Dental age is an independent marker of biological age




dental eruption, biological age, skeletal age, growth tempo, maturation, malnutrition


Background: Biological age markers are a crucial indicator whether children are decelerated in growth tempo. Skeletal maturation is the standard measure. Yet, it relies on exposing children to x-radiation. Dental eruption is a potential, but highly debated, radiation free alternative. 

Objectives: We assess the interrelationship between dental eruption and other maturational markers. We hypothesize that dental age correlates with body height and skeletal age. We further evaluate how the three different variables behave in cohorts from differing social backgrounds.

Sample and Method: Dental, skeletal and height data from the 1970s to 1990s from Guatemalan boys were converted into standard deviation scores, using external references for each measurement. The boys, aged between 7 and 12, derived from different social backgrounds (middle SES (N = 6529), low-middle SES (N = 736), low SES Ladino (N = 3653) and low SES Maya (N = 4587).

Results: Dental age shows only a weak correlation with skeletal age (0.18) and height (0.2). The distinction between cohorts differs according to each of the three measurements. All cohorts differ significantly in height. In skeletal maturation, the middle SES cohort is significantly advanced compared to all other cohorts. The periodically malnourished cohorts of low SES Mayas and Ladinos are significantly delayed in dental maturation compared to the well-nourished low-middle and middle class Ladino children.

Conclusion: Dental development is an independent system, that is regulated by different mechanisms than skeletal development and growth. Tooth eruption is sensitive to nutritional status, whereas skeletal age is more sensitive to socioeconomic background.





Aguilar, D./Castano, G. (2022). Constitutional Growth Delay, in: StatPearls. StatPearls Publishing, Treasure Island (FL).

Al-Balbeesi, H.O./Al-Nahas, N.W./Baidas, L.F./Bin Huraib, S.M./Alhaidari, R./Alwadai, G. (2018). Correlation between skeletal maturation and developmental stages of canines and third molars among Saudi subjects. The Saudi dental journal 30, 74–84.

Alcázar, M.L./Alvear, J./Muzzo, S. (1984). Influence of nutrition on the bone development of children. Archivos Latinoamericanos de Nutricion 298–307.

Alhamda, S. (2012). Relationship between nutritional status and eruption of first permanent mandibular molar teeth among the school children in Indonesia. South East Asia Journal Of Public Health 85–86.

Beunen, G.P./Rogol, A.D./Malina, R.M. (2006). Indicators of Biological Maturation and Secular Changes in Biological Maturation. Food and Nutrition Bulletin 244–256.

Bielicki, T./Koniarek, J./Malina, R.M. (1984). Interrelationships among certain measures of growth and maturation rate in boys during adolescence. Annals of human biology 11, 201–210.

Bogin, B./MacVean, R.B. (1984). Growth status of non- agrarian, semi-urban living Indians in Guatemala. Human Biology 527–538.

Bogin, B./MacVean, R.B. (1983). The Relationship of Socioeconomic Status and Sex to Body Size, Skeletal Maturation, and Cognitive Status of Guatemala City Schoolchildren. Child Development 115–128.

Bogin, B./MacVean, R.B. (1981). Nutritional and Biological Determinants of Body Fat Patterning in Urban Guatemalan Children. Human Biology 259–268.

Cox, L. (1997). The biology of bone maturation and ageing. Acta Paediatrica 86, 107–108.

Creo, L.A./Schwenk, W.F. (2017). Bone age: a handy tool for pediatric providers. Pediatrics.

Demirjian, A. (1986). Dention, in: Falkner, F., Tanner, J.M. (Eds.), Postnatal Growth Neurobiology. Springer, Boston, MA.‗ 12

Demirjian, A./Buschang, P.H./Tanguay, R./Patterson, D.K. (1985). Interrelationships among measures of somatic, skeletal, dental, and sexual maturity. American Journal of Orthodontics 433–438.

Demirjian, A./Goldstein, H./Tanner, J.M. (1973). A New System of Dental Age Assessment. Human Biology 211–227.

Demisch, A./Wartmann, P. (1956). Calcification of the Mandibular Third Molar and Its Relation to Skeletal and Chronological Age in Children. Child Development.

Greulich, W./Pyle, S. (1959). Radiographic atlas of skeletal development of the hand and wrist. Stanford university press.

Kumar, V./Venkataraghavan, K./Krishnan, R./Patil, K./Munoli, K./Karthik, S. (2013). The relationship between dental age, bone age and chronological age in underweight children. Journal of pharmacy & bioallied sciences 73–79.

Lewis, A.B. (1991). Comparisons between dental and skeletal ages. The Angle Orthodontist 87–92.;2

Liliequist, B./Lundberg, M. (1971). Skeletal and tooth development: A methodological investigation. Acta Radiologica 97–112.

Logan, W.H.G./Kronfeld, R. (1933). Development of the Human Jaws and Surrounding Structures from Birth to the Age of Fifteen Years**From the Research Department of the Chicago College of Dental Surgery, Dental Department of Loyola University.Read at the Third General Meeting of the Seventy-Fourth Annual Session of the American Dental Association, Buffalo, N. Y., Sept. 14, 1932. The Journal of the American Dental Association (1922) 20, 379–428.

Meo, S.A./Al Drees, A.M./Zadi, S.Z./Damgh, S.A./Al-Tuwaijri, A.S. (2006). Hazard of X-Ray Radiation on the Quantitative and Phagocitc Function of Polymorphonuclear Neutrophils in X-Ray Technicians. Journal of Occupational Health 88–92.

Nolla, C.M. (1960). The Development of the Permanent Teeth. Journal of Dentistry for Children 254–266.

Prokopec, M. (2001). Differential rate of growth of the human body parts., in: Dasgupta, P./Hauspie, R. (Eds.), Perspectives in Human Growth, Development and Maturation. Springer, Dordrecht.

Psoter, W./Gebrian, B./Prophete, S./Reid, B./Katz, R. (2008). Effect of early childhood malnutrition on tooth eruption in Haitian adolescents. Community dentistry and oral epidemiology 36, 179–189.

San Miguel Pentón, A./Veliz Concepción, O.L./Escudero Alemán, R.Z./Calcines Ferrer, M.E./Ortega Romero, L. (2011). Cronología de emergencia de la dentición permanente en niños del municipio de Santa Clara: Parte I: Permanent dentition emergence chronology in children from Santa Clara municipality: Part I. Revista Cubana de Estomatol 208–218.

Scheffler, C./Hermanussen, M./Bogin, B./Liana, D.S./Taolin, F./Cempaka, P.M.V.P./Irawan, M./Ibbibah, L.F./Mappapa, N.K./Payong, M.K.E./Homalessy, A.V./Takalapeta, A./Apriyanti, S./Manoeroe, M.G./Dupe, F.R./Ratri, R.R.K./Touw, S.Y./K, P.V./Murtani, B.J./Nunuhitu, R./Puspitasari, R./Riandra, I.K./Liwan, A.S./Amandari, P./Permatasari, A.A.I./Julia, M./Batubara, J./Pulungan, A. (2020). Stunting is not a synonym of malnutrition. European journal of clinical nutrition 74, 377–386.

Sierra, A.M. (1987). Assessment of dental and skeltal maturaty: A new approach. The Angle Orthodontist 194–208.

World Health Organization (2015). Stunting in a nutshell, [WWW Document]. URL




How to Cite

Boeker, S., Hermanussen, M., & Scheffler, C. . (2022). Dental age is an independent marker of biological age. Human Biology and Public Health, 3.