Infant oral mutilation

Infant oral mutilation (IOM) is the dangerous and sometimes fatal traditional or conventional dental malpractice that has been performed for decades in many areas of Africa and in underdeveloped countries.[1]


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 anaesthesia using a non-sterile tool such as a hot or sharpened nail, a bicycle spoke, or a knitting needle.[2] The eye teeth are often the ones pointed out, as they are more prominent. The tooth buds are then shown to the parent, their small, milky appearance somewhat resembling worms.[3]


This practice inflicts pain and suffering on a child who may already be sick (or who may be teething), and in some cases it is carried out on a healthy child in a bid to prevent illness. The procedure may lead to shock, and loss of blood may lead to anaemia. The unhygienic methods can cause blood infections, tetanus, pass on HIV/AIDS, and can on occasion be fatal.[4] The underlying permanent tooth buds can be damaged or eradicated, causing malformations and long term crowding.[5] In addition, the existing illness may not receive the medical attention necessary.

Geographic extent

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


  1. Wordley, J (2003). "Infant oral mutilation" (pdf). Developing Dentistry. 3 (2): 19–20.
  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 & international health : TM & IH. 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 (Berlin, Germany : 1985). 24 (5): 323–327. PMID 8362046.
  6. 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.
  7. Children’s teeth and their care. Document produced by NCTPE (National Committee of Traditional Practices of Ethiopia 1997
  8. 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.
  9. Benzian, H (2003). "World Dental Development Fund Rwanda Project Visit Report" (pdf). Developing Dentistry. 3 (2): 21–3.
  10. 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. PMID 11310242.
  11. 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. PMID 2438998.
  12. 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.
  13. 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.
  14. 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. PMC 1071025Freely accessible. PMID 10924443.
  15. 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.
  16. Espelid, E; Agnalt R (2009). "Removal of dental facilities in African folk medicine. (Translation from Norwegian)". Nor Dental Tid. 119: 294–297.
  17. 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.
  18. 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. PMID 11570446.

External links

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