In the days after the 2011 earthquake, Akiko Kumagai visited morgues across Iwate Prefecture. She was one of the few dentists in the prefecture trained in forensic dentistry, and her skills were in high demand.
Kumagai examined the remains and noted dentition, or the arrangement of teeth. She cross-referenced this information with existing dental records to identify victims.
"It was heartbreaking to see people who came to the morgues every day to search for their missing family members," she says. "It was my duty to reunite these bodies with their families."
One day, Kumagai was at a morgue when a man approached her. He guided her to a body and handed her a memo. It contained his missing wife's dental records. He suspected the body in front of them was his wife. Kumagai helped run a test and the dentition was a perfect match with the records. She told the police that the body could be identified as the man's wife.
Kumagai experienced many cases like this one over the course of several months following the disaster. She traveled throughout the prefecture, recording the dentition of hundreds of thousands of bodies.
Identifying remains using dentition was made difficult by the fact that the tsunami that followed the earthquake swept away many clinics, and dental records along with them. The method has so far been used to identify around 1,200 victims but Kumagai thinks this number would be much higher if dental records had been centralized.
"Because of our national healthcare, many Japanese people get their teeth treated," she says. "So if there was a database that was stored safely, it would play a vital role in identifying disaster victims."
The Japan Dental Association wants to turn this idea into a reality. Some regions in the country have already starting collecting dental information of people who gave consent. But efforts on a national level have faced some resistance. The creation of a centralized system would involve adopting a standard format for dental records across the country, which may violate regulations guarding personal information. The association is currently explaining to dentists the merits of the format, in the hope of convincing them to adopt it.
After the earthquake, more than 1,000 dentists across Japan took part in identification efforts. But Kumagai says many of them were inexperienced and could not contribute to the process in a meaningful way. She is currently an associate professor of forensic dentistry and trains her colleagues so they can be better prepared for disasters in the future.
"We can't ignore 2011," Kumagai says. "We need to learn from the experience and improve the identification system."
As Kumagai continues her efforts to prepare for a future disaster, about 60 sets of remains from 2011 are still unidentified. She says she will work to make sure these victims are reunited with their families.