Dentist Uses X-Rays to Verify Ages of Immigrants for INS

Dentistry Today


When immigrants under the age of 18 are detained, they are sent to shelters operated by the Office of Refugee Resettlement or released to the custody of relatives. Those who are 18 and older are sent to Immigration and Customs Enforcement adult detention centers. Immigration and Naturalization Services (INS), then, needs precise techniques for determining the ages of these new arrivals. 

According to Robert M. Trager, DDS, the eruption of wisdom teeth and the condition of the fusion of bones in the wrist usually indicate that a person is over the age of 18. After the first World Trade Center bombing on February 26, 1993, he was asked about determining age based on the x-rays of teeth. But he found that x-rays of third molars were only 83% accurate.

However, wrist x-rays showing epiphysis (when the rounded end of long bone and cartilage is ossified and becomes fused to the bone after the age of 17 in females and 18 in males) combined with dental x-rays is more than 98% accurate in determining age. Trager says that he is the only dentist in the United States who has been performing this exam ethically and scientifically for more than 20 years, with more than 1,000 determinations.

Whether an individual is a minor when he or she crosses the border also carries consequences related to his or her ability to obtain asylum and lawfully remain in the United States. Improper age determination may cause a child to unnecessarily lose status as what the Office of Refugee Resettlement calls an unaccompanied alien child and the legal protections that come with that status, such as a non-adversarial asylum interview and release to an eligible sponsor. 

Children routinely receive some dental care while in custody of the Office of Refugee Resettlement. Two groups are x-rayed: those with obvious dental issues, and those whose age is in question. When authorities believe a person who has crossed the border and claims to be a child might actually be over the age of 18, they call Trager in to take x-rays because of the precision with which he can identify an individual’s age based on them.

“I have been doing age determination for over 20 years using x-rays of the third molars and I also take an x-ray of the radius and ulnar bones of the wrists for best accuracy. I have made over 1,000 age determinations,” he said. 

Trager currently practices at both the John F. Kennedy and LaGuardia airports in New York, providing general dentistry, emergency dental care, tooth whitening, bad breath advice and treatment, cosmetic dentistry, full and partial dentures, bonding and veneers, crowns and bridges, extractions, and treatment for gum disease to airport employees and visitors alike in addition to his services for INS.

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