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Monday, August 9, 2010

Teeth Mutilation

Since time immemorial the teeth,the mouth and the face have held s seemingly intrinsic fascination for mankind.They have been and continue to be the subject of many oral and written beliefs,superstitions,traditions and the object of a wide range of decorative and mutilatory practices.At the same time they have been the cause of considerable suffering for many.

In modern World body decoration and mutilation is universal in its occurrence and is observed in all regions of the developed and under developed world. Tooth related and oral soft tissue mutilations are well recognized forms of mutilation.
Many of the dental and orofacial mutilations have relatively specific features and patterns reflecting different ethnic or tribal affiliation. A knowledge of these practices is important for the valuable insights they provide into the cultural beliefs and traditions of the people who practice them and for the very pragmatic reason that many compromise examples of customs which directly give rise to pathology of the teeth and orofacial tissues.

Tooth mutilation practices have been recorded for the inhabitants of the non-tropical environments, but most of these customs are observed among the people living in the tropical regions of the world.
These practices include:
  • Non therapeutic tooth extraction(evulsion)
  • Breaking of tooth crowns
  • Filling of tooth crowns by filling and chipping,dental inlay work
  • Lacquering and staining of teeth
  • Miscellaneous practices

Basic themes such as initiation identification and aesthetics underline many of the mutilation customs encountered throughout the tropics.
Beliefs and associations ascribed to the practice of tooth evulsions are
  • Tribal identification
  • Initiation rite
  • Sign of manhood or bravery
  • Differentiation of sexes
  • Sign of marriageable age in females
  • Sign of ceremonial rebirth
  • To ensure a life after death
  • Aesthetics and fashion
  • Therapeutic purposes
  • Sign of mourning
  • Sign of subjugation
  • Form of punishment
  • Cultural mimicry
  • To enable an individual to spit properly
  • Local superstition associated with phenomena such as rain
A number of people ascribed prophylactic benefit to certain root mutilations. Mosha describes the removal of the permanent mandibular central incisors among the Iraq, Waarusha and Masai people of Tanzania. Over half of the individuals submitted to this procedure indicated that the space left following removal of these teeth provided a route allowing passage of fluids in the event of a person becoming ill and being unable to open his/her mouth(seen in tetanus-Lock jaw).
Among the Nigerian tribes the practice of deciduous canine(usually mandibular) germinectomy is considered to guard against symptoms such as high fever.
In Africa parents complained doctors regarding fever,diarrhoea and vomiting. Doctors adviced for the removal of lower deciduous tooth germs giving the reason that the symptoms suffered by child are due to a new type of tooth namely 'nylon tooth' .
The practice of blackening of the teeth among the Jivaro Indian people of northern Peru and Ecuadorians a custom carried out in order to prevent dental caries.Tooth lacquering and dyeing is a custom performed in several other countries of the world like Vietnam,Laos,Thailand,Indonesia and Philippines.
Tooth evulsion describes the deliberate removal of a tooth for ritual or traditional purposes. The tooth is generally knocked out rather than extraction. The age at which ritual tooth evulsions are performed varies.In general permanent tooth evulsions tends to be performed. In some countries the practice of tooth evulsion is associated with events such as puberty and initiation rites in males or the first time menstruation or marriage in females.
Mutilations of tooth crown include alteration in shape or appearance of teeth. The alteration is done by chipping and filling, dyeing and lacquering, decoration of teeth crowns by inlays and overlays. The custom of altering tooth crown shape is confined to anterior teeth(canine to canine) of both jaws.The reasons for these include aesthetics,tribal identity,initiation rituals,religious motives and identification with animals.Many of the people who submitted to customs such as flattening of incisors to the gum level were ignorant of the reason why they were done.The usual answer being 'it is the law of the old people,sir'.According to the village headman this practice related to the belief that at death all people enter a purgatory and undergo a trial of chewing green bamboo. If a person's teeth are sharp the bamboo is likely to splinter and pierce the mouth and intestine. If the teeth are smooth the bamboo can be chewed without ill effects.

Tattooing of soft tissues is one of the famous practice which remains relatively popular in many non-tropical and tropical areas of the world.Skin tattooing is the most commonly encountered,tattooing of lips and gingiva is occasionally seen.The gingiva may be tattooed when females reach puberty,become betrothed or when they become married. It is practiced by men to relieve pain associated with 'diseased gums'. It is believed that gingival tattooing has therapeutic benefit.The material used for tattoo is obtained from calcified peanuts,burned wood or from lamp black.A tattooed lower lip in Sudanese woman signifies that the woman is married. Facial tattoos may incorporate a triangular shaped tattoo on the skin surface at the angle of mouth.It has its basis in ritual warding off the "evil eye"
Other forms of Soft tissue mutilation:
  • Piercing of the lips and perioral soft tissues and insertion of materials such as wood,ivory or metal
  • The temporary piercing of orfacial soft tissues for ceremonial purposes
  • Uvulectomy(removal of uvula in mouth)
  • Facial scarring
The developed and under developed regions of the tropics comprise a vast repository of beliefs and knowledge concerning health,disease and treatment.In some instances,these knowledge have been retained for hundreds of years.Awareness of them is important for those who are involved in the planning of dental health care delivery system.It is important in context of sensitive approach and respect for cultural belief by those treating patients according modern methods and by planning the dental care delivery system,convincing the people of the harmful effects of some practices.


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