January 12, 2002	Saturday	Shawwal 27, 1422

NEW YORK, Jan 11: Robert Trager may be the most powerful dentist in America — and the most controversial.

Working for the Immigration and Naturalization Service, Dr. Trager has subjected over 1,000 young people to dental and wrist X-rays to determine their age — tests that critics say are highly inaccurate and scientifically unfounded.

Based on his determination of whether they are 18 or older, his youthful subjects, many of whom say they are fleeing persecution and torture, may be summarily deported, placed in juvenile detention or sent to adult jail, where they may languish for months or years.

Trager, who has clinics at New Yorks John F. Kennedy and La Guardia airports where he treats airport employees, says he is a link in the chain protecting the United States against terrorism, especially after the Sept. 11, 2001, attacks.

“I’ve seen alleged terrorists, people who come in with forged passports from places like Pakistan and Afghanistan. I’ve also seen drug dealers,” he said in an interview.

But human rights activists regard Trager’s work with horror, even leaving aside uncomfortable parallells to judging the age of horses by checking their teeth. They also note that nearly all those examined by Trager are declared to be adults.

“It’s scary that someone without an appropriate scientific basis, is playing God with children’s lives. It’s probably unconstitutional and it’s definitely wrong,” said Rhonda Brownstein of the Southern Poverty Law Center.

Trager X-rays his subjects’ teeth to measure the eruption of the third molars or wisdom teeth, which usually break through towards the end of adolescence. He also X-rays their wrists to measure the fusion of their radius and ulna bones.

“The ones who complain, not one has been able to overturn my exam,” said Trager, who is now evaluating X-rays for the Canadian government and was recently approached for information by the Australian Embassy.

His verdicts can be critical. Under U.S. law, adults who arrive without proper documentation are subject to immediate deportation unless an immigration officer determines their story is credible enough to warrant an asylum hearing.

Minors, however, must be admitted to the country and can be released into the custody of relatives. If they are found to be victims of persecution, abuse or neglect, they can stay.

If they have no family, they are sent to juvenile detention centres. However, if Trager decides they are adult, even though they claim to be children, they are sent to adult jail.

Many medical experts say Trager’s methods are fatally flawed and the age of 18 has no biological significance.

“I find it breathtaking that someone could be so wrong about the biologic concept, draw conclusions from this serious misinterpretation that have a profound impact on the life and welfare of another human being and do it with the official or quasi-official sanction of the government,” said Nalton Ferraro, a dental surgeon at Children’s Hospital in Boston who is also on the faculty of Harvard University.

“A 15-year-old can have a very mature dentition with fully formed wisdom teeth. Conversely, an 18-year-old can have wisdom teeth that on radiograph are less mature in development and more typical of the wisdom tooth you might see in a 15 or 16 year old,” he said in an e-mail message to Reuters.

VARIATION IS THE NORM:“Variation and deviation around the ‘norm’ is also extremely common with the bone age. For example, a 16-year-old boy may have a fully developed skeleton; the bone age would then be reported as 19 years,” Ferraro said.

New York University radiology professor Herb Frommer said there are wide variations in the eruption of molars. Neill Serman, head of oral radiation at Columbia University, said wisdom teeth could well erupt by age 16, especially in girls.

“Additionally, it is common knowledge that when teeth are extracted in young children, the teeth behind the extracted teeth erupt much earlier in life,” he said.

Peter Capatano, a clinical associate professor of paediatrics at New York University Medical School, said using two unreliable tests did not reassure him.

“Using two inaccurate measures does not produce accuracy,” he said. “You have to follow the subject over time.”—Reuter