Challenges of providing reliable evidence in age assessment by dental practitioners from selected county hospitals in Kenya

Abstract

Background: Globally, individuals without documentation of date of birth require age assessment before accessing necessary civil, political and socioeconomic rights or facing legal consequences. Determination of age requires customization and a systematic multidisciplinary approach. In Kenya, there is lack of a documented local policy on age assessment; nevertheless, the dentists working in public hospitals often receive patients for age assessment. In order to improve on local practices, there is a need to investigate the current methods of age estimation being utilized by dental clinicians.

Design: Study design was cross-sectional. Data was collected prospectively from new patients.

Setting: Eight dental clinics based in level 5 hospitals randomly selected from each of the former eight provinces of Kenya.

Subjects: Patients who visited for age assessment during the study period 2019-2020.

Main Outcome measures: estimated age, age assessment methods and experienced challenges.

Results: The study included 186(58.9%) males and 130(41.1%) females, aged 1.5-79 years, average age 19.42±12.33 years. Children (248,78.5%) were significantly (Χ2(7)=39.883,p=0.000) more than adults (68,21.5%). Age was assessed through examination of presented documents, psychosocial history and tooth development patterns. There was significant use of panoramic radiographs (210,66.5%) (Χ2(7)=164.991,p=0.000). Challenges included failure to obtain reliable social history (41,45.05%) and poor imaging (23,25.27%).

Conclusion: Age assessment was mostly indicated for children. Psychosocial history and atlas method of assessing tooth development were commonly utilized. Unreliable social history and poor imaging confounded the age estimation process. Training on application and limitations of age estimation methods and development of a national protocol is recommended.