations between SES and dental health indicators were analyzed using chi-square tests for categorical variables and t-tests for continuous variables. Results Dental caries is more common in lower SES groups, attributed to factors like poor nutrition and hygiene. Partial and complete edentulism are also more prevalent in lower SES populations, often due to financial constraints and lack of awareness, leading to extractions rather than restorations. However, urban populations, regardless of SES, show greater utilization of dental restorations, likely due to the concentration of dentists in cities and access to community-based dental camps offering low-cost treatments. Periodontal diseases further reflect SES disparities. Studies show that individuals from lower SES backgrounds report more severe periodontal issues, such as gingival swelling, while higher SES groups report milder symptoms like gingival bleeding, indicating earlier intervention. Conclusion SES plays a vital role in shaping health and lifestyle outcomes. The findings in our study demonstrate the value of incorporating SES indicators, such as education, occupation, marital status, and residence, into forensic investigations to enhance the precision of identification processes. READ ALL READ LESS Keywords Socioeconomic Status (SES), Dental Health Indicators, Human Identification Corresponding Author(s) Srikant Natarajan ( [email protected] ) Close Corresponding author: Srikant Natarajan Competing interests: No competing interests were disclosed. Grant information: The author(s) declared that no grants were involved in supporting this work. Copyright: © 2025 DENNY C et al . This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. How to cite: DENNY C, Natarajan S, Jophy J et al. Assessing socioeconomic status through dental and associated tissue characteristics: A cross-sectional study for human identification [version 3; peer review: 2 approved] . F1000Research 2025, 14 :220 ( https://doi.org/10.12688/f1000research.161533.3 ) First published: 18 Feb 2025, 14 :220 ( https://doi.org/10.12688/f1000research.161533.1 ) Latest published: 18 Mar 2025, 14 :220 ( https://doi.org/10.12688/f1000research.161533.3 ) Revised Amendments from Version 2 Following the reviewer’s comments, we have made several key revisions to strengthen the manuscript. First, the statistical analysis has been retained with detailed descriptions of associations and appropriate justifications for these associations. This ensures clarity in how the variables interact and supports the robustness of the statistical methods employed. Second, to enhance the visual representation of the data, we have incorporated two bar graphs that illustrate the relationship between socioeconomic status and various oral features. These graphical representations provide a clearer comparison of trends and differences, making the findings more accessible to the reader. Third, we have revised the definition of socioeconomic status to focus on family income rather than the head of the family’s income . This adjustment aligns with contemporary research that considers overall household earnings a more comprehensive indicator of economic well-being, especially in contexts where multiple family members contribute financially. Additionally, the rationale for selecting the age range of 18 to 65 years has been explicitly justified. This range ensures the inclusion of both younger adults and older individuals, allowing for a broader assessment of oral health variations across different life stages while maintaining relevance to the study’s objectives. These revisions address the concerns raised during the review process and improve the manuscript’s clarity, analytical rigor, and alignment with current socioeconomic research frameworks. Following the reviewer’s comments, we have made several key revisions to strengthen the manuscript. First, the statistical analysis has been retained with detailed descriptions of associations and appropriate justifications for these associations. This ensures clarity in how the variables interact and supports the robustness of the statistical methods employed. Second, to enhance the visual representation of the data, we have incorporated two bar graphs that illustrate the relationship between socioeconomic status and various oral features. These graphical representations provide a clearer comparison of trends and differences, making the findings more accessible to the reader. Third, we have revised the definition of socioeconomic status to focus on family income rather than the head of the family’s income . This adjustment aligns with contemporary research that considers overall household earnings a more comprehensive indicator of economic well-being, especially in contexts where multiple family members contribute financially. Additionally, the rationale for selecting the age range of 18 to 65 years has been explicitly justified. This range ensures the inclusion of both younger adults and older individuals, allowing for a broader assessment of oral health variations across different life stages while maintaining relevance to the study’s objectives. These revisions address the concerns raised during the review process and improve the manuscript’s clarity, analytical rigor, and alignment with current socioeconomic research frameworks. See the authors' detailed response to the review by Selvamani M READ REVIEWER RESPONSES Introduction The impact of socioeconomic status (SES) on oral health is indeed significant. People with low SES tend to have higher rates of dental issues, often due to limited access to essential resources such as healthcare and proper nutrition. In India, research has shown that SES influences oral health indirectly, with poor SES negatively affecting oral health outcomes. 1 Socioeconomic status plays a vital role in mediating the relationship between dental maturation and access to crucial resources necessary for healthy growth and development. Comparing patients from different socioeconomic backgrounds can provide insights into disparities in access to resources such as nutrition and healthcare. 2 Assessing a patient’s SES through their teeth, dental treatments, and oral hygiene, as well as demographic information, occupation, and education level can offer valuable information. The idea of the project is to reverse engineer the prediction of SES on the basis of dental and associated findings. The data used for human identification is surrogately classified based on SES such as school admissions, ration cards, car rentals, travel itineraries etc. The estimation of SESs can prove to be an efficient tool to narrow down the relevant data set from which human identification is possible. Hence, this study aims to explore the connection between SES and tooth structure, shedding light on how these factors are intertwined in influencing oral health. 3 This study aims to assess the correlation between dental health status and SES among individuals, with a focus on identifying predictors of SES based on dental health indicators Methods A cross-sectional study was conducted to evaluate the correlation between dental health status and socioeconomic status among individuals. The sample of the study was composed of a total of 135 subjects who had visited the Department of Oral Medicine and Radiology for various forms of dental care. The participants were initially briefed about the study. Once the subject was willing to participate in the study, the principal investigator entered the details in the information sheet. The study was conducted after the approval of the Institutional Ethics Committee (Protocol no. 24105,13/8/2024). The study included adults aged 18-65 years. Participants were recruited using convenience sampling from various urban and rural locations. Sample size Based on the article by Ramamoorthy J and Mahalakshmi J (2022) 4 the proportion of patients with caries status in the low-income group was reported to be 21% With an alpha of 5% the corresponding z value is Z=-1. Using the formula n= ((n=((Z (α/2) /d) 2 )(p(1-p)))) with the minimum percentage difference to be deemed clinically significant at 7%, the sample size]required would be 131 for the study to ensure a diverse sample. The inclusion criteria for the study were that all the subjects were of Indian nationality and without any developmental disorders that could affect normal tooth development. The exclusion criteria were those subjects with trismus, being completely edentulous or suffering from systemic diseases that can affect dental mineralization. The required data such as demographic, socioeconomic, and health- related information were obtained through a structured questionnaire. All the entries were recorded by a single observer. SES was measured according to a modified Kuppuswamy scale (2024). 5 A detailed oral examination was conducted, along with an evaluation of tooth wear according to Roehl JC et al. (2021) 6 and the findings were entered into an Excel sheet. 6 To address potential sources of bias in the study, several measures were implemented. Participants were recruited using convenience sampling from diverse urban and rural locations to ensure representation across different socioeconomic backgrounds. A single observer recorded all data to minimize inter-observer variability, and a structured questionnaire was used to standardize the collection of demographic, socioeconomic, and health-related information. The family income was chosen to assess socioeconomic status instead of that of the head of the household. The oral examinations were conducted following standardized protocols to maintain consistency, and the SES was assessed using the validated Modified Kuppuswamy Scale (2024). 5 Additionally, exclusion criteria were clearly defined to eliminate confounding factors such as systemic diseases, developmental disorders, or edentulism that could skew dental health outcomes. These measures aimed to reduce selection, measurement, and information bias in the study. In the study, missing data were addressed through careful measures to minimize its occurrence and manage it appropriately if it arose. During data collection, participants were briefed about the importance of providing complete and accurate information, and every effort was made to ensure comprehensive responses to the structured questionnaire. If any incomplete responses or missing entries were identified, participants were contacted (where possible) to clarify or complete the missing information. Statistical analysis The SPSS 20.0 (IBM Chicago) (Statistical Package for the Social Sciences) package was used to analyze the data. Descriptive statistics were used to summarize the demographic and dental health characteristics of the participants. The selection of statistical methods was based on the nature and distribution of the data to ensure appropriate analysis and meaningful interpretation. Chi-square tests were used to assess associations between categorical variables such as socioeconomic status (SES) and oral health parameters, while t-tests were applied for comparing continuous variables between SES groups. Binary logistic regression was performed to identify predictors of higher SES based on dental and demographic characteristics, allowing for the assessment of potential influencing factors. These methods were chosen to account for the categorical and continuous nature of the variables while ensuring statistical robustness. A p-value of <0.05 was considered statistically significant, providing a rigorous basis for interpreting the results and identifying meaningful associations within the dataset. Results A total of 135 participants aged 18 and above were included in the study. Of these, 73 (54.1%) were female and 62 (45.9%) were male. Additionally, 96 (71.1%) were married and 39 (28.9%) were single. 123 (91.1%) participants were from Karnataka, while 12 (8.9%) were from outside the state. 92 (68.1%) participants lived in urban areas, and 43 (31.9%) resided in rural areas. Most of the participants were from the higher SES (66/%) when compared to lower SES (34%). For gender , a greater proportion of females were in the higher SES group (65.2%) than in the lower SES group (48.3%), although this difference was not statistically significant (p = 0.062). Marital status revealed significant differences (p = 0.022), with a greater percentage of married individuals in the lower SES group (77.5%) than in the higher SES group (58.7%). Smokeless tobacco use was more common in the lower SES group (12.4%) than in the higher SES group (2.2%), with this difference being statistically significant (p = 0.049). Education also showed significant variability across SES groups (p = 0.004), with the higher SES group showing a greater proportion of professional degrees (23.9%) compared to the lower SES group (4.5%). Occupation displayed the most significant association (p < 0.001), with a greater concentration of professionals in the higher SES group (28.3%) than in the lower SES group, where semiskilled and unskilled occupations were more common. Most other variables, including diet, smoking habits, urban-rural residence, and various oral health conditions, were not significantly different between SES groups, with p-values generally above 0.05, suggesting that there was no strong association between these factors and SES in this sample ( Figure 1 ). Figure 1. Distribution of the Demographic parameters between the categories of Socioeconommic Status. The observations related to oral manifestations and their association with socioeconomic status (SES) reveal unique patterns. The prevalence of missing teeth is higher in lower SES groups (43.8%) compared to higher SES groups (28.3%), though the difference is not statistically significant (p = 0.078). The occurrence of dental restorations is also more frequent in the lower SES group (44.9%) than in the higher SES group (34.8%), but the difference remains insignificant (p = 0.256). Dental caries is slightly more common in the lower SES group (91%) than in the higher SES group (87%), with no significant difference (p = 0.464). Gingivitis shows a higher prevalence in the higher SES group (43.5%) compared to the lower SES group (34.8%), though this difference is not statistically significant (p = 0.326). Similarly, periodontitis is slightly more common in the higher SES group (23.9%) than in the lower SES group (22.5%), with no significant difference observed (p = 0.85). Tooth wear patterns also vary between SES groups. Buccal tooth wear is higher in the lower SES group (36%) compared to the higher SES group (28.3%), but this difference is not significant (p = 0.369). Palatal tooth wear and occlusal tooth wear also do not show significant differences between SES groups, with p-values of 0.686 and 0.488, respectively. Regarding tooth surface appearance, the absence of abnormalities is slightly more common in the higher SES group (43.5%) than in the lower SES group (29.2%), though not significant (p = 0.348). Cracks in enamel are rare across both groups, and the rate of enamel and dentin wear remains similar (p = 0.688). In terms of restoration outcomes, nil restoration cases are slightly more frequent in the higher SES group (58.7%) compared to the lower SES group (51.7%), but this difference is not significant (p = 0.735). Patterns of attrition, such as rounding of cusps and grooves or shiny facets, do not significantly differ between SES groups (p = 0.248). Attrition patterns like occlusal cupping or incisal grooving are rare and do not show a notable SES-related trend. Soft tissue changes such as impressions on the cheek are more prevalent in the higher SES group (19.6%) than in the lower SES group (7.9%), but this difference is not statistically significant (p = 0.214). Pathological signs, including pain and sensitivity (50% in higher SES vs. 47.7% in lower SES) and functional problems, show minimal differences across SES groups, with no significant p-values. Similarly, deterioration of dental aesthetics does not vary significantly between groups (p = 0.896). These observations highlight that while some oral health parameters show variations between SES groups, most differences are not statistically significant ( Table 1 ) ( Figure 2 ). Table 1. Chi square test to compare the SES category I/II vs Category III/IV for all variables. Categories N SES_Upper_Lower Chi square P value SES score III/IV (N (%)) SES score I/II (N (%)) Sex Female 73 43 (48.3) 30 (65.2) 3.489 0.062 Male 62 46 (51.7) 16 (34.8) Marital Status Married 96 69 (77.5) 27 (58.7) 5.236 0.022 Single 39 20 (22.5) 19 (41.3) Location Karnataka 123 83 (93.3) 40 (87) 1.487 0.223 Non karnataka 12 6 (6.7) 6 (13) Urban/Rural Urban 92 59 (66.3) 33 (71.7) 0.415 0.52 Rural 43 30 (33.7) 13 (28.3) Habits-Alcohol Absent 127 84 (94.4) 43 (93.5) 0.044 0.833 Present 8 5 (5.6) 3 (6.5) Smoking Absent 123 81 (91) 42 (91.3) 0.003 0.955 Present 12 8 (9) 4 (8.7) Smokeless Absent 123 78 (87.6) 45 (97.8) 3.885 0.049 Present 12 11 (12.4) 1 (2.2) Diet Non-Veg 7 5 (5.6) 2 (4.3) 0.1 0.752 Veg 128 84 (94.4) 44 (95.7) Education Illiterate 0 0 (0) 0 (0) 17.427 0.004 Primary School Certificate 6 6 (6.7) 0 (0) Middle School Certificate 10 9 (10.1) 1 (2.2) High School Certificate 29 22 (24.7) 7 (15.2) Intermediate or Post High School Diploma 32 20 (22.5) 12 (26.1) Graduate or Postgraduate 43 28 (31.5) 15 (32.6) Professional Degree 15 4 (4.5) 11 (23.9) Occupation Unemployed 14 11 (12.4) 3 (6.5) 46.471 <0.001 Unskilled Worker 8 8 (9) 0 (0) Semi Skilled Worker 17 17 (19.1) 0 (0) Skilled Worker 16 14 (15.7) 2 (4.3) Clerical/Shop owner/Farm 32 23 (25.8) 9 (19.6) Semi Professional 34 15 (16.9) 19 (41.3) Professional (White Collar) 14 1 (1.1) 13 (28.3) Oral manifestations Missing teeth Absent 83 50 (56.2) 33 (71.7) 3.1 0.078 Present 52 39 (43.8) 13 (28.3) Restoration Absent 79 49 (55.1) 30 (65.2) 1.29 0.256 Present 56 40 (44.9) 16 (34.8) Dental caries Absent 14 8 (9) 6 (13) 0.536 0.464 Present 121 81 (91) 40 (87) Gingivitis Absent 84 58 (65.2) 26 (56.5) 0.965 0.326 Present 51 31 (34.8) 20 (43.5) Periodontitis Absent 104 69 (77.5) 35 (76.1) 0.036 0.85 Present 31 20 (22.5) 11 (23.9) Tooth Wear (Buccal) Absent 90 57 (64) 33 (71.7) 0.808 0.369 Present 45 32 (36) 13 (28.3) Tooth Wear (Palatal) Absent 112 73 (82) 39 (84.8) 0.163 0.686 Present 23 16 (18) 7 (15.2) Tooth Wear (Occlusal) Absent 76 52 (58.4) 24 (52.2) 0.482 0.488 Present 59 37 (41.6) 22 (47.8) Tooth Surface Absent 46 26 (29.2) 20 (43.5) 3.301 0.348 Smooth Silky Shiny appearance 51 36 (40.4) 15 (32.6) Increased incisal translucency 21 16 (18) 5 (10.9) No plaque, Discoloration or tartar 17 11 (12.4) 6 (13) Tooth Defect Absent 61 38 (42.7) 23 (50) 1.475 0.688 Enamel and dentin wear at same rate 48 32 (36) 16 (34.8) Fracture of cusps or restorations 24 18 (20.2) 6 (13) Cracks with enamel 2 1 (1.1) 1 (2.2) Distribution of tooth wear Nil 56 35 (39.3) 21 (45.7) 1.364 0.714 Wear on occluding surfaces 48 31 (34.8) 17 (37) Wear on non occluding surfaces 26 19 (21.3) 7 (15.2) located at cervical areas of teeth 5 4 (4.5) 1 (2.2) Restoration Nil 73 46 (51.7) 27 (58.7) 0.616 0.735 Clean non tarnished appearance 45 31 (34.8) 14 (30.4) Raised restoration 17 12 (13.5) 5 (10.9) Attrition pattern Nil 74 45 (50.6) 29 (63) 5.404 0.248 Rounding of cusps and grooves 40 28 (31.5) 12 (26.1) shiny facets flat and glossy 13 8 (9) 5 (10.9) occlusal cupping 5 5 (5.6) 0 (0) Incisal grooving 3 3 (3.4) 0 (0) Soft Tissue Changes Nil 114 78 (87.6) 36 (78.3) 4.482 0.214 Impressions on cheek 16 7 (7.9) 9 (19.6) Impression on tongue 4 3 (3.4) 1 (2.2) Pathological Sign Nil 40 26 (29.5) 14 (30.4) 1.086 0.896 Pain and sensitivity 65 42 (47.7) 23 (50) Functional problems 13 9 (10.2) 4 (8.7) Crumbling of dental hard tissue and restoration 6 5 (5.7) 1 (2.2) Deterioration of aesthetic appearance 10 6 (6.8) 4 (8.7) Figure 2. Association of changes in oral tissues between the categories of Socioeconommic Status. Table 1 presents a comparative analysis of various demographic, behavioral, and clinical characteristics across different SES groups, SES III/IV (lower SES) and SES I/II (higher SES). Binary logistic regression analysis was performed to predict higher SES in relation to findings of tooth morphology and diseases. In this analysis, the outcome being studied is the likelihood of belonging to a higher socioeconomic status (SES) score of III or IV than to a lower SES score of I or II. The regression results highlight several key factors influencing SES classification ( Table 2 ). Table 2. Binarly logistic regression analysis to predict the higher SES in relation to findings of the tooth morphology and diseases. Variable Category (Reference) B S.E. Wald df p-value Odds Ratio 95% C.I. for Odds Ratio (Lower) 95% C.I. for Odds Ratio (Upper) SEX Male (Female) -1.122 0.581 3.731 1 0.053 0.326 0.104 1.017 MARITAL STATUS Single (Married) 1.871 0.733 6.517 1 0.011 6.498 1.544 27.337 LOCATION Single (Karnataka) 0.789 0.887 0.793 1 0.373 2.202 0.387 12.516 URBAN/RURAL Rural (Urban) 0.009 0.599 0.000 1 0.988 1.009 0.312 3.266 HABIT Present (Absent) 0.285 1.219 0.055 1 0.815 1.330 0.122 14.506 SMOKING Present (Absent) 1.538 1.023 2.260 1 0.133 4.653 0.627 34.546 SMOKELESS Present (Absent) -1.396 1.295 1.161 1 0.281 0.248 0.020 3.136 DIET Veg (Non Veg) 1.798 1.283 1.964 1 0.161 6.039 0.488 74.695 CARIES RELATED PROBLEM Present (Absent) 0.139 0.873 0.026 1 0.873 1.150 0.208 6.360 PERIODONTIUM RELATED PROBLEM Present (Absent) 0.541 0.549 0.969 1 0.325 1.717 0.585 5.041 ANY ASSOCIATED PROBLEM Present (Absent) -19.698 15512.448 0.000 1 0.999 0.000 0.000 — TOOTH WEAR BUCCAL Present (Absent) 0.031 0.643 0.002 1 0.962 1.031 0.292 3.638 TOOTH WEAR PALATAL Present (Absent) 0.212 0.900 0.055 1 0.814 1.236 0.212 7.209 TOOTH WEAR OCCLUSAL Present (Absent) 0.786 0.617 1.622 1 0.203 2.194 0.655 7.353 TOOTH SURFACE — — 7.693 3 0.053 — — — TOOTH SURFACE(1) Smooth Silky Shiny -2.507 1.074 5.449 1 0.020 0.081 0.010 0.669 TOOTH SURFACE(2) Incisal Translucency -3.021 1.186 6.486 1 0.011 0.049 0.005 0.499 TOOTH SURFACE(3) No Plaque/Tartar -1.568 0.927 2.859 1 0.091 0.208 0.034 1.284 TOOTH DEFECT — — 1.641 3 0.650 — — — TOOTH DEFECT(1) Enamel & Dentin Wear -0.839 0.807 1.083 1 0.298 0.432 0.089 2.100 TOOTH DEFECT(2) Fracture of Cusps -0.953 0.838 1.291 1 0.256 0.386 0.075 1.995 TOOTH DEFECT(3) Cracks with Enamel 18.731 20298.220 0.000 1 0.999 136360212.606 0.000 — DISTRIBUTION — — 3.016 3 0.389 — — — DISTRIBUTION(1) Wear on Occluding Surfaces 0.982 0.939 1.095 1 0.295 2.671 0.424 16.815 DISTRIBUTION(2) Wear on Non-Occluding Surfaces 0.198 1.191 0.028 1 0.868 1.219 0.118 12.582 DISTRIBUTION(3) Cervical Area -1.199 1.667 0.517 1 0.472 0.302 0.012 7.908 RESTORATION — — 1.190 2 0.551 — — — RESTORATION(1) Clean Non-Tarnished 0.090 0.684 0.017 1 0.895 1.094 0.286 4.180 RESTORATION(2) Raised Restoration 0.992 0.963 1.062 1 0.303 2.697 0.409 17.792 SOFT AND HARD TISSUE — — 4.045 3 0.257 — — — SOFT AND HARD TISSUE(1) Impressions on Cheek 1.656 0.823 4.045 1 0.044 5.237 1.043 26.292 SOFT AND HARD TISSUE(2) Impression on Tongue 0.587 1.669 0.124 1 0.725 1.799 0.068 47.446 AGE — 0.022 0.019 1.334 1 0.248 1.022 0.985 1.062 Constant — -3.681 2.045 3.242 1 Sex shows a marginal association, where males have lower odds of being in the higher SES category (OR = 0.326, p = 0.053). Marital status is significantly associated with SES, as single individuals are 6.5 times more likely to be in the higher SES group than are married individuals (OR = 6.498, p = 0.011). Location/ residency (Urban/Rural) did not significantly show any effect on SES (OR = 2.202, p = 0.373 and OR = 1.009, p = 0.988, respectively). The presence of certain habits also did not significantly affect SES (OR = 1.330, p = 0.815), smoking (OR = 4.653, p = 0.133) or diet (vegetarians vs. nonvegetarians, OR = 6.039, p = 0.161). Similarly, the presence of caries-related problems was not strongly associated with SES (OR = 1.150, p = 0.873). Among the dental variables, specific tooth surface conditions were significantly associated: individuals with “Smooth Silky Shiny” tooth surfaces were less likely to belong to a higher SES group (OR = 0.081, p = 0.020), as were those with increased incisal translucency (OR = 0.049, p = 0.011). Soft and hard tissue impressions on the cheek significantly increased the odds of being in the higher SES category (OR = 5.237, p = 0.044). Finally, age and other specific oral conditions such as tooth defects Tooth defects and tooth wear were not significantly associated with SES status. In summary, single marital status and cheek impressions are associated with higher odds of belonging to a higher SES group, whereas certain tooth surface conditions, particularly smooth and translucent surfaces, are linked with lower odds of higher SES classification. Discussion Socioeconomic status (SES) represents the relative position of individuals, families, or groups within a societal hierarchy based on access to valued goods like wealth, social recognition, and privileges. 7 It is a multidimensional construct encompassing income, educational attainment, occupation, and quality of personal care, including oral health maintenance. 8 SES significantly impacts health outcomes, with lower SES associated with greater health issues, including dental problems due to limited healthcare access, poor nutrition, and low health literacy. 4 , 9 Teeth and their associated characteristics, along with demographic information, can provide insights into an individual’s SES, aiding in identification by narrowing potential datasets on the basis of socioeconomic factors which could aid in forensic investigations. 10 The modified Kuppuswamy scale, introduced in 1981 and updated in 2024, categorizes SES based on education, occupation, and monthly income of the head of the family. It classifies individuals into upper, upper-middle, lower-middle, upper-lower, or lower classes, but limitations exist, particularly in distinguishing joint versus nuclear families and its urban-centric focus. 5 , 11 SES also influences education, with higher SES groups more likely to attain professional degrees due to fewer financial constraints and greater awareness of the benefits of education. Occupation is another critical factor, with higher SES groups predominantly engaged in professional roles, while lower SES groups often work in semi-skilled or unskilled jobs. Marital status: In our study, we found that individuals with lower socioeconomic status (SES) were more prevalent in terms of marital status. Individuals with higher SES, delay marriage and childbirth to focus on their education and careers. 12 Marital status can be an indirect indicator of socioeconomic position, as it can be associated with factors such as income, social support, and access to healthcare. Residence (Urban/Rural): It is generally understood that a place of residence (urban/rural) can indirectly influence SES. The reasons are as follows: a) access to education and employment opportunities often differs between urban and rural areas, b) cost of living and income levels can vary significantly between these locations and c) availability and quality of healthcare services may also differ. These factors can contribute to socioeconomic disparities between urban and rural populations. Therefore, while the sources focus primarily on the impact of individual-level socioeconomic factors, it is important to acknowledge that a place of residence can play a complex and multifaceted role in shaping both SES and health outcomes. 13 Most of the study participants were from urban areas, as our institution is situated in an urban environment, regardless of whether they belong to higher or lower socioeconomic status even though it was statistically insignificant. Education: Research shows that socioeconomic status (SES) plays a significant role in educational outcomes, with the higher SES group showing a greater proportion of professional degrees than the lower SES group. Notably, parents with higher SES are more likely to send their children to attain higher degrees. This could be because they can afford as they do not have any financial restraints and are more knowledgeable about education than people of lower SES. 14 Occupation: Displayed the most significant association, with a greater concentration of professionals in the higher SES group than in the lower SES group, where semiskilled and unskilled occupations were more common. Smokeless tobacco: Various studies have highlighted the correlation between SES and health behaviors, such as smokeless tobacco use, which is more prevalent among lower SES groups. 15 , 16 Tobacco use is closely related to SES. 17 The consumption of tobacco is more prevalent among the lower impoverished in India. 18 The various oral health issues observed associated with the use of tobacco products were staining of teeth, tooth wear, tooth loss, dental caries, edentulousness. Additionally, tobacco use contributes to the buildup of plaque and calculus, with exposure of tooth root surface, periodontal pocket formation, increasing the risk of periodontitis, especially in the front teeth. Other issues include tobacco pouch keratosis, various potentially malignant oral disorders, and an increased risk of oral squamous cell carcinoma. 19 , 20 It is also noted that tobacco consumption is declining more rapidly among people with higher SES than among those with when compared to the lower SES 21 reflecting better awareness and access to cessation resources. Oral findings: Dental caries (DC): More commonly seen in people with lower SES. 4 , 22 , 23 This could be because Individuals with lower SES often have poor oral hygiene practices and increase susceptibility to dental caries (DC). Though statistically insignificant in some studies, lower SES groups consistently exhibit higher dental caries prevalence, which is linked to factors like poor education, income constraints, and lack of awareness about oral health. Edentulism: Partial or complete edentulism was more common in individuals with lower SES, these findings are similar to those of our study but statistically insignificant. They attributed the reason for edentulousness to lack of awareness and financial constraints, education and occupation as the root cause, hence, they would have opted for extraction of teeth. 24 , 25 Restorations: Although statistically insignificant in our study, we observed that even individuals with lower SES had gotten tooth restored. This could be due to most of our patients were from urban area where almost the 3/4 th dentist of India reside. 26 Dental institutions in India provide community-based dental camps in rural areas which spread awareness about dental health hand also provide dental treatment either free of cost or at minimal rates. Periodontal diseases: Individuals with lower socioeconomic status tended to report more advanced symptoms of periodontal disease, including gingival swelling, whereas those with higher socioeconomic status were more likely to report early-stage symptoms, such as gingival bleeding. 27 – 29 These findings were similar to those of our study. Tooth wear: The lower socioeconomic group was found to be the most affected by tooth wear. 30 , 31 These findings were in line with our study although they were statistically insignificant. Possible explanations for this disparity include a lack of awareness, knowledge, and education regarding the factors that contribute to tooth wear. 32 Smooth silky shiny teeth are a sign of mineral loss and incisal translucency is a sign of enamel loss. Individuals with low socioeconomic status are more susceptible to demineralization because of differing priority needs, lower levels of education, and limited access to preventive programs. 33 These findings are similar to our observations. A systematic review and meta-analysis of observational studies performed by Entezami S(2021) revealed that tooth wear was greater in individuals with higher SES due to increased consumption of juices with high acidic contents. 34 Soft tissue changes: Impressions on the cheek significantly increase the odds of being in the higher SES category. This could be due to the stress related to higher SES as society rapidly evolves, as individuals encounter a variety of stressors, including those related to work, family, relationships, finances, socio-cultural issues, and health. 35 Hashibe M, Jacob BJ et al (2003) 36 reported that people with high income could have more people in their household especially in the Indian population which could affect cleanliness which lead to development of fungal and viral lesions, however,in their study they reported that oral lesions were more common in people with lower SES which was in accordance with the study done by Taruna T, Singh YP, et al. (2023). 37 Dental health indicators provide significant insights into SES. For example, dental caries is more common in lower SES groups, attributed to factors like poor nutrition and hygiene. Partial and complete edentulism are also more prevalent in lower SES populations, often due to financial constraints and lack of awareness, leading to extractions rather than restorations. However, urban populations, regardless of SES, show greater utilization of dental restorations, likely due to the concentration of dentists in cities and access to community-based dental camps offering low-cost treatments. Periodontal diseases further reflect SES disparities. Studies show that individuals from lower SES backgrounds report more severe periodontal issues, such as gingival swelling, while higher SES groups report milder symptoms like gingival bleeding, indicating earlier intervention. Conclusion Overall, SES plays a vital role in shaping health and lifestyle outcomes, influencing access to education, healthcare, and occupational opportunities. By understanding the socioeconomic roots of health disparities, researchers and policymakers can better target interventions to improve health equity. These findings also demonstrate the value of incorporating SES indicators, such as education, occupation, marital status, and residence, into forensic investigations to enhance the precision of identification processes. Ethical considerations Ethics approval and consent to participate: Approval for the study was taken prior to conducting the study from Institutional Ethics Committee, Manipal College of Dental Sciences, Mangalore (Protocol no. 24105,13/8/2024). Written informed consent for publication of their details was obtained from the study participants. Data availability Figshare repository: Assessing Socioeconomic Status Through Dental and Associated Tissue Characteristics: A Cross-Sectional Study for Human Identification, https://www.doi.org/10.6084/m9.figshare.28308611.v2 . 38 The project contains the following underlying data: 1. SES EXCEL 1.xlsx. Data are available under the terms of the Creative Commons Attribution 4.0 International license (CC-BY 4.0). Acknowledgements Nil. References 1. Zhang T, Hong J, Yu X, et al. : Association between socioeconomic status and dental caries among Chinese preschool children: a cross-sectional national study. BMJ Open. 2021 May 21; 11 (5): e042908. PubMed Abstract | Publisher Full Text | Free Full Text 2. Carneiro JL, Caldas IM, Afonso A, et al. : Examining the socioeconomic effects on third molar maturation in a Portuguese sample of children, adolescents and young adults. Int. J. Legal Med. 2017 Jan; 131 (1): 235–242. PubMed Abstract | Publisher Full Text 3. 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PubMed Abstract | Publisher Full Text | Free Full Text 24. Agrawal R, Shakya P, Jain D, et al. : Prevalence of Dentulism, Partial Edentulism and Complete Edentulism in Rural and Urban Population of Malwa Region of India: A Population-based Study. Int. J. Prosthodont. Restor. Dent. 2014; 4 (4): 112–119. Publisher Full Text 25. Aeran H, Thapliyal A, Sharma N, et al. : Partial edentulism and its correlation to age, gender, socioeconomic status and incidence of various Kennedy’s classes - A cross-sectional study. Int. J. Oral. Health Dent. 2021; 7 (1): 8–13. Publisher Full Text 26. Ramdas S, Guru RC, Guru SR, et al. : Awareness, Cost-effectiveness, and Extension of Prosthodontic Treatment to Underprivileged Patients across Dental Colleges in India: A Cross-sectional Survey. J. Health Sci. Res. 2018; 9 (1): 1–5. Publisher Full Text 27. 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Dent J (Basel). 2022 Nov 18; 10 (11): 216. PubMed Abstract | Publisher Full Text | Free Full Text 31. Wetselaar P, Vermaire JH, Visscher CM, et al. : The Prevalence of Tooth Wear in the Dutch Adult Population. Caries Res. 2016; 50 (6): 543–550. PubMed Abstract | Publisher Full Text | Free Full Text 32. Baber H, et al. : Socioeconomic status and dental wear - A correlation. Biol. Eng. Med. 2017; 2 (3): 1–3. Publisher Full Text 33. Almosa NA: Enamel Demineralization: A Comprehensive Literature Review - Part I. EC Dent. Sci. 2024; 23 (10): 01–10. 34. Entezami S, Peres KG, Li H, et al. : Tooth wear and socioeconomic status in childhood and adulthood: Findings from a systematic review and meta-analysis of observational studies. J. Dent. 2021 Dec; 115 : 103827. Epub 2021 Sep 30. PubMed Abstract | Publisher Full Text 35. Ma R: Psychological Stress and Coping Strategies in Modern Society. TSSEHR. 2024 Sep. 26 [cited 2024 Dec. 27]; 13 : 240–247. Publisher Full Text Reference Source 36. Hashibe M, Jacob BJ, Thomas G, et al. : Socioeconomic status, lifestyle factors and oral premalignant lesions. Oral Oncol. 2003 Oct; 39 (7): 664–671. PubMed Abstract | Publisher Full Text 37. Taruna T, Singh YP, Waghmare R, et al. : Analyzing the Frequency of Premalignant Lesions and Oral Malignancy in Indian Subjects Attending Outpatient Department From the Low Socioeconomic Group. Cureus. 2023 Jul 17; 15 (7): e42035. PubMed Abstract | Publisher Full Text | Free Full Text 38. Denny C: SES EXCEL 1. Dataset. figshare. 2025. Publisher Full Text Comments on this article Comments (1) Version 3 VERSION 3 PUBLISHED 18 Mar 2025 Revised Comment ADD YOUR COMMENT Version 1 VERSION 1 PUBLISHED 18 Feb 2025 Discussion is closed on this version, please comment on the latest version above. Author Response 18 Mar 2025 CEENA DENNY , Department of Oral Medicine Radiology, Manipal College of Dental Sciences, Mangalore, Manipal Academy of Higher Education, Manipal, 576104, India 18 Mar 2025 Author Response I have made the necessary changes in the manuscript Reviewer 1 Socioeconomic status is a well documented determinant of oral health, as it influences access to dental care, oral ... Continue reading I have made the necessary changes in the manuscript Reviewer 1 Socioeconomic status is a well documented determinant of oral health, as it influences access to dental care, oral hygiene practices and diet. In case of females, their oral health status will be influenced by SEC of parent before marriage which is very important factor in relation to dental caries and periodontal health. The study's demographic distribution, with 54.1% females and 71.1% married participants, their oral health must have had influence by both parents SEC (before marriage) as well as spouse (currently). So it's a suggestion if it can be mentioned in inclusion criteria if both income was taken into consideration or not and then can be discussed about its impact in the discussion part. REPLY. The family income was chosen to assess socioeconomic status instead of that of the head of the household (ADDED IN METHODS) REVIEWER 2 a. Participation Selection Criteria: Although the author has outlined the inclusion and exclusion criteria, it would be helpful to provide a rationale for these choices. For instance, what was the reasoning behind limiting the age range to 18-65 years? REPLY: The age group of 18 to 65 represents a crucial stage in an individual's life, during which oral health plays a significant role in overall well-being. This transitional period marks the beginning of socioeconomic status (SES) development, as individuals gain greater independence and take on new responsibilities. After reaching the age of 65, many individuals experience a notable increase in tooth loss. This trend can be attributed to the cumulative effects of long-standing periodontal disease, a heightened prevalence of systemic health issues, and, in some cases, inadequate dental care. b. Statistical Analysis: It would be beneficial to justify the selection of the statistical methods used. For example, an explanation of why the chi-square test, t-test, and binary logistic regression were deemed appropriate for the data would add clarity. REPLY:The selection of statistical methods was based on the nature and distribution of the data to ensure appropriate analysis and meaningful interpretation. Chi-square tests were used to assess associations between categorical variables such as socioeconomic status (SES) and oral health parameters, while t-tests were applied for comparing continuous variables between SES groups. Binary logistic regression was performed to identify predictors of higher SES based on dental and demographic characteristics, allowing for the assessment of potential influencing factors. These methods were chosen to account for the categorical and continuous nature of the variables while ensuring statistical robustness. A p-value of <0.05 was considered statistically significant, providing a rigorous basis for interpreting the results and identifying meaningful associations within the dataset c. Tables and Figures: Consider incorporating visual aids, such as graphs or charts, to present key data for easier comprehension. For instance, a bar chart showing the differences in dental health parameters across SES groups could improve understanding. REPLY:Added at the end of manuscript I have made the necessary changes in the manuscript Reviewer 1 Socioeconomic status is a well documented determinant of oral health, as it influences access to dental care, oral hygiene practices and diet. In case of females, their oral health status will be influenced by SEC of parent before marriage which is very important factor in relation to dental caries and periodontal health. The study's demographic distribution, with 54.1% females and 71.1% married participants, their oral health must have had influence by both parents SEC (before marriage) as well as spouse (currently). So it's a suggestion if it can be mentioned in inclusion criteria if both income was taken into consideration or not and then can be discussed about its impact in the discussion part. REPLY. The family income was chosen to assess socioeconomic status instead of that of the head of the household (ADDED IN METHODS) REVIEWER 2 a. Participation Selection Criteria: Although the author has outlined the inclusion and exclusion criteria, it would be helpful to provide a rationale for these choices. For instance, what was the reasoning behind limiting the age range to 18-65 years? REPLY: The age group of 18 to 65 represents a crucial stage in an individual's life, during which oral health plays a significant role in overall well-being. This transitional period marks the beginning of socioeconomic status (SES) development, as individuals gain greater independence and take on new responsibilities. After reaching the age of 65, many individuals experience a notable increase in tooth loss. This trend can be attributed to the cumulative effects of long-standing periodontal disease, a heightened prevalence of systemic health issues, and, in some cases, inadequate dental care. b. Statistical Analysis: It would be beneficial to justify the selection of the statistical methods used. For example, an explanation of why the chi-square test, t-test, and binary logistic regression were deemed appropriate for the data would add clarity. REPLY:The selection of statistical methods was based on the nature and distribution of the data to ensure appropriate analysis and meaningful interpretation. Chi-square tests were used to assess associations between categorical variables such as socioeconomic status (SES) and oral health parameters, while t-tests were applied for comparing continuous variables between SES groups. Binary logistic regression was performed to identify predictors of higher SES based on dental and demographic characteristics, allowing for the assessment of potential influencing factors. These methods were chosen to account for the categorical and continuous nature of the variables while ensuring statistical robustness. A p-value of <0.05 was considered statistically significant, providing a rigorous basis for interpreting the results and identifying meaningful associations within the dataset c. Tables and Figures: Consider incorporating visual aids, such as graphs or charts, to present key data for easier comprehension. For instance, a bar chart showing the differences in dental health parameters across SES groups could improve understanding. REPLY:Added at the end of manuscript Competing Interests: No competing interests were disclosed. Close Report a concern Discussion is closed on this version, please comment on the latest version above. Author details Author details 1 Department of Oral Medicine Radiology, Manipal College of Dental Sciences, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India 2 Department of Oral Pathology and Microbiology, Manipal College of Dental Sciences, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India CEENA DENNY Roles: Conceptualization, Data Curation, Formal Analysis, Investigation, Methodology, Writing – Original Draft Preparation Srikant Natarajan Roles: Conceptualization, Data Curation, Formal Analysis, Supervision, Writing – Review & Editing Jasmine Jophy Roles: Data Curation, Investigation, Writing – Review & Editing Nandita KP Roles: Data Curation, Methodology, Writing – Review & Editing Amita Juanita Lewis Roles: Data Curation, Methodology, Writing – Review & Editing Shwetha Yellapurkar Roles: Data Curation, Writing – Review & Editing Competing interests No competing interests were disclosed. Grant information The author(s) declared that no grants were involved in supporting this work. Article Versions (3) version 3 Revised Published: 18 Mar 2025, 14:220 https://doi.org/10.12688/f1000research.161533.3 version 2 Revised Published: 07 Mar 2025, 14:220 https://doi.org/10.12688/f1000research.161533.2 version 1 Published: 18 Feb 2025, 14:220 https://doi.org/10.12688/f1000research.161533.1 Copyright © 2025 DENNY C et al . This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Download Export To Sciwheel Bibtex EndNote ProCite Ref. Manager (RIS) Sente metrics Views Downloads F1000Research - - PubMed Central info_outline Data from PMC are received and updated monthly. - - Citations open_in_new 0 open_in_new 0 open_in_new SEE MORE DETAILS CITE how to cite this article DENNY C, Natarajan S, Jophy J et al. Assessing socioeconomic status through dental and associated tissue characteristics: A cross-sectional study for human identification [version 3; peer review: 2 approved] . F1000Research 2025, 14 :220 ( https://doi.org/10.12688/f1000research.161533.3 ) NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS track receive updates on this article Track an article to receive email alerts on any updates to this article. TRACK THIS ARTICLE Share Open Peer Review Current Reviewer Status: ? Key to Reviewer Statuses VIEW HIDE Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Version 2 VERSION 2 PUBLISHED 07 Mar 2025 Revised Views 0 Cite How to cite this report: Veena KM. Reviewer Report For: Assessing socioeconomic status through dental and associated tissue characteristics: A cross-sectional study for human identification [version 3; peer review: 2 approved] . F1000Research 2025, 14 :220 ( https://doi.org/10.5256/f1000research.178770.r369920 ) The direct URL for this report is: https://f1000research.com/articles/14-220/v2#referee-response-369920 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 13 Mar 2025 Korikkar Mahaling Veena , Oral medicine and Radiology, Yenepoya Dental College, Yenepoya (deemed to be) University, Mangaluru, Karnataka, India Approved VIEWS 0 https://doi.org/10.5256/f1000research.178770.r369920 The authors have considered the suggestion given and incorporated them ... Continue reading READ ALL The authors have considered the suggestion given and incorporated them in the manuscript and I have no further comments to make. Competing Interests: No competing interests were disclosed. Reviewer Expertise: Potentially malignant disorders of the oral mucosa I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Veena KM. Reviewer Report For: Assessing socioeconomic status through dental and associated tissue characteristics: A cross-sectional study for human identification [version 3; peer review: 2 approved] . F1000Research 2025, 14 :220 ( https://doi.org/10.5256/f1000research.178770.r369920 ) The direct URL for this report is: https://f1000research.com/articles/14-220/v2#referee-response-369920 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Respond or Comment COMMENT ON THIS REPORT Views 0 Cite How to cite this report: M S. Reviewer Report For: Assessing socioeconomic status through dental and associated tissue characteristics: A cross-sectional study for human identification [version 3; peer review: 2 approved] . F1000Research 2025, 14 :220 ( https://doi.org/10.5256/f1000research.178770.r369921 ) The direct URL for this report is: https://f1000research.com/articles/14-220/v2#referee-response-369921 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 12 Mar 2025 Selvamani M , Mahe Institute of Dental Sciences and Hospital, Mahé, India Approved VIEWS 0 https://doi.org/10.5256/f1000research.178770.r369921 The article is excellently written, and I ... Continue reading READ ALL The article is excellently written, and I have no additional comments or suggestions to make. Competing Interests: No competing interests were disclosed. Reviewer Expertise: Forensic Odontology, Forensic Science, Odontogenic Cyst & Tumors I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. Close READ LESS CITE CITE HOW TO CITE THIS REPORT M S. Reviewer Report For: Assessing socioeconomic status through dental and associated tissue characteristics: A cross-sectional study for human identification [version 3; peer review: 2 approved] . F1000Research 2025, 14 :220 ( https://doi.org/10.5256/f1000research.178770.r369921 ) The direct URL for this report is: https://f1000research.com/articles/14-220/v2#referee-response-369921 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Respond or Comment COMMENT ON THIS REPORT Version 1 VERSION 1 PUBLISHED 18 Feb 2025 Views 0 Cite How to cite this report: M S. Reviewer Report For: Assessing socioeconomic status through dental and associated tissue characteristics: A cross-sectional study for human identification [version 3; peer review: 2 approved] . F1000Research 2025, 14 :220 ( https://doi.org/10.5256/f1000research.177572.r367471 ) The direct URL for this report is: https://f1000research.com/articles/14-220/v1#referee-response-367471 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 28 Feb 2025 Selvamani M , Mahe Institute of Dental Sciences and Hospital, Mahé, India Approved with Reservations VIEWS 0 https://doi.org/10.5256/f1000research.177572.r367471 The article effectively aligns with the study's objective, ensuring that the conclusions drawn are well-supported by the results obtained. The research presents an innovative approach with significant implications, particularly in the field of human identification through the assessment of socio-economic ... Continue reading READ ALL The article effectively aligns with the study's objective, ensuring that the conclusions drawn are well-supported by the results obtained. The research presents an innovative approach with significant implications, particularly in the field of human identification through the assessment of socio-economic status. This study contributes valuable insights and has the potential to enhance forensic and social research methodologies. My decision is approved with reservations. Here are a few suggestions I would like to forward for the author: a. Participation Selection Criteria: Although the author has outlined the inclusion and exclusion criteria, it would be helpful to provide a rationale for these choices. For instance, what was the reasoning behind limiting the age range to 18-65 years? b. Statistical Analysis: It would be beneficial to justify the selection of the statistical methods used. For example, an explanation of why the chi-square test, t-test, and binary logistic regression were deemed appropriate for the data would add clarity. c. Tables and Figures: Consider incorporating visual aids, such as graphs or charts, to present key data for easier comprehension. For instance, a bar chart showing the differences in dental health parameters across SES groups could improve understanding. Is the work clearly and accurately presented and does it cite the current literature? Yes Is the study design appropriate and is the work technically sound? Yes Are sufficient details of methods and analysis provided to allow replication by others? Yes If applicable, is the statistical analysis and its interpretation appropriate? Yes Are all the source data underlying the results available to ensure full reproducibility? Yes Are the conclusions drawn adequately supported by the results? Yes Competing Interests: No competing interests were disclosed. Reviewer Expertise: Forensic Odontology, Forensic Science, Odontogenic Cyst & Tumors I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. Close READ LESS CITE CITE HOW TO CITE THIS REPORT M S. Reviewer Report For: Assessing socioeconomic status through dental and associated tissue characteristics: A cross-sectional study for human identification [version 3; peer review: 2 approved] . F1000Research 2025, 14 :220 ( https://doi.org/10.5256/f1000research.177572.r367471 ) The direct URL for this report is: https://f1000research.com/articles/14-220/v1#referee-response-367471 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Author Response 07 Mar 2025 CEENA DENNY , Department of Oral Medicine Radiology, Manipal College of Dental Sciences, Mangalore, Manipal Academy of Higher Education, Manipal, 576104, India 07 Mar 2025 Author Response I have added a sentence and highlighted it in under the methods section The family income was chosen to assess socioeconomic status instead of that of the head ... Continue reading I have added a sentence and highlighted it in under the methods section The family income was chosen to assess socioeconomic status instead of that of the head of the household. I have added a sentence and highlighted it in under the methods section The family income was chosen to assess socioeconomic status instead of that of the head of the household. Competing Interests: No competing interests were disclosed. Close Report a concern Respond or Comment COMMENTS ON THIS REPORT Author Response 07 Mar 2025 CEENA DENNY , Department of Oral Medicine Radiology, Manipal College of Dental Sciences, Mangalore, Manipal Academy of Higher Education, Manipal, 576104, India 07 Mar 2025 Author Response I have added a sentence and highlighted it in under the methods section The family income was chosen to assess socioeconomic status instead of that of the head ... Continue reading I have added a sentence and highlighted it in under the methods section The family income was chosen to assess socioeconomic status instead of that of the head of the household. I have added a sentence and highlighted it in under the methods section The family income was chosen to assess socioeconomic status instead of that of the head of the household. Competing Interests: No competing interests were disclosed. Close Report a concern COMMENT ON THIS REPORT Views 0 Cite How to cite this report: Veena KM. Reviewer Report For: Assessing socioeconomic status through dental and associated tissue characteristics: A cross-sectional study for human identification [version 3; peer review: 2 approved] . F1000Research 2025, 14 :220 ( https://doi.org/10.5256/f1000research.177572.r367473 ) The direct URL for this report is: https://f1000research.com/articles/14-220/v1#referee-response-367473 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 22 Feb 2025 Korikkar Mahaling Veena , Oral medicine and Radiology, Yenepoya Dental College, Yenepoya (deemed to be) University, Mangaluru, Karnataka, India Approved with Reservations VIEWS 0 https://doi.org/10.5256/f1000research.177572.r367473 Socioeconomic status is a well documented determinant of oral health, as it influences access to dental care, oral hygiene practices and diet. In case of females, their oral health status will be influenced by SEC of parent before marriage which ... Continue reading READ ALL Socioeconomic status is a well documented determinant of oral health, as it influences access to dental care, oral hygiene practices and diet. In case of females, their oral health status will be influenced by SEC of parent before marriage which is very important factor in relation to dental caries and periodontal health. The study's demographic distribution, with 54.1% females and 71.1% married participants, their oral health must have had influence by both parents SEC (before marriage) as well as spouse (currently). So it's a suggestion if it can be mentioned in inclusion criteria if both income was taken into consideration or not and then can be discussed about its impact in the discussion part. Is the work clearly and accurately presented and does it cite the current literature? Yes Is the study design appropriate and is the work technically sound? Yes Are sufficient details of methods and analysis provided to allow replication by others? Yes If applicable, is the statistical analysis and its interpretation appropriate? I cannot comment. A qualified statistician is required. Are all the source data underlying the results available to ensure full reproducibility? No source data required Are the conclusions drawn adequately supported by the results? Partly Competing Interests: No competing interests were disclosed. Reviewer Expertise: Potentially malignant disorders of the oral mucosa I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Veena KM. Reviewer Report For: Assessing socioeconomic status through dental and associated tissue characteristics: A cross-sectional study for human identification [version 3; peer review: 2 approved] . F1000Research 2025, 14 :220 ( https://doi.org/10.5256/f1000research.177572.r367473 ) The direct URL for this report is: https://f1000research.com/articles/14-220/v1#referee-response-367473 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Respond or Comment COMMENT ON THIS REPORT Comments on this article Comments (1) Version 3 VERSION 3 PUBLISHED 18 Mar 2025 Revised Comment ADD YOUR COMMENT Version 1 VERSION 1 PUBLISHED 18 Feb 2025 Discussion is closed on this version, please comment on the latest version above. Author Response 18 Mar 2025 CEENA DENNY , Department of Oral Medicine Radiology, Manipal College of Dental Sciences, Mangalore, Manipal Academy of Higher Education, Manipal, 576104, India 18 Mar 2025 Author Response I have made the necessary changes in the manuscript Reviewer 1 Socioeconomic status is a well documented determinant of oral health, as it influences access to dental care, oral ... Continue reading I have made the necessary changes in the manuscript Reviewer 1 Socioeconomic status is a well documented determinant of oral health, as it influences access to dental care, oral hygiene practices and diet. In case of females, their oral health status will be influenced by SEC of parent before marriage which is very important factor in relation to dental caries and periodontal health. The study's demographic distribution, with 54.1% females and 71.1% married participants, their oral health must have had influence by both parents SEC (before marriage) as well as spouse (currently). So it's a suggestion if it can be mentioned in inclusion criteria if both income was taken into consideration or not and then can be discussed about its impact in the discussion part. REPLY. The family income was chosen to assess socioeconomic status instead of that of the head of the household (ADDED IN METHODS) REVIEWER 2 a. Participation Selection Criteria: Although the author has outlined the inclusion and exclusion criteria, it would be helpful to provide a rationale for these choices. For instance, what was the reasoning behind limiting the age range to 18-65 years? REPLY: The age group of 18 to 65 represents a crucial stage in an individual's life, during which oral health plays a significant role in overall well-being. This transitional period marks the beginning of socioeconomic status (SES) development, as individuals gain greater independence and take on new responsibilities. After reaching the age of 65, many individuals experience a notable increase in tooth loss. This trend can be attributed to the cumulative effects of long-standing periodontal disease, a heightened prevalence of systemic health issues, and, in some cases, inadequate dental care. b. Statistical Analysis: It would be beneficial to justify the selection of the statistical methods used. For example, an explanation of why the chi-square test, t-test, and binary logistic regression were deemed appropriate for the data would add clarity. REPLY:The selection of statistical methods was based on the nature and distribution of the data to ensure appropriate analysis and meaningful interpretation. Chi-square tests were used to assess associations between categorical variables such as socioeconomic status (SES) and oral health parameters, while t-tests were applied for comparing continuous variables between SES groups. Binary logistic regression was performed to identify predictors of higher SES based on dental and demographic characteristics, allowing for the assessment of potential influencing factors. These methods were chosen to account for the categorical and continuous nature of the variables while ensuring statistical robustness. A p-value of <0.05 was considered statistically significant, providing a rigorous basis for interpreting the results and identifying meaningful associations within the dataset c. Tables and Figures: Consider incorporating visual aids, such as graphs or charts, to present key data for easier comprehension. For instance, a bar chart showing the differences in dental health parameters across SES groups could improve understanding. REPLY:Added at the end of manuscript I have made the necessary changes in the manuscript Reviewer 1 Socioeconomic status is a well documented determinant of oral health, as it influences access to dental care, oral hygiene practices and diet. In case of females, their oral health status will be influenced by SEC of parent before marriage which is very important factor in relation to dental caries and periodontal health. The study's demographic distribution, with 54.1% females and 71.1% married participants, their oral health must have had influence by both parents SEC (before marriage) as well as spouse (currently). So it's a suggestion if it can be mentioned in inclusion criteria if both income was taken into consideration or not and then can be discussed about its impact in the discussion part. REPLY. The family income was chosen to assess socioeconomic status instead of that of the head of the household (ADDED IN METHODS) REVIEWER 2 a. Participation Selection Criteria: Although the author has outlined the inclusion and exclusion criteria, it would be helpful to provide a rationale for these choices. For instance, what was the reasoning behind limiting the age range to 18-65 years? REPLY: The age group of 18 to 65 represents a crucial stage in an individual's life, during which oral health plays a significant role in overall well-being. This transitional period marks the beginning of socioeconomic status (SES) development, as individuals gain greater independence and take on new responsibilities. After reaching the age of 65, many individuals experience a notable increase in tooth loss. This trend can be attributed to the cumulative effects of long-standing periodontal disease, a heightened prevalence of systemic health issues, and, in some cases, inadequate dental care. b. Statistical Analysis: It would be beneficial to justify the selection of the statistical methods used. For example, an explanation of why the chi-square test, t-test, and binary logistic regression were deemed appropriate for the data would add clarity. REPLY:The selection of statistical methods was based on the nature and distribution of the data to ensure appropriate analysis and meaningful interpretation. Chi-square tests were used to assess associations between categorical variables such as socioeconomic status (SES) and oral health parameters, while t-tests were applied for comparing continuous variables between SES groups. Binary logistic regression was performed to identify predictors of higher SES based on dental and demographic characteristics, allowing for the assessment of potential influencing factors. These methods were chosen to account for the categorical and continuous nature of the variables while ensuring statistical robustness. A p-value of <0.05 was considered statistically significant, providing a rigorous basis for interpreting the results and identifying meaningful associations within the dataset c. Tables and Figures: Consider incorporating visual aids, such as graphs or charts, to present key data for easier comprehension. For instance, a bar chart showing the differences in dental health parameters across SES groups could improve understanding. REPLY:Added at the end of manuscript Competing Interests: No competing interests were disclosed. Close Report a concern Discussion is closed on this version, please comment on the latest version above. keyboard_arrow_left keyboard_arrow_right Open Peer Review Reviewer Status info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Reviewer Reports Invited Reviewers 1 2 Version 3 (revision) 18 Mar 25 Version 2 (revision) 07 Mar 25 read read Version 1 18 Feb 25 read read Korikkar Mahaling Veena , Yenepoya Dental College, Yenepoya (deemed to be) University, Mangaluru, India Selvamani M , Mahe Institute of Dental Sciences and Hospital, Mahé, India Comments on this article All Comments (1) Add a comment Sign up for content alerts Sign Up You are now signed up to receive this alert Browse by related subjects keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2025 Veena K. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 13 Mar 2025 | for Version 2 Korikkar Mahaling Veena , Oral medicine and Radiology, Yenepoya Dental College, Yenepoya (deemed to be) University, Mangaluru, Karnataka, India 0 Views copyright © 2025 Veena K. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (0) Approved info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions The authors have considered the suggestion given and incorporated them in the manuscript and I have no further comments to make. Competing Interests No competing interests were disclosed. Reviewer Expertise Potentially malignant disorders of the oral mucosa I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. reply Respond to this report Responses (0) Veena KM. Peer Review Report For: Assessing socioeconomic status through dental and associated tissue characteristics: A cross-sectional study for human identification [version 3; peer review: 2 approved] . F1000Research 2025, 14 :220 ( https://doi.org/10.5256/f1000research.178770.r369920) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/14-220/v2#referee-response-369920 keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2025 M S. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 12 Mar 2025 | for Version 2 Selvamani M , Mahe Institute of Dental Sciences and Hospital, Mahé, India 0 Views copyright © 2025 M S. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (0) Approved info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions The article is excellently written, and I have no additional comments or suggestions to make. Competing Interests No competing interests were disclosed. Reviewer Expertise Forensic Odontology, Forensic Science, Odontogenic Cyst & Tumors I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. reply Respond to this report Responses (0) M S. Peer Review Report For: Assessing socioeconomic status through dental and associated tissue characteristics: A cross-sectional study for human identification [version 3; peer review: 2 approved] . F1000Research 2025, 14 :220 ( https://doi.org/10.5256/f1000research.178770.r369921) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/14-220/v2#referee-response-369921 keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2025 M S. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 28 Feb 2025 | for Version 1 Selvamani M , Mahe Institute of Dental Sciences and Hospital, Mahé, India 0 Views copyright © 2025 M S. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (1) Approved With Reservations info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions The article effectively aligns with the study's objective, ensuring that the conclusions drawn are well-supported by the results obtained. The research presents an innovative approach with significant implications, particularly in the field of human identification through the assessment of socio-economic status. This study contributes valuable insights and has the potential to enhance forensic and social research methodologies. My decision is approved with reservations. Here are a few suggestions I would like to forward for the author: a. Participation Selection Criteria: Although the author has outlined the inclusion and exclusion criteria, it would be helpful to provide a rationale for these choices. For instance, what was the reasoning behind limiting the age range to 18-65 years? b. Statistical Analysis: It would be beneficial to justify the selection of the statistical methods used. For example, an explanation of why the chi-square test, t-test, and binary logistic regression were deemed appropriate for the data would add clarity. c. Tables and Figures: Consider incorporating visual aids, such as graphs or charts, to present key data for easier comprehension. For instance, a bar chart showing the differences in dental health parameters across SES groups could improve understanding. Is the work clearly and accurately presented and does it cite the current literature? Yes Is the study design appropriate and is the work technically sound? Yes Are sufficient details of methods and analysis provided to allow replication by others? Yes If applicable, is the statistical analysis and its interpretation appropriate? Yes Are all the source data underlying the results available to ensure full reproducibility? Yes Are the conclusions drawn adequately supported by the results? Yes Competing Interests No competing interests were disclosed. Reviewer Expertise Forensic Odontology, Forensic Science, Odontogenic Cyst & Tumors I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. reply Respond to this report Responses (1) Author Response 07 Mar 2025 CEENA DENNY, Department of Oral Medicine Radiology, Manipal College of Dental Sciences, Mangalore, Manipal Academy of Higher Education, Manipal, 576104, India I have added a sentence and highlighted it in under the methods section The family income was chosen to assess socioeconomic status instead of that of the head of the household. View more View less Competing Interests No competing interests were disclosed. reply Respond Report a concern M S. Peer Review Report For: Assessing socioeconomic status through dental and associated tissue characteristics: A cross-sectional study for human identification [version 3; peer review: 2 approved] . F1000Research 2025, 14 :220 ( https://doi.org/10.5256/f1000research.177572.r367471) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/14-220/v1#referee-response-367471 keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2025 Veena K. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 22 Feb 2025 | for Version 1 Korikkar Mahaling Veena , Oral medicine and Radiology, Yenepoya Dental College, Yenepoya (deemed to be) University, Mangaluru, Karnataka, India 0 Views copyright © 2025 Veena K. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (0) Approved With Reservations info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Socioeconomic status is a well documented determinant of oral health, as it influences access to dental care, oral hygiene practices and diet. In case of females, their oral health status will be influenced by SEC of parent before marriage which is very important factor in relation to dental caries and periodontal health. The study's demographic distribution, with 54.1% females and 71.1% married participants, their oral health must have had influence by both parents SEC (before marriage) as well as spouse (currently). So it's a suggestion if it can be mentioned in inclusion criteria if both income was taken into consideration or not and then can be discussed about its impact in the discussion part. Is the work clearly and accurately presented and does it cite the current literature? Yes Is the study design appropriate and is the work technically sound? Yes Are sufficient details of methods and analysis provided to allow replication by others? Yes If applicable, is the statistical analysis and its interpretation appropriate? I cannot comment. A qualified statistician is required. Are all the source data underlying the results available to ensure full reproducibility? No source data required Are the conclusions drawn adequately supported by the results? Partly Competing Interests No competing interests were disclosed. Reviewer Expertise Potentially malignant disorders of the oral mucosa I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. reply Respond to this report Responses (0) Veena KM. Peer Review Report For: Assessing socioeconomic status through dental and associated tissue characteristics: A cross-sectional study for human identification [version 3; peer review: 2 approved] . F1000Research 2025, 14 :220 ( https://doi.org/10.5256/f1000research.177572.r367473) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/14-220/v1#referee-response-367473 Alongside their report, reviewers assign a status to the article: Approved - the paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations - A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved - fundamental flaws in the paper seriously undermine the findings and conclusions Adjust parameters to alter display View on desktop for interactive features Includes Interactive Elements View on desktop for interactive features Competing Interests Policy Provide sufficient details of any financial or non-financial competing interests to enable users to assess whether your comments might lead a reasonable person to question your impartiality. 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