Department of Dentistry/OMFS, Health+Hospitals/Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA.
College of Graduate Health Studies, AT Still University, Kirksville, Missouri, USA.
J Public Health Dent. 2022 Jun;82(3):349-351. doi: 10.1111/jphd.12496. Epub 2022 Feb 16.
Unaccompanied migrant minors are increasingly seeking asylum status in the United States (U.S.) where guidelines for age assessment call for the use of multiple forms of evidence. A commonly used approach in the U.S. is dental radiographs to assess the root development of third molars. Not only has research shown this methodology to be unreliable and imprecise, but the evidence has shown significant variability in dental development by chronologic age, race/ethnicity, sex, socioeconomic status, systemic disease, nutritional health, and other environmental factors. Misclassification of minors as adults based upon the imprecise tool of dental age assessment can have serious and harmful consequences. In the U.S., this misclassification has resulted in the housing of minors with adults in Immigrant and Custom Enforcement (ICE) operated jails. In addition, there are significant ethical concerns with regard to the use of radiographs for purposes that are neither diagnostic nor therapeutic and the lack of informed consent. In this commentary we review the (1) inadequacy of dental radiographs as a means of chronologic age assessment for minors, and (2) the ethical implications of implementing this flawed and inappropriate assessment on a highly vulnerable population.
孤身未成年移民越来越多地寻求在美国获得庇护身份，美国的年龄评估指南要求使用多种形式的证据。美国常用的方法是通过牙 X 光片来评估第三磨牙的牙根发育情况。不仅有研究表明这种方法不可靠且不准确，而且证据表明，牙龄发育在很大程度上因年龄、种族/民族、性别、社会经济地位、系统性疾病、营养健康和其他环境因素而异。基于不准确的牙龄评估工具将未成年人错误分类为成年人，可能会产生严重和有害的后果。在美国，这种错误分类导致未成年人与成年人一起被关押在移民和海关执法局（ICE）运营的监狱中。此外，使用 X 光片进行既非诊断又非治疗目的的检查，且缺乏知情同意，这引发了重大的伦理问题。在这篇评论中，我们回顾了（1）牙 X 光片作为未成年人生物年龄评估手段的不足，以及（2）在高度脆弱人群中实施这种有缺陷和不适当评估的伦理影响。
