age estimation from oral and dental structures 293
13.5 Summary, Conclusions, and Recommendations
Teeth are common and they preserve well in traumatic settings (protected
by thick surrounding bones and tissues), and they undergo a variety of
age- progressive changes. These features make them of value to the forensic
odontologist. We have reviewed some of the common methods used for
age estimation. Collectively, the methods can be applied from before birth
(all primary teeth begin formation in the second trimester) into very old age.
Improved oral health—fewer caries and less periodontal disease—means that
more forensic cases will have teeth (and more teeth) than in the past.
A predictable conclusion from this review is that more studies are
needed, but not just more of the same. We identify two areas of need: First,
Westernized countries are quickly becoming the homes of diverse peoples
from around the globe, and the forensic specialist is ill-equipped to account
for the range of racial variation. Few dental standards for age or sex are
available for nonwhites. The problem becomes more complex when a person
grows up in one cultural setting, then immigrates to quite another. More
studies of ethnically-racially diverse segments of our population are needed.
Second, our opinion is that forensic odontology research in age estimation
has been lacking in scope and execution, with numerous reports suffering
from small sample sizes and restricted analysis. Larger studies with more
in-depth analysis would improve the precision of age estimations due to a
better understanding of the nature of the differences and recognition of cases
where normative standards do not apply.
For practical forensic casework the specific method or methods that are
appropriate vary. While the capabilities and resources of investigators differ,
we offer these guidelines for choosing the method or methods with the most
potential for each case.
For living persons, the techniques utilizing radiological assessment are
m o s t a p p l i c a b l e. I n c h i l d r e n u p t o t h e a g e o f p u b e r t y, t h o s e t e c h n i q u e s a s s e s s i n g
dental development are more accurate but more complex and time-consuming
than those using eruption/emergence schedules. From puberty to the time
that growth and development have ceased, around age twenty-one, the most
useful dental techniques involve analyzing the development or mineralization
of the teeth, including the third molar. It is well known that third molar devel-
opment variations are greater than for any other human tooth, but those are
likely the only teeth still developing in the target age group. There is a need for
more and larger population studies for specific geographic and ethnic groups.
For adults after t he age of around twent y-one years, t he applicable denta l tech-
niques are those that look at gross, histological, biochemical, and trace ele-
ment changes to teeth. In living adults these are limited to the radiological
and visual examination techniques unless a valid clinical reason for removing