Dental age assessment deconstructed - a review of terminology and frequently neglected controversies

This paper addresses the presumption that tooth development is commensurate with accurate age assessment. The strong correlation between dental maturity and chronological age has been applied extensively through the study of developing teeth. This is the premise on which numerous methods have been designed, tested and implemented, often through misguided or misapplied protocols that have made the measure of maturity a mathematical cognate of chronological age. Variation in dental maturity, which is immanent to all populations due to biological diversity, has been frequently ignored or obscured by the emphasis of certain metrics and inconsistent interpretation of results. Bias has skewed perception; the need for clarity is indisputable. Factors that play a substantial role in the accuracy, applicability and limitations of dental age assessment are discussed through an impartial review and analysis of methodology. The influence of statistical methods on the perception of accuracy in age assessment, the importance of adequate sample selection as well as repeatability at the developmental stage assignment are illustrated objectively through subject literature. Of significance is the analysis of terminology used in the field of forensic odontology. The research confirms that when used improperly or inconsistently, terminology is misleading and can become a source of misunderstanding and error. To redress this issue, terms and phrases that are concise and transparent are underscored and proposed for consistent usage. Principal factors to assist forensic odontologists in selecting the most appropriate method to assess age have been identified and are complemented by practical guidelines for individual age assessment.