Abstract

Dental age estimation is used in situations where reliable identification documents or other methods like biometric databases
are unavailable. Since tooth development is genetically determined and less influenced by environmental factors than skeletal growth, it provides a more trustworthy basis for assessing a child’s age. Radiological assessment—particularly panoramic radiography— is a simple, minimally invasive, and repeatable method.
Two main radiological approaches are used: atlas-based (e.g., the AlQahtani atlas) and stage-based assessment methods (e.g., the Demirjian method). Atlas-based methods require no calculations, while stage-based systems convert developmental stages into numerical values.
When choosing a method, the child’s or adolescent’s ethnic background must be considered, and it is recommended to apply at least two methods independently. For the Estonian population, techniques developed on European ancestry samples—such as those by Cameriere, Willems, and Mincer— are likely the most suitable, although the field remains locally understudied.
Because radiological examinations involve exposure to ionizing radiation, they should only be performed when justified and with the lowest reasonable dose. Research should rely on previously acquired radiographs. Legally, radiographs for age assessment may be taken only when the stated and estimated ages differ significantly and the chosen method is appropriate for the child’s sex and ethnicity.