An open, cross-verified, tested reference implementation of dental age-estimation methods — Cameriere (open apices & adult pulp/tooth area), Demirjian, Willems, and Kvaal — as a dependency-free Python library, a CLI, and a zero-install web app.
⚠️ Research and education only. Estimated dental age is not chronological age and carries substantial uncertainty. OdontoAge must never be the sole basis for any legal, forensic, immigration, or clinical decision about a real person. Age assessment of living people (e.g. asylum age-disputes) is scientifically limited and ethically contested — see Ethics & limitations.
Dental age estimation underpins forensic identification, paediatric assessment, and — controversially — legal age-disputes. The field runs on a handful of published scoring systems (Demirjian, Willems, Cameriere, Kvaal). Yet method-comparison papers keep appearing, and every team re-implements these methods by hand in spreadsheets or behind closed web calculators. There has been no open, tested, citable, embeddable implementation.
OdontoAge fills that gap: one place where the numbers are encoded once, cross-verified against the primary literature, unit-tested, and exposed identically to Python, the command line, and the browser.
https://hezarani.github.io/odontoage/ — enter tooth stages or apex measurements and get every applicable method side-by-side, each with a 95% interval, a reasoning trace, and its citation.
| Method | Dentition | Input | Output | Status |
|---|---|---|---|---|
| Cameriere — Italian (2006) | children ~5–15 y | open-apex measurements | age + interval | ✅ verified |
| Cameriere — European (2007) | children ~4–16 y | open-apex measurements | age + interval | ✅ verified |
| Demirjian (1976) | children ~2.5–17 y | 7-tooth stages A–H | maturity score (0–100) | ✅ verified |
| Willems (2001) | children ~3–18 y | 7-tooth stages A–H | age (direct) | ✅ verified |
| Cameriere — adult (2009) | adults ~20–85 y | canine pulp/tooth area ratio (RA), upper or lower | age + interval | ✅ verified |
| Kvaal (1995) | adults ~20–85 y | pulp/tooth size ratios (9 tooth/model equations) | age + interval | ✅ verified |
All six shipped methods are now cross-verified and enabled. The safety gate remains part of the design: any method whose parameters are not confirmed against ≥2 independent authoritative sources (see docs/EVIDENCE.md) is hard-gated off and raises MethodNotVerifiedError rather than returning an unverified number — a wrong constant in a forensic tool is worse than no tool.
pip install odontoageZero runtime dependencies (pure standard library).
import odontoage
# Cameriere European formula from precomputed morphometric variables
e = odontoage.estimate(
"cameriere_european_2007", sex="male",
variables={"x5": 0.06, "N0": 5, "s": 0.42},
)
print(e) # -> Cameriere — European formula (open apices): 12.40 y
print(e.estimated_age_years) # 12.40...
print(e.citation, e.doi)
# ...or straight from per-tooth apex measurements (mm)
teeth = {
"I1": {"closed": True}, "I2": {"closed": True}, "C": {"closed": True},
"PM1": {"open": True, "Ai": 0.42, "Li": 21.0},
"PM2": {"open": True, "Ai": 1.05, "Li": 21.0},
"M1": {"closed": True}, "M2": {"closed": True},
}
e = odontoage.estimate("cameriere_european_2007", sex="female", teeth=teeth)
# Run every applicable method at once
for est in odontoage.compare(sex="male", variables={"x5": 0.06, "N0": 5, "s": 0.42}):
print(est.method, round(est.estimated_age_years, 2))Every Estimate carries: estimated_age_years, an approximate 95% interval, an optional maturity_score (Demirjian), a step-by-step reasoning trace, the citation/doi, and a disclaimer.
odontoage list --verified
odontoage estimate cameriere_european_2007 --sex male --vars "x5=0.06,N0=5,s=0.42"
odontoage compare --sex male --teeth "I1=closed,I2=closed,C=closed,PM1=0.42/21,PM2=1.05/21,M1=closed,M2=closed"The children's methods (Demirjian, Willems, Cameriere open apices) use the seven permanent lower-left teeth (FDI 31–37): central incisor, lateral incisor, canine, 1st premolar, 2nd premolar, 1st molar, 2nd molar. Cameriere's x5 is the 2nd premolar. The adult methods use other teeth: Cameriere (2009) an upper or lower canine; Kvaal (1995) the maxillary central incisor, lateral incisor and 2nd premolar and the mandibular lateral incisor, canine and 1st premolar.
Exact encoded parameters, their primary sources, the verification method, and accuracy/caveats live in docs/EVIDENCE.md. Every number is confirmed against ≥2 independent sources; the Python and JavaScript engines are checked for bit-for-bit agreement in the test suite; scientific invariants (e.g. Demirjian stage-H scores summing to 100) are asserted automatically.
To cite OdontoAge, use CITATION.cff or the Zenodo DOI 10.5281/zenodo.22694379.
- Dental age ≠ chronological age. Even the best methods have wide individual error (often ±1 year in children; several years in adults).
- Population variation. The reference samples are population-specific (e.g. Demirjian: French-Canadian; Willems: Belgian). Demirjian is known to overestimate elsewhere. Treat outputs as reference implementations of published standards, not ground truth for your population.
- Living persons / age-disputes. Radiographic age assessment of living people (including unaccompanied minors in asylum proceedings) is scientifically limited and ethically contested; professional and radiology bodies have raised concerns about radiation without clinical benefit and about misclassifying children as adults. OdontoAge exists to make the methods transparent and testable, not to endorse any particular use. Keep a qualified expert in the loop.
Every encoded parameter traces to the sources below; exact values and the verification method are in docs/EVIDENCE.md, and the machine-readable registry is odontoage/data/sources.json.
Methods it implements
- Demirjian, A., Goldstein, H. & Tanner, J.M. (1973). A new system of dental age assessment. Human Biology 45(2):211–227. PMID 4714564 (no DOI)
- Demirjian, A. & Goldstein, H. (1976). New systems for dental maturity based on seven and four teeth. Annals of Human Biology 3(5):411–421. doi:10.1080/03014467600001671
- Willems, G. et al. (2001). Dental age estimation in Belgian children: Demirjian's technique revisited. Journal of Forensic Sciences 46(4):893–895. doi:10.1520/JFS15064J
- Cameriere, R., Ferrante, L. & Cingolani, M. (2006). Age estimation in children by measurement of open apices in teeth. International Journal of Legal Medicine 120(1):49–52. doi:10.1007/s00414-005-0047-9
- Cameriere, R. et al. (2007). Age estimation in children by measurement of open apices in teeth: a European formula. International Journal of Legal Medicine 121(6):449–453. doi:10.1007/s00414-007-0179-1
- Cameriere, R. et al. (2009). Age estimation by pulp/tooth area ratio in canines: study of a Portuguese sample to test Cameriere's method. Forensic Science International 193(1–3):128.e1–128.e6. doi:10.1016/j.forsciint.2009.09.011
- Kvaal, S.I. et al. (1995). Age estimation of adults from dental radiographs. Forensic Science International 74(3):175–185. doi:10.1016/0379-0738(95)01760-G
Prior work and cross-verification sources
- Cameriere, R., Ferrante, L. & Cingolani, M. (2004). Variations in pulp/tooth area ratio as an indicator of age: a preliminary study. Journal of Forensic Sciences 49(2):317–319. doi:10.1520/JFS2003259
- Hostiuc, S. et al. (2021). Age estimation using the Cameriere methods of open apices: a meta-analysis. Healthcare 9(2):237. doi:10.3390/healthcare9020237
New methods are added as data, not code: drop a cross-verified parameter set into odontoage/data/, cite ≥2 sources, add fixtures. See CONTRIBUTING.md.
MIT © 2026 Hossein Boustani Hezarani. Method parameters are facts/formulae from the cited literature; OdontoAge encodes and cites them and does not reproduce copyrighted figures, atlas images, or descriptive prose.