Infant oral mutilation

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Infant oral mutilation (IOM) is a dangerous and sometimes fatal traditional dental procedure performed in many areas of Africa. [1]

Contents

Description

Typically, a parent may take a sick child to a traditional healer, who will look in the child's mouth and attribute the illness to "tooth worms". The healer will point out the small, white, developing tooth buds as being "tooth worms", and then dig the "worms" out of the gums without local anesthesia and using a non-sterile tool (normally a bicycle spoke). [2] The canine teeth are often the ones pointed out, as they are more prominent. The excised tooth buds are then shown to the parent, their small, milky appearance somewhat resembling worms. [3]

Harm

This practice inflicts pain and suffering on a child who may already be sick (or teething), and in some cases it is carried out on a healthy child in a bid to prevent illness. The unhygienic methods can cause blood infections, tetanus, pass on HIV/AIDS, and can on occasion be fatal during or after the procedure. [4] The underlying permanent tooth buds can be damaged or eradicated, causing lifelong dental problems. [5] Dental care providers, especially outside Africa, may not necessarily be equipped with the knowledge or skills to diagnose and manage the consequences of this procedure. [6] In addition, the existing illness may not receive the medical attention necessary.

Geographic extent

There is published evidence of IOM occurring in Chad, [7] DR Congo, Ethiopia, [8] Kenya, [9] Rwanda, [10] Somalia, [11] Sudan, [12] Tanzania [13] and Uganda. [4] It has also been observed in African immigrants now living in France, [7] Israel, [6] [14] USA, [15] Australia, [16] Norway, [17] New Zealand [18] and the UK. [11] [19] A Literature analysis of the above published papers with full references is available online. [20]

Related Research Articles

<span class="mw-page-title-main">Dentistry</span> Branch of medicine

Dentistry, also known as dental medicine and oral medicine, is the branch of medicine focused on the teeth, gums, and mouth. It consists of the study, diagnosis, prevention, management, and treatment of diseases, disorders, and conditions of the mouth, most commonly focused on dentition as well as the oral mucosa. Dentistry may also encompass other aspects of the craniofacial complex including the temporomandibular joint. The practitioner is called a dentist.

<span class="mw-page-title-main">Dental dam</span> A thin, rectangular sheet used in dentistry to isolate the operative site

A dental dam or rubber dam is a thin, 6-inch (150 mm) square sheet, usually latex or nitrile, used in dentistry to isolate the operative site from the rest of the mouth. Sometimes termed "Kofferdam", it was designed in the United States in 1864 by Sanford Christie Barnum. It is used mainly in endodontic, fixed prosthodontic and general restorative treatments. Its purpose is both to prevent saliva interfering with the dental work, and to prevent instruments and materials from being inhaled, swallowed or damaging the mouth. In dentistry, use of a rubber dam is sometimes referred to as isolation or moisture control.

<span class="mw-page-title-main">Tooth decay</span> Deformation of teeth due to acids produced by bacteria

Tooth decay, also known as cavities or caries, is the breakdown of teeth due to acids produced by bacteria. The cavities may be a number of different colors from yellow to black. Symptoms may include pain and difficulty with eating. Complications may include inflammation of the tissue around the tooth, tooth loss and infection or abscess formation.

<span class="mw-page-title-main">Hyperdontia</span> Condition of having extra teeth beyond the regular number of teeth

Hyperdontia is the condition of having supernumerary teeth, or teeth that appear in addition to the regular number of teeth. They can appear in any area of the dental arch and can affect any dental organ. The opposite of hyperdontia is hypodontia, where there is a congenital lack of teeth, which is a condition seen more commonly than hyperdontia. The scientific definition of hyperdontia is "any tooth or odontogenic structure that is formed from tooth germ in excess of usual number for any given region of the dental arch." The additional teeth, which may be few or many, can occur on any place in the dental arch. Their arrangement may be symmetrical or non-symmetrical.

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<span class="mw-page-title-main">Dental abrasion</span> Medical condition

Abrasion is the non-carious, mechanical wear of tooth from interaction with objects other than tooth-tooth contact. It most commonly affects the premolars and canines, usually along the cervical margins. Based on clinical surveys, studies have shown that abrasion is the most common but not the sole aetiological factor for development of non-carious cervical lesions (NCCL) and is most frequently caused by incorrect toothbrushing technique.

<span class="mw-page-title-main">Dental erosion</span> Medical condition

Acid erosion is a type of tooth wear. It is defined as the irreversible loss of tooth structure due to chemical dissolution by acids not of bacterial origin. Dental erosion is the most common chronic condition of children ages 5–17, although it is only relatively recently that it has been recognised as a dental health problem. There is generally widespread ignorance of the damaging effects of acid erosion; this is particularly the case with erosion due to consumption of fruit juices because they tend to be considered as healthy. Acid erosion begins initially in the enamel, causing it to become thin, and can progress into dentin, giving the tooth a dull yellow appearance and leading to dentin hypersensitivity.

<span class="mw-page-title-main">Dental lamina</span>

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<span class="mw-page-title-main">Dental extraction</span> Operation to remove a tooth

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<span class="mw-page-title-main">Alveolar process</span> Bulge on jaws holding teeth

The alveolar process or alveolar bone is the thickened ridge of bone that contains the tooth sockets on the jaw bones. The structures are covered by gums as part of the oral cavity.

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<span class="mw-page-title-main">Root canal treatment</span> Dental treatment

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<span class="mw-page-title-main">Tooth impaction</span> Prevention of tooth eruption by a physical barrier

An impacted tooth is one that fails to erupt into the dental arch within the expected developmental window. Because impacted teeth do not erupt, they are retained throughout the individual's lifetime unless extracted or exposed surgically. Teeth may become impacted because of adjacent teeth, dense overlying bone, excessive soft tissue or a genetic abnormality. Most often, the cause of impaction is inadequate arch length and space in which to erupt. That is the total length of the alveolar arch is smaller than the tooth arch. The wisdom teeth are frequently impacted because they are the last teeth to erupt in the oral cavity. Mandibular third molars are more commonly impacted than their maxillary counterparts.

<span class="mw-page-title-main">Dental trauma</span> Medical condition

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In dentistry, overeruption is the physiological movement of a tooth lacking an opposing partner in the dental occlusion. Because of the lack of opposing force and the natural eruptive potential of the tooth there is a tendency for the tooth to erupt out of the line of the occlusion.

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<span class="mw-page-title-main">Tooth wear</span> Medical condition

Tooth wear refers to loss of tooth substance by means other than dental caries. Tooth wear is a very common condition that occurs in approximately 97% of the population. This is a normal physiological process occurring throughout life; but with increasing lifespan of individuals and increasing retention of teeth for life, the incidence of non-carious tooth surface loss has also shown a rise. Tooth wear varies substantially between people and groups, with extreme attrition and enamel fractures common in archaeological samples, and erosion more common today.

<span class="mw-page-title-main">Molar incisor hypomineralisation</span> Medical condition

Molar incisor hypomineralisation (MIH) is a type of enamel defect affecting, as the name suggests, the first molars and incisors in the permanent dentition. MIH is considered a worldwide problem and usually occurs in children under 10 years old. This developmental condition is caused by the lack of mineralisation of enamel during its maturation phase, due to interruption to the function of ameloblasts. Many factors have been suggested, such as genetics and medical problems during pregnancy, but only childhood illness, fever in particular, seems to be associated with MIH. However, further studies on the aetiology of MIH are required because it is believed to be multifactorial.

Tooth transplantation is mainly divided into two types:

Atraumatic restorative treatment (ART) is a method for cleaning out tooth decay from teeth using only hand instruments and placing a filling. It does not use rotary dental instruments to prepare the tooth and can be performed in settings with no access to dental equipment. No drilling or local anaesthetic injections are required. ART is considered a conservative approach, not only because it removes the decayed tissue with hand instruments, avoiding removing more tissue necessary which preserves as much tooth structure as possible, but also because it avoids pulp irritation and minimises patient discomfort. ART can be used for small, medium and deep cavities caused by dental caries.

References

  1. ↑ Wordley, J (2003). "Infant oral mutilation" (PDF). Developing Dentistry. 3 (2): 19–20. Archived from the original (PDF) on 2011-01-05. Retrieved 2011-05-06.
  2. ↑ Ellis, J.; Arubaku, W. (2005). "Complications from traditional tooth extraction in South-western Uganda". Tropical Doctor. 35 (4): 245–246. doi:10.1258/004947505774938701. PMID   16354490.
  3. ↑ Abusinna, I. (1979). "Lugbara teeth germectomy of canines for the newborn babies. A magico-religious phenomena in some African tribes". Egyptian Dental Journal. 25 (3): 209–214. PMID   299152.
  4. 1 2 Iriso, R.; Accorsi, S.; Akena, S.; Amone, J.; Fabiani, M.; Ferrarese, N.; Lukwiya, M.; Rosolen, T.; Declich, S. (2000). "'Killer' canines: The morbidity and mortality of ebino in northern Uganda". Tropical Medicine and International Health. 5 (10): 706–710. doi: 10.1046/j.1365-3156.2000.00625.x . PMID   11044265.
  5. ↑ Welbury, R.; Nunn, J.; Gordon, P.; Green-Abate, C. (1993). ""Killer" canine removal and its sequelae in Addis Ababa". Quintessence International. 24 (5): 323–327. PMID   8362046.
  6. 1 2 Dinur, N.; Becker, T.; Levin, A.; Zadik, Y.; Itzhak, JB.; Azizi, H. (2021). "Long-term dental implications of infant oral mutilation: a case series". British Dental Journal. 231 (6): 335–340. doi:10.1038/s41415-021-3456-3. PMID   34561584.
  7. 1 2 Khonsari, R. H.; Corre, P.; Perrin, J. P.; Piot, B. (2009). "Orthodontic Consequences of Ritual Dental Mutilations in Northern Tchad". Journal of Oral and Maxillofacial Surgery. 67 (4): 902–905. doi:10.1016/j.joms.2008.06.098. PMID   19304055.
  8. ↑ Children’s teeth and their care. Document produced by NCTPE (National Committee of Traditional Practices of Ethiopia 1997
  9. ↑ Hassanali, J.; Amwayi, P.; Muriithi, A. (1995). "Removal of deciduous canine tooth buds in Kenyan rural Maasai". East African Medical Journal. 72 (4): 207–209. PMID   7621751.
  10. ↑ Benzian, H (2003). "World Dental Development Fund Rwanda Project Visit Report" (PDF). Developing Dentistry. 3 (2): 21–3. Archived from the original (PDF) on 2011-01-05. Retrieved 2011-05-06.
  11. 1 2 Rodd, H.; Davidson, L. (2000). "'Ilko dacowo:' canine enucleation and dental sequelae in Somali children". International Journal of Paediatric Dentistry. 10 (4): 290–297. doi:10.1046/j.1365-263x.2000.00213.x. PMID   11310242.
  12. ↑ A/wahab, M. (1987). "Traditional practice as a cause of infant morbidity and mortality in Juba area (Sudan)". Annals of Tropical Paediatrics. 7 (1): 18–21. doi:10.1080/02724936.1987.11748467. PMID   2438998.
  13. ↑ Matee, M.; Van Palenstein Helderman, W. (1991). "Extraction of 'nylon' teeth and associated abnormalities in Tanzanian children". African Dental Journal. 5: 21–25. PMID   1819291.
  14. ↑ Holan, G.; Mamber, E. (1994). "Extraction of primary canine tooth buds: Prevalence and associated dental abnormalities in a group of Ethiopian Jewish children". International Journal of Paediatric Dentistry. 4 (1): 25–30. doi:10.1111/j.1365-263x.1994.tb00097.x. PMID   7748844.
  15. ↑ Graham, E.; Domoto, P.; Lynch, H.; Egbert, M. (2000). "Dental injuries due to African traditional therapies for diarrhea". The Western Journal of Medicine. 173 (2): 135–137. doi:10.1136/ewjm.173.2.135. PMC   1071025 . PMID   10924443.
  16. ↑ Amailuk, P.; Grubor, D. (2008). "Erupted compound odontoma: Case report of a 15-year-old Sudanese boy with a history of traditional dental mutilation". BDJ. 204 (1): 11–14. doi: 10.1038/bdj.2007.1184 . PMID   18192989.
  17. ↑ Espelid, E; Agnalt R (2009). "Removal of dental facilities in African folk medicine. (Translation from Norwegian)". Nor Dental Tid. 119: 294–297.
  18. ↑ De Beavis, F. O.; Foster, A. C.; Fuge, K. N.; Whyman, R. A. (2011). "Infant oral mutilation: A New Zealand case series". The New Zealand Dental Journal. 107 (2): 57–59. PMID   21721338.
  19. ↑ Dewhurst, S.; Mason, C. (2001). "Traditional tooth bud gouging in a Ugandan family: A report involving three sisters". International Journal of Paediatric Dentistry. 11 (4): 292–297. doi:10.1046/j.1365-263x.2001.00279.x. PMID   11570446.
  20. ↑ "www.dentaid.org". 22 June 2011. Archived from the original on 22 June 2011.
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