The Journal of the American Dental Association
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J Am Dent Assoc, Vol 139, No 4, 442-450.
© 2008 American Dental Association
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CLINICAL PRACTICE

JADA Continuing Education

Extirpation of the Primary Canine Tooth Follicles

A Form of Infant Oral Mutilation



Paul C. Edwards, MSc, DDS, Nicholas Levering, MS, DDS, Erin Wetzel, DDS and Tarnjit Saini, MS, DDS

Background. Ebinyo is a form of infant oral mutilation (IOM), widely practiced in rural areas of eastern Africa, in which traditional healers and other village elders extirpate the primary canine tooth follicles of infants by using crude, often unsterilized, instruments or utensils. Traditional folklore suggests that the underlying tooth follicles, thought to resemble worms, are the cause of high temperature, vomiting, loss of appetite and diarrhea in infants. In addition to the serious and potentially fatal immediate postsurgical complications, many of those who undergo this practice exhibit characteristic long-term adverse dentoalveolar effects. Children in these families also may be at greater risk of undergoing other mutilation rituals because of their cultural background.

Case Description. We report on the clinical and radiographic findings in five siblings who apparently were subjected to IOM as infants before immigrating to the United States.

Clinical Implications. Although the practice of IOM is believed to be exceedingly rare in developed countries, it is important that dentists and allied dental personnel who treat refugees from areas of the world in which IOM is endemic be aware of the social factors behind this practice as well as be able to recognize its dental and psychological sequelae.

Key Words: Ebinyo; infant oral mutilation; primary canine follicle removal

Abbreviations: IOM: Infant oral mutilation






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