What this added up to was an indigent woman who had not been reported missing as far as we could tell because she had no home, no one who knew or cared she was gone. She was the tragically typical street person, we assumed, until we got her on table six in the autopsy room, where forensic dentist Dr. Graham waited to chart her teeth.
A broad-shouldered young man with an air of abstraction that I associated with medical school professors, he was an oral surgeon on Staten Island when he worked on the living. But today was his day to work on those who complained with silent tongues, which he did for a fee that probably would not cover his taxi fare and lunch. Rigor mortis was set, and like an obstinate child who hates the dentist, the dead woman would not cooperate. He finally pried her jaws open with a thin file.
‘Well Merry Christmas,’ he said, moving a bright light close. ‘She’s got a mouth full of gold.’
‘Most curious,’ Horowitz said, like a mathematician pondering a problem.
‘These are gold foil restorations.’ Graham began “pointing out kidney bean-shaped gold fillings near the gum line of each front tooth. ‘She has them here and here and here.’ He pointed again and again. ‘Six in all. This is just very rare. In fact, I’ve never seen it. Not in a morgue.’
‘What the hell is gold foil?’ Marino asked.
‘It’s a pain in the ass, is what it is,’ said Graham. ‘A very difficult, unattractive restoration.’
‘I believe in the old days, they were required to pass your dental license exam,’ I said.
‘That’s right.’ Graham continued to work. ‘The students hated them.’
He went on to explain that gold foil restorations required the dentist to pound gold pellets into a tooth, and the slightest bit of moisture would cause the filling to fall out. Although the restorations were very good, they were labor intensive, painful and expensive.
‘And not many patients,’ he added, ‘want gold showing, especially on the facial surface of their front teeth.’
He continued charting various repairs, extractions, shapes and misshapes that made this woman who she was. She had a slightly open bite and a semicircular wear pattern to her front teeth possibly consistent with her biting down on a pipe, since it was reported to him that she had been seen with a pipe.
‘If she was a chronic pipe smoker, wouldn’t you expect her teeth to be stained from tobacco?’ I said, for I saw no evidence of it.
‘Possibly. But look at how eroded her tooth surfaces are – these scooped-out areas at the gum line that required the gold foil.’ He showed us. ‘The major damage to her teeth is consistent with obsessive overbrushing.’
‘So if she brushed the hell out of her teeth ten times a day, she’s not going to have tobacco stains,’ Marino said.
‘Brushing the hell out of her teeth doesn’t fit with her poor hygiene,’ I commented. ‘In fact, her mouth seems inconsistent with everything else about her.’
‘Can you tell when she had this work done?’ Rader asked.
‘Not really,’ Graham said as he continued probing. ‘But it is consistently good. I’d say it was probably the same dentist who did all of it, and about the only area in the country where you find gold foil restorations still being done is the West Coast.’
‘I’m wondering how you can know that,’ Detective O’Donnell said to him.
‘You can only get these restorations done where there are dentists who still do them. I don’t do them. I personally don’t know anybody who does them. But there is an organization called the American Academy of Gold Foil Operators that has several hundred members – dentists who pride themselves on still doing this particular restoration. And the largest concentration of them is in Washington State.’
‘Why would someone want a restoration like this?’ O’Donnell then asked.
‘Gold lasts a long time.’ Graham glanced up at him. ‘There are people who are nervous about what is put into their mouths. The chemicals in composite white fillings supposedly can cause nerve damage. They stain and wear out more quickly. Some people believe silver causes everything from cystic fibrosis to hair loss.’