olubunmi bankole university of ibadan nigeria - kapd.or.ke perceptions and practices... · dental...
TRANSCRIPT
Cultural perceptions and practices regarding oral health of children
Olubunmi BankoleUniversity of Ibadan
Nigeria
Outline 1 Developmental anomalies2 Teething3 Timing of eruption4 Eruption sequence5 Diet6 Oral hygiene 7 Common dental diseases 8 Oral habits9 Practices related to puberty and grooming 10Oral health utilization
Introduction
bull Teeth mouth face -fascination mankind
bull Subject of superstitions and traditions
bull Culture - learned behavior socially acquired (Park 2002)
bull Family unit reflects the culture of a wider society
bull Extended families plays a vital role in child rearing and behavior (Chandra et al 2009)
bull Negative traditions behaviors are sometimes harmful to the individual health
bull With increasing education taboos beliefs are gradually disappearing
bull DEVELOMENTAL ANOMALIES
CLEFT LIP AND PALATE(CLP)
bull One of the most prevalent oro-facial deformities
bull Prevalence 1 out of every 500 to 1000 live births (Cooper et al2006)
bull Myriads of problems - discrimination prejudice abandonment
bull Tendency towards social withdrawal
bull Attitudes of patients families and community towards CLP crucial in the treatment outcomes and social emotional development of the patients (Chan et al2006)
A baby with cleft lip and palate
Before intervention After intervention
Perceived causes of CLP (Globally - Among Indians Chinese )
bull Starvation in pregnancy
bull Staring at solar eclipse during pregnancy
bull Will of God Fate (el-Shazly et al 2010)
bull Punishment for past sinswrongdoings
bull Use of scissors or other sharp objects during pregnancy ( Ross 2007)
In Africa Perception Effect
Worms in a pregnant woman lsquos stomach if
starved of food
Consuming poisoned rabbit meat
Fate Will of God (Olasoji et al 2007) Nodelayed
treatment
Reincarnation of ldquoAbikurdquo (Unpublished data)
Transference of spirits of unborn babies
Family stigma
Work of evil spirits result of being cursed Consult traditional
healers
Penalty for previous sins
wrongdoing contravening taboos
Practices bull Use of animals hoofs as dummy for child to suck -
improve shape musculature and speech ndash Similar naso alveolar moulding
bull Blood letting to lsquorestore balance Hazardous Risk of excessive blood loss infection
bull Give to charity as atonement repentance for past sins and wrongdoings
bull Fast praypilgrimage bathing in consecrated river to cleanse away sins
bull Psychological support
Loh J and Ascoli M Cross-cultural attitudes and perceptions towards cleft lip and
palate deformities World cultural research review 127-134 ( 2011)
MALOCCLUSION bull Proclined teeth (ldquoEyin Shamgarrdquo) in South
Western Nigeria
bull Perceived causes Carelessness of mother in application of teething concoctions to bath baby
bull Child opening mouth when sleeping (Unpublished work)
bull Jewish community study poor teeth in parents grandparents seen their children (Scambler et al 2010)
Practices Childrsquos lips continually pulled together by parents
TONGUE TIE (ANKYLOGLOSSIA)Perception
Among some tribes in Port Harcourt it is believed that most babies are born with tongue tie (Opara and Eke 2013)
Also among Ishan in Edo State
bull Perceived effects speech difficulties (stammering) inability to cry well difficulty breast feeding poor hearing
Tongue tie Practices
bull Culture in south south Nigeria supports routine clipping of frenulum in all newborns (Opara and Eke 2013)
bull Done between ages 0-1 month
bull Carried out by nurses traditional birth assistants using scissors or finger nails
bull (368) mothers in Port Harcourt had babies treated for tongue tie (Opara and Eke 2013)
bull Complications bleeding infection and soft tissue injuries
TEETHINGbull Eruption of teeth -important milestone
bull Myriads of symptoms are erroneously linked to the teething process ( Adam and Abhulimhen-Iyoha (2015)
bull Passive immunity decreases
bull Children exposed to a wide variety of illnesses
bull Danger is that mothers may not seek medical consultation for some childhood illnesses (Igeand Olubukola 2013 )
bull May lead to increased child mortality
Perceived Teething SymptomsSymptoms Egypt
El-gilany
and Abusaad
(2017)
Sudan
Awadkamil
(2012)
Kenya
James et
al 2015
Nigeria
Bankole et al
(2017)
Fever 832 866 764 692
Diarrhea 51 833 739 807
Boils 644
Weight loss 473
Cough 608
Vomiting 147
Conjunctivitis 201
Practices Teething Remedies Remedies Opeoduand Denloye2014
Kenya (James et al 2015
Bankole et al 2017)
Analgesics 634 677
Teething powder
syrup
435 655 420313
Antibiotic 142
Sedatives 46
Traditional
Concoction herbs
15 481
Teething soap etc 750
Other Folk RemediesSource httpswwwlifelovelizcom20150108traditional-
teething-remedies-around-world
Caribbean Hang raw egg over where baby sleeps
India Ayurvedic Remedy with cloves
Chinese Traditional Chinese Medicine (TCM) Acupuncture Acupressure
Japanese Wooden Teething Ring
France Sophie the giraffe - teething toy
Baltic Amber Teething Necklace Dangers strangulation aspiration beads
German Zwieback Toast
bull Acupressure
bull Massaging two important acupoints called the ldquotwo gatesrdquo or Large Intestine 4 (Li 4) and Liver 3 (Liv 3) can ease babyrsquos teething pain
bull It is simple effective and easy to do anywhere
bull Shonishin ndashJapanese needleless therapybull Source www bonnchirocomshonishin-needle-less-acupuncture-for-infants-and-
toddlers
Health education to the nurses and Community health officers at Ibadan Nigeria
Photoposter
Educational tool (In collaboration with WHO) In English and 3 major Nigerian languages
bull Effectiveness tested (Bankole et al 2005)
bull More effective as instructional tool in interactive atmosphere than just pasted on walls
TIMING OF ERUPTION Natalneonatal teeth
Associated with erroneous cultural beliefs among community nurses and
traditional birth attendants (TBA)
Britain ndashHeroes
China ndashBearers of misfortune
Natal tooth
Perceptions regarding natalneonatal teeth in infants
Traditional birth
attendaants
Bankole et al
(2013
Igbo Ora
Community
Unpublished
PERCEIVED CAUSES
Evil spirits evil child Abiku 319 487
Mothers contravened taboos 92 35
Prolonged maternal gestation 49
EFFECT ON THE FAMILY
Curse 74 106
Abomination 245 360
Embarrassment 11 360
Practices regarding natalneonatal teeth
Traditional birth
attendants
Bankole et al 2003)
Practices
Immediate extraction
Spiritual cleansing
356 Pain infection HIV
hepatitis B tetanus
Get rid of child 49 Infanticide
EFFECT ON CHILD
Strange odd behavior 313 Stigmatization
Evil spiritual powers 411 Stigmatization
Mental retardation
dull
31
With Traditional Birth Attendants at Ibadan South East Local government area
REVERSAL OF ERUPTION SEQUENCE
bull African ethnographies - infants whose upper teeth erupt before their lower teeth have been killed because of such ldquodevelopmental anomaliesrdquo
bull Considered a bad omen and sign of misfortune among Hamar Ethiopia Benin Rebublic
bull Reversal of eruption sequence of primary incisors in infants in Yoruba community has led to unpleasant circumstances
Reversal of eruption sequence
Reversal of eruption sequence
TraditionalBirth Attendants
Bankole and Lawal (2018)
PERCEIVED CAUSES
Evil spirits 218 476
Contravening taboos 80 26
EFFECT ON THE FAMILY
Curse 135 214Abomination 276 218
Embarrassment 233 114
Practices regarding reversal of eruption sequence of the anterior primary teeth
Practices Bankole and
Lawal(2018 )Effect
Immediate extraction 337 Pain infection HJV
hepatitis B infection
tetanus
HideGet rid of child 613 Infanticide
EFFECT ON CHILD
Strange behavior 227 Stigmatization
Evil powers 417 Stigmatization
Mental retardation 25
Dr Bankole and Dr Lawal with the Traditional Birth Attendants at the Ibadan South West LGA
DIETDental caries has escalated in developing countries
bull Misconception Food and drinks refined processed or modern is best and associated with affluence (Aderinokun et al 2011)
bull Parents donrsquot want their children to be deprived of what they lacked when young
bull This has led to a cultural shift in diet
bull Some African American believe motherrsquos diet during pregnancy cause dental caries in the child
bull Somali refugees Hutterites and Latino immigrant caregivers believed genetics plays a role in development early childhood caries (Prowse 2014)
Practices
bull YorubaHausa community common snacks have assumed local flavours several shapes coloursof sweets sold
bull Natural foods fruits are being sweetened Oke Bankole et al 2011 )
bull Nomadic Fulani sugary diet in between their meals sweetened drinks in bottles Sippy cups (827) and (716) give pacifiers dipped in sweet liquids Reduce temper tantrums with sweets Bankole et al 2015
Infant feeding practices
bull Babies with sweetened drinks in bottles pacifiers dipped in sweet liquidsputting infant to bed with a bottle of sweetened liquid Reported among Mexican Americans and Puerto Ricans Hong Kong Saudi mothers Al-Zahrani et al 2014
bull High risk factors contributing development of early childhood caries in infants
Diet
bull Perception
Animals such as pig are unclean
bull Practices
bull Hindus donrsquot eat beef Muslims donrsquot eat pork
bull Protective prevent taeniasis cystecercosis -edematous oral ulcers gingival bleeding lesions mimicking mucocles in children
(Alves et al 2011)
Dental Fluorosis bull In East and central African countries (tribal
areas of Tanzania Magadi a fluoride rich tronaused in cooking
bull Used as a tenderizer and preservative
bull High Fluoride Concentration 7900 ppm
bull Magadi use may suggest high prevalence of fluorosis in northern Tanzania (Kaseva 2006)
Oral Hygiene
Perceptions among mothers
bull Hausa Fulani- 142 - babyrsquos mouth should be cleaned before teeth erupt
bull Yoruba- Babyrsquos mouthtongue cleaned before teeth erupt to prevent thrush
bull Hausa Fulani- 635 - commencement tooth cleaning between 6 and 12 months of age (Bankole et al 2017)
bull Yoruba- chewing sticks should not be used at night Causes premature death of mother (Oke et al 2011)
Practices
Hausa Fulani- 594 cleaned infants teeth once daily
- 614 children start cleaning their teeth unsupervised before the age of six years
- 751 of supervision was carried out by the grandparents
- Sudan -343 mothers donrsquot clean childrenrsquos teeth below the age of 2 years (Abduljalil et al 2016)
-Hausa - mothers start cleaning childrenrsquos teeth when enough teeth to justify effort (Oke et al 2011)
Oral hygiene practices
Cleaning materials used in infancyearly childhood
CommunityTribe
GlycerinFresh tomato Hydrogen peroxideAluminum sulphateVerona Amygdalina (bitter leaf)Iyere (African black pepper)Alligator pepperCitrus lime Combinations
Yoruba - Nigeria (Aderinokun 2000)
Alum (Aluminum sulphate) Bitter leaf (Verona Amygdalina)
Iyere (African black pepper)
Citrus lime Alligator pepper
Oral hygiene practices
Tooth Cleaning materials
CommunityTribe Side effect
Salt and cotton wool
Hausa (Oke et al 2011)
Finger Nomadic Fulani
Wooden twigSalvadora persiccatwig (miswak) Neem tree Chewing stick
Nomadic Fulani ( Bankole et al 2017)
Somali
India (Kochar et al 2014)
Yoruba Senegal (Diouf 2013)
Improper use ndashgingival trauma
round ceramics omadic ulani
brasion sensiti it
and omadic ulani
shes ood charcoal
Somali (Beveridge
India Senegal
Tooth Cleaning materials
CommunityTribe Side effect
Ground ceramics Nomadic Fulani Tooth abrasion
Sand Nomadic Fulani
AshesWood
Charcoal
Somali India Senegal
Tooth abrasion
IMPORTANCE OF THE PRIMARY DENTITION IN CHILDREN
bull Primary teeth in children are sometimes not regarded as important
bull Mothers of preschool children in Mumbai -436 believed 192 were uncertain that there is no need to visit a dentist for treating milk teeth as they will soon fall off (Jain et al 2014)
COMMON DENTAL DISEASES
Dental Caries
bull Early childhood caries is a significant public health problem caries affecting children globally
bull In recent years in developing countries like Sub-Saharan Africa the prevalence is predicted to increase
bull Early childhood caries is largely untreated in a study in South Africa reported a caries prevalence of 716 and these 675 were untreated (Mohammed and Barnes 2018 )
Dental caries Perceived cause of dental
caries
Community tribe
Worms (resembling
maggots)
Borom bop (master of the
head)
Lagatas
Smaller version of pubu
Worms -removed from
ears
Yoruba Nomadic Fulani
Chinese (Dong et al 2007)
Senegalese ( Diouf et al 2003)
Brazil
Papua New Guinea
Indian (Nagaraj et al2014)
Dental caries -Care remedies Dental care remedies Community tribe Effect
Hydrochloric acid (Wet cell
battery liquid)
Aluminum Phosphate
(Alum)
Tobacco snuff
Charcoal and salt
Gentian violet
Atare (Alligator Pepper)
Yoruba Brazil
Kenya (Mulu Maryanne)
Yoruba (Oke et al 2011)
Chemical burns
mucosal ulceration
Erosion
Tetracycline capsule (topical)
Paracetamol (topical)
Hausa Nomadic Fulani
Hausa
Greyish brown tooth
discolouration
Mucosal ulceration
Traditional concoction
Dental are remedies Dental care remedies Community
tribe
Effect
White wineVinegar Powdered alum musk and frankincense
Chinese (Dong et al 2007)
Herbs traditional medicine
Aborigines (Wong 2005)
Nettles
Hot sweet potato
Wads hot leaves ginger
Residue smoking pipe
White sap of shrub used
to kill maggots
Insecticide ointment
Papua New
Guinea
Predisposition to
oral cancer
Toxic
Dental care remedies Dental care remedies Community Effect
Cooked meat
salt alcohol grease
deodorant
Iran
fingernail polish remover
black tar
Garlic Warm coconut milk
Brazil Toxic
Kawakawa Māori(Pepper Tree
Leaves) chewed
Harakeke -Korari Flax
the gum used for toothache
Maori
GingivitisPeriodontal disease
Perceptions
bull Bleeding gums caused by
bull Child stores food in pouch of mouth and does not clean teeth
Remedies for gingival periodontal disease
Remedies Community tribe
Effect
Aluminium phosphate (Alum ) + Lapalapa sap (Jatropha curcas)Warm water and salt Tomato and alum+polystrene foam or cotton woolHydrogen peroxide
Yoruba
Antibiotics NomadiFulani
Resistant strains Hyper sensitivityreactions
Herbs
ORAL HABITS Kola nut chewing
Common West Central Africa Symbol of hospitality Contains caffeine tannin
bull Helps students keep awakewithstand fatigue
Practices
bull One-year prevalence student use was 291 Erinfolami et al (2011)
bull Majority started at age 14 years or below
bull Dangers -insomnia nausea tooth discolourationcarcinogenic potential for development of oral cancer
Areca Nut Chewing Habitbull Areca nut is the seed of areca palm
bull Widely grown- Asia India Bangladesh Japan
bull Believed to help fatigue
bull Highest period of risk for first use is between 5 and 12 Farrand et al 2001
74 4-16 age group in Karachi indulged in the habit (Shah et al 2002)
Dangers Oral sub mucous fibrosis
bull Risk of oral cancer 99 times( Wollina et al 2004 ) Foreign body aspiration Severe tooth wear -- sensitivity root fractures
Mandibular arch with generalized staining in the deciduous dentition
Prajapati D Nayak R Nayak UA Shah PJ Areca nut chewing habit in preschoolers Two rare case reports and literature review Int J Dent Health Concern 201511-5 (Permission given)
Mandibular arch with generalized staining in the deciduous dentition
Prajapati D Nayak R Nayak UA Shah PJ Areca nut chewing habit in preschoolers Two rare case reports and literature review Int J Dent Health Concern 201511-5 (Permission given)
Oral tobacco use and cigar smoking
bull High prevalence tobacco use in any form is reported among school going adolescents aged 13ndash15 years in India (Arora and Reddy 2005) Smoking Chutta is relatively popular may begin in childhood in India
bull Acts as a stimulant euphoric
bull May sleep with tobacco mixture in mouth
Harmful effects halitosis brown black staining gingival recession if wad is held against gingivaleucoplakia oral squamous cell carcinoma
Tobacco use in children
PRACTICES RELATED TO PUBERTY AND GROOMING
Tooth filing tooth sharpening
Practiced -Nigeria Niger-Delta area (Ukeghesonand Akadiri ) Democratic Republic of Congo Thailand Indonesia
bull Perception Historically -spiritual reasons Contemporary times - aesthetic reasons
bull In Nigeria maxillary midline diastema is regarded as a symbol of beauty (Arigbede and Adesuwa 2012
bull Teeth filed- because represent negative emotions eg anger jealousy (Balinese Indonesia)
30 respondents would not mind having artificially created diastema (Omotosho and Kadri (2010)
Practices
bull Done in adolescence - fashionable
bull Manually done Usually incisors
Harmful effects
bull pain during process
bull Tooth discolouration (teeth -non vital)
bull Infection -pus discharge lip swelling
Tooth filing
Peri-apical x-ray of lower central incisor
Lacquering and staining of teethPerformed in Vietnam Laos Thailand Indonesia and Philippines
Perception For cosmetic reasons
bull Main ingredient dye dark-brown solution of ferric acetate called kanemizu (iron filings in vinegar)
bull Coating the teeth with this liquid helped to prevent tooth decay and enamel decay
bull Practice has slowly declined
Traditional gingival tattooinglips bull Practiced in Africarsquos Sahel region Woddebe
Fulani tribe Senegal Ethiopia middle eastern countries
Perception Reason aesthetic appeal superstition
bull Practices Done when females reach puberty
bull Kanuri females Borno State Nigeria tattooing lip gingiva usually performed thorns of Balanites aegyptiaca (Bukar et al 2004 )
bull Pigments -Mixture charcoal and seeds of Acacia nilotica vartomentosa
Lip plug lip plate
bull The lip plate (lip plug or lip disc) form of body modification
bull Amazonian tribes young males traditionally -rite of passage indicate status and prestige
bull Mursi of Ethiopia girls age 13 to 18
bull At puberty mother cuts her lower lip
bull Held open by a wooden plug - inserted into thereby stretching the lip
bull At times -combined with removal of two or four lower anterior incisal teeth
Lip plug lip plate
TRADITIONAL DENTAL SERVICES
bull Perceptions
Cause of illness determines treatment taken Practices
bull Yoruba community patronize traditional dentists (Oke Bankole et al 2011) Edo state
bull Services rendered include worm extraction tooth extraction drug prescription and offering sacrifices to deities
bull Charges based on the worm count
Northern Nigeria called Serdia Toothache associated with dandruff
Cameroon traditional healers perform atraumatic tooth extraction Agbor et al (2011)
bull Leaves stems of Dichrocephala integrifolia
bull Tooth pulled out fingerssharp instrument
bull No pain Plant has anaesthetic properties
bull Dangers infection sepsis infection with hepatitis B Human Immunodeficiency Virus
bull Jewish Unlikely keep Friday appointment with the dentist for their children
bull Routine appointments on Fridays avoided (Scambler et al )
The traditional healer harvesting the medicinal plant in Cameroon
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J Ethnobiol Ethnomed 2011 715
Tooth extraction by a traditional dentist
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J EthnobiolEthnomed 2011 715
bull Health is a consequence of an individualrsquos lifestyle
bull Essential to Identify cultural factors that are harmful and those that are beneficial
bull As paediatric dentists we should discourage the unhealthy practices through rigorous health education and promote the adoption of healthy practices
bull Need for multicentric research on the cultural influence of the family and peers regarding oral health of children
bull Bankole OO Lawal FB Ibiyemi O (2017) Dispelling myths associated with natalneonatal teeth ldquoAdunnirdquo a health education video in a native Nigerian language Annals of Ibadan Postgraduate Medicine15(2)137-141
Thank you for listening
Outline 1 Developmental anomalies2 Teething3 Timing of eruption4 Eruption sequence5 Diet6 Oral hygiene 7 Common dental diseases 8 Oral habits9 Practices related to puberty and grooming 10Oral health utilization
Introduction
bull Teeth mouth face -fascination mankind
bull Subject of superstitions and traditions
bull Culture - learned behavior socially acquired (Park 2002)
bull Family unit reflects the culture of a wider society
bull Extended families plays a vital role in child rearing and behavior (Chandra et al 2009)
bull Negative traditions behaviors are sometimes harmful to the individual health
bull With increasing education taboos beliefs are gradually disappearing
bull DEVELOMENTAL ANOMALIES
CLEFT LIP AND PALATE(CLP)
bull One of the most prevalent oro-facial deformities
bull Prevalence 1 out of every 500 to 1000 live births (Cooper et al2006)
bull Myriads of problems - discrimination prejudice abandonment
bull Tendency towards social withdrawal
bull Attitudes of patients families and community towards CLP crucial in the treatment outcomes and social emotional development of the patients (Chan et al2006)
A baby with cleft lip and palate
Before intervention After intervention
Perceived causes of CLP (Globally - Among Indians Chinese )
bull Starvation in pregnancy
bull Staring at solar eclipse during pregnancy
bull Will of God Fate (el-Shazly et al 2010)
bull Punishment for past sinswrongdoings
bull Use of scissors or other sharp objects during pregnancy ( Ross 2007)
In Africa Perception Effect
Worms in a pregnant woman lsquos stomach if
starved of food
Consuming poisoned rabbit meat
Fate Will of God (Olasoji et al 2007) Nodelayed
treatment
Reincarnation of ldquoAbikurdquo (Unpublished data)
Transference of spirits of unborn babies
Family stigma
Work of evil spirits result of being cursed Consult traditional
healers
Penalty for previous sins
wrongdoing contravening taboos
Practices bull Use of animals hoofs as dummy for child to suck -
improve shape musculature and speech ndash Similar naso alveolar moulding
bull Blood letting to lsquorestore balance Hazardous Risk of excessive blood loss infection
bull Give to charity as atonement repentance for past sins and wrongdoings
bull Fast praypilgrimage bathing in consecrated river to cleanse away sins
bull Psychological support
Loh J and Ascoli M Cross-cultural attitudes and perceptions towards cleft lip and
palate deformities World cultural research review 127-134 ( 2011)
MALOCCLUSION bull Proclined teeth (ldquoEyin Shamgarrdquo) in South
Western Nigeria
bull Perceived causes Carelessness of mother in application of teething concoctions to bath baby
bull Child opening mouth when sleeping (Unpublished work)
bull Jewish community study poor teeth in parents grandparents seen their children (Scambler et al 2010)
Practices Childrsquos lips continually pulled together by parents
TONGUE TIE (ANKYLOGLOSSIA)Perception
Among some tribes in Port Harcourt it is believed that most babies are born with tongue tie (Opara and Eke 2013)
Also among Ishan in Edo State
bull Perceived effects speech difficulties (stammering) inability to cry well difficulty breast feeding poor hearing
Tongue tie Practices
bull Culture in south south Nigeria supports routine clipping of frenulum in all newborns (Opara and Eke 2013)
bull Done between ages 0-1 month
bull Carried out by nurses traditional birth assistants using scissors or finger nails
bull (368) mothers in Port Harcourt had babies treated for tongue tie (Opara and Eke 2013)
bull Complications bleeding infection and soft tissue injuries
TEETHINGbull Eruption of teeth -important milestone
bull Myriads of symptoms are erroneously linked to the teething process ( Adam and Abhulimhen-Iyoha (2015)
bull Passive immunity decreases
bull Children exposed to a wide variety of illnesses
bull Danger is that mothers may not seek medical consultation for some childhood illnesses (Igeand Olubukola 2013 )
bull May lead to increased child mortality
Perceived Teething SymptomsSymptoms Egypt
El-gilany
and Abusaad
(2017)
Sudan
Awadkamil
(2012)
Kenya
James et
al 2015
Nigeria
Bankole et al
(2017)
Fever 832 866 764 692
Diarrhea 51 833 739 807
Boils 644
Weight loss 473
Cough 608
Vomiting 147
Conjunctivitis 201
Practices Teething Remedies Remedies Opeoduand Denloye2014
Kenya (James et al 2015
Bankole et al 2017)
Analgesics 634 677
Teething powder
syrup
435 655 420313
Antibiotic 142
Sedatives 46
Traditional
Concoction herbs
15 481
Teething soap etc 750
Other Folk RemediesSource httpswwwlifelovelizcom20150108traditional-
teething-remedies-around-world
Caribbean Hang raw egg over where baby sleeps
India Ayurvedic Remedy with cloves
Chinese Traditional Chinese Medicine (TCM) Acupuncture Acupressure
Japanese Wooden Teething Ring
France Sophie the giraffe - teething toy
Baltic Amber Teething Necklace Dangers strangulation aspiration beads
German Zwieback Toast
bull Acupressure
bull Massaging two important acupoints called the ldquotwo gatesrdquo or Large Intestine 4 (Li 4) and Liver 3 (Liv 3) can ease babyrsquos teething pain
bull It is simple effective and easy to do anywhere
bull Shonishin ndashJapanese needleless therapybull Source www bonnchirocomshonishin-needle-less-acupuncture-for-infants-and-
toddlers
Health education to the nurses and Community health officers at Ibadan Nigeria
Photoposter
Educational tool (In collaboration with WHO) In English and 3 major Nigerian languages
bull Effectiveness tested (Bankole et al 2005)
bull More effective as instructional tool in interactive atmosphere than just pasted on walls
TIMING OF ERUPTION Natalneonatal teeth
Associated with erroneous cultural beliefs among community nurses and
traditional birth attendants (TBA)
Britain ndashHeroes
China ndashBearers of misfortune
Natal tooth
Perceptions regarding natalneonatal teeth in infants
Traditional birth
attendaants
Bankole et al
(2013
Igbo Ora
Community
Unpublished
PERCEIVED CAUSES
Evil spirits evil child Abiku 319 487
Mothers contravened taboos 92 35
Prolonged maternal gestation 49
EFFECT ON THE FAMILY
Curse 74 106
Abomination 245 360
Embarrassment 11 360
Practices regarding natalneonatal teeth
Traditional birth
attendants
Bankole et al 2003)
Practices
Immediate extraction
Spiritual cleansing
356 Pain infection HIV
hepatitis B tetanus
Get rid of child 49 Infanticide
EFFECT ON CHILD
Strange odd behavior 313 Stigmatization
Evil spiritual powers 411 Stigmatization
Mental retardation
dull
31
With Traditional Birth Attendants at Ibadan South East Local government area
REVERSAL OF ERUPTION SEQUENCE
bull African ethnographies - infants whose upper teeth erupt before their lower teeth have been killed because of such ldquodevelopmental anomaliesrdquo
bull Considered a bad omen and sign of misfortune among Hamar Ethiopia Benin Rebublic
bull Reversal of eruption sequence of primary incisors in infants in Yoruba community has led to unpleasant circumstances
Reversal of eruption sequence
Reversal of eruption sequence
TraditionalBirth Attendants
Bankole and Lawal (2018)
PERCEIVED CAUSES
Evil spirits 218 476
Contravening taboos 80 26
EFFECT ON THE FAMILY
Curse 135 214Abomination 276 218
Embarrassment 233 114
Practices regarding reversal of eruption sequence of the anterior primary teeth
Practices Bankole and
Lawal(2018 )Effect
Immediate extraction 337 Pain infection HJV
hepatitis B infection
tetanus
HideGet rid of child 613 Infanticide
EFFECT ON CHILD
Strange behavior 227 Stigmatization
Evil powers 417 Stigmatization
Mental retardation 25
Dr Bankole and Dr Lawal with the Traditional Birth Attendants at the Ibadan South West LGA
DIETDental caries has escalated in developing countries
bull Misconception Food and drinks refined processed or modern is best and associated with affluence (Aderinokun et al 2011)
bull Parents donrsquot want their children to be deprived of what they lacked when young
bull This has led to a cultural shift in diet
bull Some African American believe motherrsquos diet during pregnancy cause dental caries in the child
bull Somali refugees Hutterites and Latino immigrant caregivers believed genetics plays a role in development early childhood caries (Prowse 2014)
Practices
bull YorubaHausa community common snacks have assumed local flavours several shapes coloursof sweets sold
bull Natural foods fruits are being sweetened Oke Bankole et al 2011 )
bull Nomadic Fulani sugary diet in between their meals sweetened drinks in bottles Sippy cups (827) and (716) give pacifiers dipped in sweet liquids Reduce temper tantrums with sweets Bankole et al 2015
Infant feeding practices
bull Babies with sweetened drinks in bottles pacifiers dipped in sweet liquidsputting infant to bed with a bottle of sweetened liquid Reported among Mexican Americans and Puerto Ricans Hong Kong Saudi mothers Al-Zahrani et al 2014
bull High risk factors contributing development of early childhood caries in infants
Diet
bull Perception
Animals such as pig are unclean
bull Practices
bull Hindus donrsquot eat beef Muslims donrsquot eat pork
bull Protective prevent taeniasis cystecercosis -edematous oral ulcers gingival bleeding lesions mimicking mucocles in children
(Alves et al 2011)
Dental Fluorosis bull In East and central African countries (tribal
areas of Tanzania Magadi a fluoride rich tronaused in cooking
bull Used as a tenderizer and preservative
bull High Fluoride Concentration 7900 ppm
bull Magadi use may suggest high prevalence of fluorosis in northern Tanzania (Kaseva 2006)
Oral Hygiene
Perceptions among mothers
bull Hausa Fulani- 142 - babyrsquos mouth should be cleaned before teeth erupt
bull Yoruba- Babyrsquos mouthtongue cleaned before teeth erupt to prevent thrush
bull Hausa Fulani- 635 - commencement tooth cleaning between 6 and 12 months of age (Bankole et al 2017)
bull Yoruba- chewing sticks should not be used at night Causes premature death of mother (Oke et al 2011)
Practices
Hausa Fulani- 594 cleaned infants teeth once daily
- 614 children start cleaning their teeth unsupervised before the age of six years
- 751 of supervision was carried out by the grandparents
- Sudan -343 mothers donrsquot clean childrenrsquos teeth below the age of 2 years (Abduljalil et al 2016)
-Hausa - mothers start cleaning childrenrsquos teeth when enough teeth to justify effort (Oke et al 2011)
Oral hygiene practices
Cleaning materials used in infancyearly childhood
CommunityTribe
GlycerinFresh tomato Hydrogen peroxideAluminum sulphateVerona Amygdalina (bitter leaf)Iyere (African black pepper)Alligator pepperCitrus lime Combinations
Yoruba - Nigeria (Aderinokun 2000)
Alum (Aluminum sulphate) Bitter leaf (Verona Amygdalina)
Iyere (African black pepper)
Citrus lime Alligator pepper
Oral hygiene practices
Tooth Cleaning materials
CommunityTribe Side effect
Salt and cotton wool
Hausa (Oke et al 2011)
Finger Nomadic Fulani
Wooden twigSalvadora persiccatwig (miswak) Neem tree Chewing stick
Nomadic Fulani ( Bankole et al 2017)
Somali
India (Kochar et al 2014)
Yoruba Senegal (Diouf 2013)
Improper use ndashgingival trauma
round ceramics omadic ulani
brasion sensiti it
and omadic ulani
shes ood charcoal
Somali (Beveridge
India Senegal
Tooth Cleaning materials
CommunityTribe Side effect
Ground ceramics Nomadic Fulani Tooth abrasion
Sand Nomadic Fulani
AshesWood
Charcoal
Somali India Senegal
Tooth abrasion
IMPORTANCE OF THE PRIMARY DENTITION IN CHILDREN
bull Primary teeth in children are sometimes not regarded as important
bull Mothers of preschool children in Mumbai -436 believed 192 were uncertain that there is no need to visit a dentist for treating milk teeth as they will soon fall off (Jain et al 2014)
COMMON DENTAL DISEASES
Dental Caries
bull Early childhood caries is a significant public health problem caries affecting children globally
bull In recent years in developing countries like Sub-Saharan Africa the prevalence is predicted to increase
bull Early childhood caries is largely untreated in a study in South Africa reported a caries prevalence of 716 and these 675 were untreated (Mohammed and Barnes 2018 )
Dental caries Perceived cause of dental
caries
Community tribe
Worms (resembling
maggots)
Borom bop (master of the
head)
Lagatas
Smaller version of pubu
Worms -removed from
ears
Yoruba Nomadic Fulani
Chinese (Dong et al 2007)
Senegalese ( Diouf et al 2003)
Brazil
Papua New Guinea
Indian (Nagaraj et al2014)
Dental caries -Care remedies Dental care remedies Community tribe Effect
Hydrochloric acid (Wet cell
battery liquid)
Aluminum Phosphate
(Alum)
Tobacco snuff
Charcoal and salt
Gentian violet
Atare (Alligator Pepper)
Yoruba Brazil
Kenya (Mulu Maryanne)
Yoruba (Oke et al 2011)
Chemical burns
mucosal ulceration
Erosion
Tetracycline capsule (topical)
Paracetamol (topical)
Hausa Nomadic Fulani
Hausa
Greyish brown tooth
discolouration
Mucosal ulceration
Traditional concoction
Dental are remedies Dental care remedies Community
tribe
Effect
White wineVinegar Powdered alum musk and frankincense
Chinese (Dong et al 2007)
Herbs traditional medicine
Aborigines (Wong 2005)
Nettles
Hot sweet potato
Wads hot leaves ginger
Residue smoking pipe
White sap of shrub used
to kill maggots
Insecticide ointment
Papua New
Guinea
Predisposition to
oral cancer
Toxic
Dental care remedies Dental care remedies Community Effect
Cooked meat
salt alcohol grease
deodorant
Iran
fingernail polish remover
black tar
Garlic Warm coconut milk
Brazil Toxic
Kawakawa Māori(Pepper Tree
Leaves) chewed
Harakeke -Korari Flax
the gum used for toothache
Maori
GingivitisPeriodontal disease
Perceptions
bull Bleeding gums caused by
bull Child stores food in pouch of mouth and does not clean teeth
Remedies for gingival periodontal disease
Remedies Community tribe
Effect
Aluminium phosphate (Alum ) + Lapalapa sap (Jatropha curcas)Warm water and salt Tomato and alum+polystrene foam or cotton woolHydrogen peroxide
Yoruba
Antibiotics NomadiFulani
Resistant strains Hyper sensitivityreactions
Herbs
ORAL HABITS Kola nut chewing
Common West Central Africa Symbol of hospitality Contains caffeine tannin
bull Helps students keep awakewithstand fatigue
Practices
bull One-year prevalence student use was 291 Erinfolami et al (2011)
bull Majority started at age 14 years or below
bull Dangers -insomnia nausea tooth discolourationcarcinogenic potential for development of oral cancer
Areca Nut Chewing Habitbull Areca nut is the seed of areca palm
bull Widely grown- Asia India Bangladesh Japan
bull Believed to help fatigue
bull Highest period of risk for first use is between 5 and 12 Farrand et al 2001
74 4-16 age group in Karachi indulged in the habit (Shah et al 2002)
Dangers Oral sub mucous fibrosis
bull Risk of oral cancer 99 times( Wollina et al 2004 ) Foreign body aspiration Severe tooth wear -- sensitivity root fractures
Mandibular arch with generalized staining in the deciduous dentition
Prajapati D Nayak R Nayak UA Shah PJ Areca nut chewing habit in preschoolers Two rare case reports and literature review Int J Dent Health Concern 201511-5 (Permission given)
Mandibular arch with generalized staining in the deciduous dentition
Prajapati D Nayak R Nayak UA Shah PJ Areca nut chewing habit in preschoolers Two rare case reports and literature review Int J Dent Health Concern 201511-5 (Permission given)
Oral tobacco use and cigar smoking
bull High prevalence tobacco use in any form is reported among school going adolescents aged 13ndash15 years in India (Arora and Reddy 2005) Smoking Chutta is relatively popular may begin in childhood in India
bull Acts as a stimulant euphoric
bull May sleep with tobacco mixture in mouth
Harmful effects halitosis brown black staining gingival recession if wad is held against gingivaleucoplakia oral squamous cell carcinoma
Tobacco use in children
PRACTICES RELATED TO PUBERTY AND GROOMING
Tooth filing tooth sharpening
Practiced -Nigeria Niger-Delta area (Ukeghesonand Akadiri ) Democratic Republic of Congo Thailand Indonesia
bull Perception Historically -spiritual reasons Contemporary times - aesthetic reasons
bull In Nigeria maxillary midline diastema is regarded as a symbol of beauty (Arigbede and Adesuwa 2012
bull Teeth filed- because represent negative emotions eg anger jealousy (Balinese Indonesia)
30 respondents would not mind having artificially created diastema (Omotosho and Kadri (2010)
Practices
bull Done in adolescence - fashionable
bull Manually done Usually incisors
Harmful effects
bull pain during process
bull Tooth discolouration (teeth -non vital)
bull Infection -pus discharge lip swelling
Tooth filing
Peri-apical x-ray of lower central incisor
Lacquering and staining of teethPerformed in Vietnam Laos Thailand Indonesia and Philippines
Perception For cosmetic reasons
bull Main ingredient dye dark-brown solution of ferric acetate called kanemizu (iron filings in vinegar)
bull Coating the teeth with this liquid helped to prevent tooth decay and enamel decay
bull Practice has slowly declined
Traditional gingival tattooinglips bull Practiced in Africarsquos Sahel region Woddebe
Fulani tribe Senegal Ethiopia middle eastern countries
Perception Reason aesthetic appeal superstition
bull Practices Done when females reach puberty
bull Kanuri females Borno State Nigeria tattooing lip gingiva usually performed thorns of Balanites aegyptiaca (Bukar et al 2004 )
bull Pigments -Mixture charcoal and seeds of Acacia nilotica vartomentosa
Lip plug lip plate
bull The lip plate (lip plug or lip disc) form of body modification
bull Amazonian tribes young males traditionally -rite of passage indicate status and prestige
bull Mursi of Ethiopia girls age 13 to 18
bull At puberty mother cuts her lower lip
bull Held open by a wooden plug - inserted into thereby stretching the lip
bull At times -combined with removal of two or four lower anterior incisal teeth
Lip plug lip plate
TRADITIONAL DENTAL SERVICES
bull Perceptions
Cause of illness determines treatment taken Practices
bull Yoruba community patronize traditional dentists (Oke Bankole et al 2011) Edo state
bull Services rendered include worm extraction tooth extraction drug prescription and offering sacrifices to deities
bull Charges based on the worm count
Northern Nigeria called Serdia Toothache associated with dandruff
Cameroon traditional healers perform atraumatic tooth extraction Agbor et al (2011)
bull Leaves stems of Dichrocephala integrifolia
bull Tooth pulled out fingerssharp instrument
bull No pain Plant has anaesthetic properties
bull Dangers infection sepsis infection with hepatitis B Human Immunodeficiency Virus
bull Jewish Unlikely keep Friday appointment with the dentist for their children
bull Routine appointments on Fridays avoided (Scambler et al )
The traditional healer harvesting the medicinal plant in Cameroon
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J Ethnobiol Ethnomed 2011 715
Tooth extraction by a traditional dentist
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J EthnobiolEthnomed 2011 715
bull Health is a consequence of an individualrsquos lifestyle
bull Essential to Identify cultural factors that are harmful and those that are beneficial
bull As paediatric dentists we should discourage the unhealthy practices through rigorous health education and promote the adoption of healthy practices
bull Need for multicentric research on the cultural influence of the family and peers regarding oral health of children
bull Bankole OO Lawal FB Ibiyemi O (2017) Dispelling myths associated with natalneonatal teeth ldquoAdunnirdquo a health education video in a native Nigerian language Annals of Ibadan Postgraduate Medicine15(2)137-141
Thank you for listening
Introduction
bull Teeth mouth face -fascination mankind
bull Subject of superstitions and traditions
bull Culture - learned behavior socially acquired (Park 2002)
bull Family unit reflects the culture of a wider society
bull Extended families plays a vital role in child rearing and behavior (Chandra et al 2009)
bull Negative traditions behaviors are sometimes harmful to the individual health
bull With increasing education taboos beliefs are gradually disappearing
bull DEVELOMENTAL ANOMALIES
CLEFT LIP AND PALATE(CLP)
bull One of the most prevalent oro-facial deformities
bull Prevalence 1 out of every 500 to 1000 live births (Cooper et al2006)
bull Myriads of problems - discrimination prejudice abandonment
bull Tendency towards social withdrawal
bull Attitudes of patients families and community towards CLP crucial in the treatment outcomes and social emotional development of the patients (Chan et al2006)
A baby with cleft lip and palate
Before intervention After intervention
Perceived causes of CLP (Globally - Among Indians Chinese )
bull Starvation in pregnancy
bull Staring at solar eclipse during pregnancy
bull Will of God Fate (el-Shazly et al 2010)
bull Punishment for past sinswrongdoings
bull Use of scissors or other sharp objects during pregnancy ( Ross 2007)
In Africa Perception Effect
Worms in a pregnant woman lsquos stomach if
starved of food
Consuming poisoned rabbit meat
Fate Will of God (Olasoji et al 2007) Nodelayed
treatment
Reincarnation of ldquoAbikurdquo (Unpublished data)
Transference of spirits of unborn babies
Family stigma
Work of evil spirits result of being cursed Consult traditional
healers
Penalty for previous sins
wrongdoing contravening taboos
Practices bull Use of animals hoofs as dummy for child to suck -
improve shape musculature and speech ndash Similar naso alveolar moulding
bull Blood letting to lsquorestore balance Hazardous Risk of excessive blood loss infection
bull Give to charity as atonement repentance for past sins and wrongdoings
bull Fast praypilgrimage bathing in consecrated river to cleanse away sins
bull Psychological support
Loh J and Ascoli M Cross-cultural attitudes and perceptions towards cleft lip and
palate deformities World cultural research review 127-134 ( 2011)
MALOCCLUSION bull Proclined teeth (ldquoEyin Shamgarrdquo) in South
Western Nigeria
bull Perceived causes Carelessness of mother in application of teething concoctions to bath baby
bull Child opening mouth when sleeping (Unpublished work)
bull Jewish community study poor teeth in parents grandparents seen their children (Scambler et al 2010)
Practices Childrsquos lips continually pulled together by parents
TONGUE TIE (ANKYLOGLOSSIA)Perception
Among some tribes in Port Harcourt it is believed that most babies are born with tongue tie (Opara and Eke 2013)
Also among Ishan in Edo State
bull Perceived effects speech difficulties (stammering) inability to cry well difficulty breast feeding poor hearing
Tongue tie Practices
bull Culture in south south Nigeria supports routine clipping of frenulum in all newborns (Opara and Eke 2013)
bull Done between ages 0-1 month
bull Carried out by nurses traditional birth assistants using scissors or finger nails
bull (368) mothers in Port Harcourt had babies treated for tongue tie (Opara and Eke 2013)
bull Complications bleeding infection and soft tissue injuries
TEETHINGbull Eruption of teeth -important milestone
bull Myriads of symptoms are erroneously linked to the teething process ( Adam and Abhulimhen-Iyoha (2015)
bull Passive immunity decreases
bull Children exposed to a wide variety of illnesses
bull Danger is that mothers may not seek medical consultation for some childhood illnesses (Igeand Olubukola 2013 )
bull May lead to increased child mortality
Perceived Teething SymptomsSymptoms Egypt
El-gilany
and Abusaad
(2017)
Sudan
Awadkamil
(2012)
Kenya
James et
al 2015
Nigeria
Bankole et al
(2017)
Fever 832 866 764 692
Diarrhea 51 833 739 807
Boils 644
Weight loss 473
Cough 608
Vomiting 147
Conjunctivitis 201
Practices Teething Remedies Remedies Opeoduand Denloye2014
Kenya (James et al 2015
Bankole et al 2017)
Analgesics 634 677
Teething powder
syrup
435 655 420313
Antibiotic 142
Sedatives 46
Traditional
Concoction herbs
15 481
Teething soap etc 750
Other Folk RemediesSource httpswwwlifelovelizcom20150108traditional-
teething-remedies-around-world
Caribbean Hang raw egg over where baby sleeps
India Ayurvedic Remedy with cloves
Chinese Traditional Chinese Medicine (TCM) Acupuncture Acupressure
Japanese Wooden Teething Ring
France Sophie the giraffe - teething toy
Baltic Amber Teething Necklace Dangers strangulation aspiration beads
German Zwieback Toast
bull Acupressure
bull Massaging two important acupoints called the ldquotwo gatesrdquo or Large Intestine 4 (Li 4) and Liver 3 (Liv 3) can ease babyrsquos teething pain
bull It is simple effective and easy to do anywhere
bull Shonishin ndashJapanese needleless therapybull Source www bonnchirocomshonishin-needle-less-acupuncture-for-infants-and-
toddlers
Health education to the nurses and Community health officers at Ibadan Nigeria
Photoposter
Educational tool (In collaboration with WHO) In English and 3 major Nigerian languages
bull Effectiveness tested (Bankole et al 2005)
bull More effective as instructional tool in interactive atmosphere than just pasted on walls
TIMING OF ERUPTION Natalneonatal teeth
Associated with erroneous cultural beliefs among community nurses and
traditional birth attendants (TBA)
Britain ndashHeroes
China ndashBearers of misfortune
Natal tooth
Perceptions regarding natalneonatal teeth in infants
Traditional birth
attendaants
Bankole et al
(2013
Igbo Ora
Community
Unpublished
PERCEIVED CAUSES
Evil spirits evil child Abiku 319 487
Mothers contravened taboos 92 35
Prolonged maternal gestation 49
EFFECT ON THE FAMILY
Curse 74 106
Abomination 245 360
Embarrassment 11 360
Practices regarding natalneonatal teeth
Traditional birth
attendants
Bankole et al 2003)
Practices
Immediate extraction
Spiritual cleansing
356 Pain infection HIV
hepatitis B tetanus
Get rid of child 49 Infanticide
EFFECT ON CHILD
Strange odd behavior 313 Stigmatization
Evil spiritual powers 411 Stigmatization
Mental retardation
dull
31
With Traditional Birth Attendants at Ibadan South East Local government area
REVERSAL OF ERUPTION SEQUENCE
bull African ethnographies - infants whose upper teeth erupt before their lower teeth have been killed because of such ldquodevelopmental anomaliesrdquo
bull Considered a bad omen and sign of misfortune among Hamar Ethiopia Benin Rebublic
bull Reversal of eruption sequence of primary incisors in infants in Yoruba community has led to unpleasant circumstances
Reversal of eruption sequence
Reversal of eruption sequence
TraditionalBirth Attendants
Bankole and Lawal (2018)
PERCEIVED CAUSES
Evil spirits 218 476
Contravening taboos 80 26
EFFECT ON THE FAMILY
Curse 135 214Abomination 276 218
Embarrassment 233 114
Practices regarding reversal of eruption sequence of the anterior primary teeth
Practices Bankole and
Lawal(2018 )Effect
Immediate extraction 337 Pain infection HJV
hepatitis B infection
tetanus
HideGet rid of child 613 Infanticide
EFFECT ON CHILD
Strange behavior 227 Stigmatization
Evil powers 417 Stigmatization
Mental retardation 25
Dr Bankole and Dr Lawal with the Traditional Birth Attendants at the Ibadan South West LGA
DIETDental caries has escalated in developing countries
bull Misconception Food and drinks refined processed or modern is best and associated with affluence (Aderinokun et al 2011)
bull Parents donrsquot want their children to be deprived of what they lacked when young
bull This has led to a cultural shift in diet
bull Some African American believe motherrsquos diet during pregnancy cause dental caries in the child
bull Somali refugees Hutterites and Latino immigrant caregivers believed genetics plays a role in development early childhood caries (Prowse 2014)
Practices
bull YorubaHausa community common snacks have assumed local flavours several shapes coloursof sweets sold
bull Natural foods fruits are being sweetened Oke Bankole et al 2011 )
bull Nomadic Fulani sugary diet in between their meals sweetened drinks in bottles Sippy cups (827) and (716) give pacifiers dipped in sweet liquids Reduce temper tantrums with sweets Bankole et al 2015
Infant feeding practices
bull Babies with sweetened drinks in bottles pacifiers dipped in sweet liquidsputting infant to bed with a bottle of sweetened liquid Reported among Mexican Americans and Puerto Ricans Hong Kong Saudi mothers Al-Zahrani et al 2014
bull High risk factors contributing development of early childhood caries in infants
Diet
bull Perception
Animals such as pig are unclean
bull Practices
bull Hindus donrsquot eat beef Muslims donrsquot eat pork
bull Protective prevent taeniasis cystecercosis -edematous oral ulcers gingival bleeding lesions mimicking mucocles in children
(Alves et al 2011)
Dental Fluorosis bull In East and central African countries (tribal
areas of Tanzania Magadi a fluoride rich tronaused in cooking
bull Used as a tenderizer and preservative
bull High Fluoride Concentration 7900 ppm
bull Magadi use may suggest high prevalence of fluorosis in northern Tanzania (Kaseva 2006)
Oral Hygiene
Perceptions among mothers
bull Hausa Fulani- 142 - babyrsquos mouth should be cleaned before teeth erupt
bull Yoruba- Babyrsquos mouthtongue cleaned before teeth erupt to prevent thrush
bull Hausa Fulani- 635 - commencement tooth cleaning between 6 and 12 months of age (Bankole et al 2017)
bull Yoruba- chewing sticks should not be used at night Causes premature death of mother (Oke et al 2011)
Practices
Hausa Fulani- 594 cleaned infants teeth once daily
- 614 children start cleaning their teeth unsupervised before the age of six years
- 751 of supervision was carried out by the grandparents
- Sudan -343 mothers donrsquot clean childrenrsquos teeth below the age of 2 years (Abduljalil et al 2016)
-Hausa - mothers start cleaning childrenrsquos teeth when enough teeth to justify effort (Oke et al 2011)
Oral hygiene practices
Cleaning materials used in infancyearly childhood
CommunityTribe
GlycerinFresh tomato Hydrogen peroxideAluminum sulphateVerona Amygdalina (bitter leaf)Iyere (African black pepper)Alligator pepperCitrus lime Combinations
Yoruba - Nigeria (Aderinokun 2000)
Alum (Aluminum sulphate) Bitter leaf (Verona Amygdalina)
Iyere (African black pepper)
Citrus lime Alligator pepper
Oral hygiene practices
Tooth Cleaning materials
CommunityTribe Side effect
Salt and cotton wool
Hausa (Oke et al 2011)
Finger Nomadic Fulani
Wooden twigSalvadora persiccatwig (miswak) Neem tree Chewing stick
Nomadic Fulani ( Bankole et al 2017)
Somali
India (Kochar et al 2014)
Yoruba Senegal (Diouf 2013)
Improper use ndashgingival trauma
round ceramics omadic ulani
brasion sensiti it
and omadic ulani
shes ood charcoal
Somali (Beveridge
India Senegal
Tooth Cleaning materials
CommunityTribe Side effect
Ground ceramics Nomadic Fulani Tooth abrasion
Sand Nomadic Fulani
AshesWood
Charcoal
Somali India Senegal
Tooth abrasion
IMPORTANCE OF THE PRIMARY DENTITION IN CHILDREN
bull Primary teeth in children are sometimes not regarded as important
bull Mothers of preschool children in Mumbai -436 believed 192 were uncertain that there is no need to visit a dentist for treating milk teeth as they will soon fall off (Jain et al 2014)
COMMON DENTAL DISEASES
Dental Caries
bull Early childhood caries is a significant public health problem caries affecting children globally
bull In recent years in developing countries like Sub-Saharan Africa the prevalence is predicted to increase
bull Early childhood caries is largely untreated in a study in South Africa reported a caries prevalence of 716 and these 675 were untreated (Mohammed and Barnes 2018 )
Dental caries Perceived cause of dental
caries
Community tribe
Worms (resembling
maggots)
Borom bop (master of the
head)
Lagatas
Smaller version of pubu
Worms -removed from
ears
Yoruba Nomadic Fulani
Chinese (Dong et al 2007)
Senegalese ( Diouf et al 2003)
Brazil
Papua New Guinea
Indian (Nagaraj et al2014)
Dental caries -Care remedies Dental care remedies Community tribe Effect
Hydrochloric acid (Wet cell
battery liquid)
Aluminum Phosphate
(Alum)
Tobacco snuff
Charcoal and salt
Gentian violet
Atare (Alligator Pepper)
Yoruba Brazil
Kenya (Mulu Maryanne)
Yoruba (Oke et al 2011)
Chemical burns
mucosal ulceration
Erosion
Tetracycline capsule (topical)
Paracetamol (topical)
Hausa Nomadic Fulani
Hausa
Greyish brown tooth
discolouration
Mucosal ulceration
Traditional concoction
Dental are remedies Dental care remedies Community
tribe
Effect
White wineVinegar Powdered alum musk and frankincense
Chinese (Dong et al 2007)
Herbs traditional medicine
Aborigines (Wong 2005)
Nettles
Hot sweet potato
Wads hot leaves ginger
Residue smoking pipe
White sap of shrub used
to kill maggots
Insecticide ointment
Papua New
Guinea
Predisposition to
oral cancer
Toxic
Dental care remedies Dental care remedies Community Effect
Cooked meat
salt alcohol grease
deodorant
Iran
fingernail polish remover
black tar
Garlic Warm coconut milk
Brazil Toxic
Kawakawa Māori(Pepper Tree
Leaves) chewed
Harakeke -Korari Flax
the gum used for toothache
Maori
GingivitisPeriodontal disease
Perceptions
bull Bleeding gums caused by
bull Child stores food in pouch of mouth and does not clean teeth
Remedies for gingival periodontal disease
Remedies Community tribe
Effect
Aluminium phosphate (Alum ) + Lapalapa sap (Jatropha curcas)Warm water and salt Tomato and alum+polystrene foam or cotton woolHydrogen peroxide
Yoruba
Antibiotics NomadiFulani
Resistant strains Hyper sensitivityreactions
Herbs
ORAL HABITS Kola nut chewing
Common West Central Africa Symbol of hospitality Contains caffeine tannin
bull Helps students keep awakewithstand fatigue
Practices
bull One-year prevalence student use was 291 Erinfolami et al (2011)
bull Majority started at age 14 years or below
bull Dangers -insomnia nausea tooth discolourationcarcinogenic potential for development of oral cancer
Areca Nut Chewing Habitbull Areca nut is the seed of areca palm
bull Widely grown- Asia India Bangladesh Japan
bull Believed to help fatigue
bull Highest period of risk for first use is between 5 and 12 Farrand et al 2001
74 4-16 age group in Karachi indulged in the habit (Shah et al 2002)
Dangers Oral sub mucous fibrosis
bull Risk of oral cancer 99 times( Wollina et al 2004 ) Foreign body aspiration Severe tooth wear -- sensitivity root fractures
Mandibular arch with generalized staining in the deciduous dentition
Prajapati D Nayak R Nayak UA Shah PJ Areca nut chewing habit in preschoolers Two rare case reports and literature review Int J Dent Health Concern 201511-5 (Permission given)
Mandibular arch with generalized staining in the deciduous dentition
Prajapati D Nayak R Nayak UA Shah PJ Areca nut chewing habit in preschoolers Two rare case reports and literature review Int J Dent Health Concern 201511-5 (Permission given)
Oral tobacco use and cigar smoking
bull High prevalence tobacco use in any form is reported among school going adolescents aged 13ndash15 years in India (Arora and Reddy 2005) Smoking Chutta is relatively popular may begin in childhood in India
bull Acts as a stimulant euphoric
bull May sleep with tobacco mixture in mouth
Harmful effects halitosis brown black staining gingival recession if wad is held against gingivaleucoplakia oral squamous cell carcinoma
Tobacco use in children
PRACTICES RELATED TO PUBERTY AND GROOMING
Tooth filing tooth sharpening
Practiced -Nigeria Niger-Delta area (Ukeghesonand Akadiri ) Democratic Republic of Congo Thailand Indonesia
bull Perception Historically -spiritual reasons Contemporary times - aesthetic reasons
bull In Nigeria maxillary midline diastema is regarded as a symbol of beauty (Arigbede and Adesuwa 2012
bull Teeth filed- because represent negative emotions eg anger jealousy (Balinese Indonesia)
30 respondents would not mind having artificially created diastema (Omotosho and Kadri (2010)
Practices
bull Done in adolescence - fashionable
bull Manually done Usually incisors
Harmful effects
bull pain during process
bull Tooth discolouration (teeth -non vital)
bull Infection -pus discharge lip swelling
Tooth filing
Peri-apical x-ray of lower central incisor
Lacquering and staining of teethPerformed in Vietnam Laos Thailand Indonesia and Philippines
Perception For cosmetic reasons
bull Main ingredient dye dark-brown solution of ferric acetate called kanemizu (iron filings in vinegar)
bull Coating the teeth with this liquid helped to prevent tooth decay and enamel decay
bull Practice has slowly declined
Traditional gingival tattooinglips bull Practiced in Africarsquos Sahel region Woddebe
Fulani tribe Senegal Ethiopia middle eastern countries
Perception Reason aesthetic appeal superstition
bull Practices Done when females reach puberty
bull Kanuri females Borno State Nigeria tattooing lip gingiva usually performed thorns of Balanites aegyptiaca (Bukar et al 2004 )
bull Pigments -Mixture charcoal and seeds of Acacia nilotica vartomentosa
Lip plug lip plate
bull The lip plate (lip plug or lip disc) form of body modification
bull Amazonian tribes young males traditionally -rite of passage indicate status and prestige
bull Mursi of Ethiopia girls age 13 to 18
bull At puberty mother cuts her lower lip
bull Held open by a wooden plug - inserted into thereby stretching the lip
bull At times -combined with removal of two or four lower anterior incisal teeth
Lip plug lip plate
TRADITIONAL DENTAL SERVICES
bull Perceptions
Cause of illness determines treatment taken Practices
bull Yoruba community patronize traditional dentists (Oke Bankole et al 2011) Edo state
bull Services rendered include worm extraction tooth extraction drug prescription and offering sacrifices to deities
bull Charges based on the worm count
Northern Nigeria called Serdia Toothache associated with dandruff
Cameroon traditional healers perform atraumatic tooth extraction Agbor et al (2011)
bull Leaves stems of Dichrocephala integrifolia
bull Tooth pulled out fingerssharp instrument
bull No pain Plant has anaesthetic properties
bull Dangers infection sepsis infection with hepatitis B Human Immunodeficiency Virus
bull Jewish Unlikely keep Friday appointment with the dentist for their children
bull Routine appointments on Fridays avoided (Scambler et al )
The traditional healer harvesting the medicinal plant in Cameroon
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J Ethnobiol Ethnomed 2011 715
Tooth extraction by a traditional dentist
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J EthnobiolEthnomed 2011 715
bull Health is a consequence of an individualrsquos lifestyle
bull Essential to Identify cultural factors that are harmful and those that are beneficial
bull As paediatric dentists we should discourage the unhealthy practices through rigorous health education and promote the adoption of healthy practices
bull Need for multicentric research on the cultural influence of the family and peers regarding oral health of children
bull Bankole OO Lawal FB Ibiyemi O (2017) Dispelling myths associated with natalneonatal teeth ldquoAdunnirdquo a health education video in a native Nigerian language Annals of Ibadan Postgraduate Medicine15(2)137-141
Thank you for listening
bull DEVELOMENTAL ANOMALIES
CLEFT LIP AND PALATE(CLP)
bull One of the most prevalent oro-facial deformities
bull Prevalence 1 out of every 500 to 1000 live births (Cooper et al2006)
bull Myriads of problems - discrimination prejudice abandonment
bull Tendency towards social withdrawal
bull Attitudes of patients families and community towards CLP crucial in the treatment outcomes and social emotional development of the patients (Chan et al2006)
A baby with cleft lip and palate
Before intervention After intervention
Perceived causes of CLP (Globally - Among Indians Chinese )
bull Starvation in pregnancy
bull Staring at solar eclipse during pregnancy
bull Will of God Fate (el-Shazly et al 2010)
bull Punishment for past sinswrongdoings
bull Use of scissors or other sharp objects during pregnancy ( Ross 2007)
In Africa Perception Effect
Worms in a pregnant woman lsquos stomach if
starved of food
Consuming poisoned rabbit meat
Fate Will of God (Olasoji et al 2007) Nodelayed
treatment
Reincarnation of ldquoAbikurdquo (Unpublished data)
Transference of spirits of unborn babies
Family stigma
Work of evil spirits result of being cursed Consult traditional
healers
Penalty for previous sins
wrongdoing contravening taboos
Practices bull Use of animals hoofs as dummy for child to suck -
improve shape musculature and speech ndash Similar naso alveolar moulding
bull Blood letting to lsquorestore balance Hazardous Risk of excessive blood loss infection
bull Give to charity as atonement repentance for past sins and wrongdoings
bull Fast praypilgrimage bathing in consecrated river to cleanse away sins
bull Psychological support
Loh J and Ascoli M Cross-cultural attitudes and perceptions towards cleft lip and
palate deformities World cultural research review 127-134 ( 2011)
MALOCCLUSION bull Proclined teeth (ldquoEyin Shamgarrdquo) in South
Western Nigeria
bull Perceived causes Carelessness of mother in application of teething concoctions to bath baby
bull Child opening mouth when sleeping (Unpublished work)
bull Jewish community study poor teeth in parents grandparents seen their children (Scambler et al 2010)
Practices Childrsquos lips continually pulled together by parents
TONGUE TIE (ANKYLOGLOSSIA)Perception
Among some tribes in Port Harcourt it is believed that most babies are born with tongue tie (Opara and Eke 2013)
Also among Ishan in Edo State
bull Perceived effects speech difficulties (stammering) inability to cry well difficulty breast feeding poor hearing
Tongue tie Practices
bull Culture in south south Nigeria supports routine clipping of frenulum in all newborns (Opara and Eke 2013)
bull Done between ages 0-1 month
bull Carried out by nurses traditional birth assistants using scissors or finger nails
bull (368) mothers in Port Harcourt had babies treated for tongue tie (Opara and Eke 2013)
bull Complications bleeding infection and soft tissue injuries
TEETHINGbull Eruption of teeth -important milestone
bull Myriads of symptoms are erroneously linked to the teething process ( Adam and Abhulimhen-Iyoha (2015)
bull Passive immunity decreases
bull Children exposed to a wide variety of illnesses
bull Danger is that mothers may not seek medical consultation for some childhood illnesses (Igeand Olubukola 2013 )
bull May lead to increased child mortality
Perceived Teething SymptomsSymptoms Egypt
El-gilany
and Abusaad
(2017)
Sudan
Awadkamil
(2012)
Kenya
James et
al 2015
Nigeria
Bankole et al
(2017)
Fever 832 866 764 692
Diarrhea 51 833 739 807
Boils 644
Weight loss 473
Cough 608
Vomiting 147
Conjunctivitis 201
Practices Teething Remedies Remedies Opeoduand Denloye2014
Kenya (James et al 2015
Bankole et al 2017)
Analgesics 634 677
Teething powder
syrup
435 655 420313
Antibiotic 142
Sedatives 46
Traditional
Concoction herbs
15 481
Teething soap etc 750
Other Folk RemediesSource httpswwwlifelovelizcom20150108traditional-
teething-remedies-around-world
Caribbean Hang raw egg over where baby sleeps
India Ayurvedic Remedy with cloves
Chinese Traditional Chinese Medicine (TCM) Acupuncture Acupressure
Japanese Wooden Teething Ring
France Sophie the giraffe - teething toy
Baltic Amber Teething Necklace Dangers strangulation aspiration beads
German Zwieback Toast
bull Acupressure
bull Massaging two important acupoints called the ldquotwo gatesrdquo or Large Intestine 4 (Li 4) and Liver 3 (Liv 3) can ease babyrsquos teething pain
bull It is simple effective and easy to do anywhere
bull Shonishin ndashJapanese needleless therapybull Source www bonnchirocomshonishin-needle-less-acupuncture-for-infants-and-
toddlers
Health education to the nurses and Community health officers at Ibadan Nigeria
Photoposter
Educational tool (In collaboration with WHO) In English and 3 major Nigerian languages
bull Effectiveness tested (Bankole et al 2005)
bull More effective as instructional tool in interactive atmosphere than just pasted on walls
TIMING OF ERUPTION Natalneonatal teeth
Associated with erroneous cultural beliefs among community nurses and
traditional birth attendants (TBA)
Britain ndashHeroes
China ndashBearers of misfortune
Natal tooth
Perceptions regarding natalneonatal teeth in infants
Traditional birth
attendaants
Bankole et al
(2013
Igbo Ora
Community
Unpublished
PERCEIVED CAUSES
Evil spirits evil child Abiku 319 487
Mothers contravened taboos 92 35
Prolonged maternal gestation 49
EFFECT ON THE FAMILY
Curse 74 106
Abomination 245 360
Embarrassment 11 360
Practices regarding natalneonatal teeth
Traditional birth
attendants
Bankole et al 2003)
Practices
Immediate extraction
Spiritual cleansing
356 Pain infection HIV
hepatitis B tetanus
Get rid of child 49 Infanticide
EFFECT ON CHILD
Strange odd behavior 313 Stigmatization
Evil spiritual powers 411 Stigmatization
Mental retardation
dull
31
With Traditional Birth Attendants at Ibadan South East Local government area
REVERSAL OF ERUPTION SEQUENCE
bull African ethnographies - infants whose upper teeth erupt before their lower teeth have been killed because of such ldquodevelopmental anomaliesrdquo
bull Considered a bad omen and sign of misfortune among Hamar Ethiopia Benin Rebublic
bull Reversal of eruption sequence of primary incisors in infants in Yoruba community has led to unpleasant circumstances
Reversal of eruption sequence
Reversal of eruption sequence
TraditionalBirth Attendants
Bankole and Lawal (2018)
PERCEIVED CAUSES
Evil spirits 218 476
Contravening taboos 80 26
EFFECT ON THE FAMILY
Curse 135 214Abomination 276 218
Embarrassment 233 114
Practices regarding reversal of eruption sequence of the anterior primary teeth
Practices Bankole and
Lawal(2018 )Effect
Immediate extraction 337 Pain infection HJV
hepatitis B infection
tetanus
HideGet rid of child 613 Infanticide
EFFECT ON CHILD
Strange behavior 227 Stigmatization
Evil powers 417 Stigmatization
Mental retardation 25
Dr Bankole and Dr Lawal with the Traditional Birth Attendants at the Ibadan South West LGA
DIETDental caries has escalated in developing countries
bull Misconception Food and drinks refined processed or modern is best and associated with affluence (Aderinokun et al 2011)
bull Parents donrsquot want their children to be deprived of what they lacked when young
bull This has led to a cultural shift in diet
bull Some African American believe motherrsquos diet during pregnancy cause dental caries in the child
bull Somali refugees Hutterites and Latino immigrant caregivers believed genetics plays a role in development early childhood caries (Prowse 2014)
Practices
bull YorubaHausa community common snacks have assumed local flavours several shapes coloursof sweets sold
bull Natural foods fruits are being sweetened Oke Bankole et al 2011 )
bull Nomadic Fulani sugary diet in between their meals sweetened drinks in bottles Sippy cups (827) and (716) give pacifiers dipped in sweet liquids Reduce temper tantrums with sweets Bankole et al 2015
Infant feeding practices
bull Babies with sweetened drinks in bottles pacifiers dipped in sweet liquidsputting infant to bed with a bottle of sweetened liquid Reported among Mexican Americans and Puerto Ricans Hong Kong Saudi mothers Al-Zahrani et al 2014
bull High risk factors contributing development of early childhood caries in infants
Diet
bull Perception
Animals such as pig are unclean
bull Practices
bull Hindus donrsquot eat beef Muslims donrsquot eat pork
bull Protective prevent taeniasis cystecercosis -edematous oral ulcers gingival bleeding lesions mimicking mucocles in children
(Alves et al 2011)
Dental Fluorosis bull In East and central African countries (tribal
areas of Tanzania Magadi a fluoride rich tronaused in cooking
bull Used as a tenderizer and preservative
bull High Fluoride Concentration 7900 ppm
bull Magadi use may suggest high prevalence of fluorosis in northern Tanzania (Kaseva 2006)
Oral Hygiene
Perceptions among mothers
bull Hausa Fulani- 142 - babyrsquos mouth should be cleaned before teeth erupt
bull Yoruba- Babyrsquos mouthtongue cleaned before teeth erupt to prevent thrush
bull Hausa Fulani- 635 - commencement tooth cleaning between 6 and 12 months of age (Bankole et al 2017)
bull Yoruba- chewing sticks should not be used at night Causes premature death of mother (Oke et al 2011)
Practices
Hausa Fulani- 594 cleaned infants teeth once daily
- 614 children start cleaning their teeth unsupervised before the age of six years
- 751 of supervision was carried out by the grandparents
- Sudan -343 mothers donrsquot clean childrenrsquos teeth below the age of 2 years (Abduljalil et al 2016)
-Hausa - mothers start cleaning childrenrsquos teeth when enough teeth to justify effort (Oke et al 2011)
Oral hygiene practices
Cleaning materials used in infancyearly childhood
CommunityTribe
GlycerinFresh tomato Hydrogen peroxideAluminum sulphateVerona Amygdalina (bitter leaf)Iyere (African black pepper)Alligator pepperCitrus lime Combinations
Yoruba - Nigeria (Aderinokun 2000)
Alum (Aluminum sulphate) Bitter leaf (Verona Amygdalina)
Iyere (African black pepper)
Citrus lime Alligator pepper
Oral hygiene practices
Tooth Cleaning materials
CommunityTribe Side effect
Salt and cotton wool
Hausa (Oke et al 2011)
Finger Nomadic Fulani
Wooden twigSalvadora persiccatwig (miswak) Neem tree Chewing stick
Nomadic Fulani ( Bankole et al 2017)
Somali
India (Kochar et al 2014)
Yoruba Senegal (Diouf 2013)
Improper use ndashgingival trauma
round ceramics omadic ulani
brasion sensiti it
and omadic ulani
shes ood charcoal
Somali (Beveridge
India Senegal
Tooth Cleaning materials
CommunityTribe Side effect
Ground ceramics Nomadic Fulani Tooth abrasion
Sand Nomadic Fulani
AshesWood
Charcoal
Somali India Senegal
Tooth abrasion
IMPORTANCE OF THE PRIMARY DENTITION IN CHILDREN
bull Primary teeth in children are sometimes not regarded as important
bull Mothers of preschool children in Mumbai -436 believed 192 were uncertain that there is no need to visit a dentist for treating milk teeth as they will soon fall off (Jain et al 2014)
COMMON DENTAL DISEASES
Dental Caries
bull Early childhood caries is a significant public health problem caries affecting children globally
bull In recent years in developing countries like Sub-Saharan Africa the prevalence is predicted to increase
bull Early childhood caries is largely untreated in a study in South Africa reported a caries prevalence of 716 and these 675 were untreated (Mohammed and Barnes 2018 )
Dental caries Perceived cause of dental
caries
Community tribe
Worms (resembling
maggots)
Borom bop (master of the
head)
Lagatas
Smaller version of pubu
Worms -removed from
ears
Yoruba Nomadic Fulani
Chinese (Dong et al 2007)
Senegalese ( Diouf et al 2003)
Brazil
Papua New Guinea
Indian (Nagaraj et al2014)
Dental caries -Care remedies Dental care remedies Community tribe Effect
Hydrochloric acid (Wet cell
battery liquid)
Aluminum Phosphate
(Alum)
Tobacco snuff
Charcoal and salt
Gentian violet
Atare (Alligator Pepper)
Yoruba Brazil
Kenya (Mulu Maryanne)
Yoruba (Oke et al 2011)
Chemical burns
mucosal ulceration
Erosion
Tetracycline capsule (topical)
Paracetamol (topical)
Hausa Nomadic Fulani
Hausa
Greyish brown tooth
discolouration
Mucosal ulceration
Traditional concoction
Dental are remedies Dental care remedies Community
tribe
Effect
White wineVinegar Powdered alum musk and frankincense
Chinese (Dong et al 2007)
Herbs traditional medicine
Aborigines (Wong 2005)
Nettles
Hot sweet potato
Wads hot leaves ginger
Residue smoking pipe
White sap of shrub used
to kill maggots
Insecticide ointment
Papua New
Guinea
Predisposition to
oral cancer
Toxic
Dental care remedies Dental care remedies Community Effect
Cooked meat
salt alcohol grease
deodorant
Iran
fingernail polish remover
black tar
Garlic Warm coconut milk
Brazil Toxic
Kawakawa Māori(Pepper Tree
Leaves) chewed
Harakeke -Korari Flax
the gum used for toothache
Maori
GingivitisPeriodontal disease
Perceptions
bull Bleeding gums caused by
bull Child stores food in pouch of mouth and does not clean teeth
Remedies for gingival periodontal disease
Remedies Community tribe
Effect
Aluminium phosphate (Alum ) + Lapalapa sap (Jatropha curcas)Warm water and salt Tomato and alum+polystrene foam or cotton woolHydrogen peroxide
Yoruba
Antibiotics NomadiFulani
Resistant strains Hyper sensitivityreactions
Herbs
ORAL HABITS Kola nut chewing
Common West Central Africa Symbol of hospitality Contains caffeine tannin
bull Helps students keep awakewithstand fatigue
Practices
bull One-year prevalence student use was 291 Erinfolami et al (2011)
bull Majority started at age 14 years or below
bull Dangers -insomnia nausea tooth discolourationcarcinogenic potential for development of oral cancer
Areca Nut Chewing Habitbull Areca nut is the seed of areca palm
bull Widely grown- Asia India Bangladesh Japan
bull Believed to help fatigue
bull Highest period of risk for first use is between 5 and 12 Farrand et al 2001
74 4-16 age group in Karachi indulged in the habit (Shah et al 2002)
Dangers Oral sub mucous fibrosis
bull Risk of oral cancer 99 times( Wollina et al 2004 ) Foreign body aspiration Severe tooth wear -- sensitivity root fractures
Mandibular arch with generalized staining in the deciduous dentition
Prajapati D Nayak R Nayak UA Shah PJ Areca nut chewing habit in preschoolers Two rare case reports and literature review Int J Dent Health Concern 201511-5 (Permission given)
Mandibular arch with generalized staining in the deciduous dentition
Prajapati D Nayak R Nayak UA Shah PJ Areca nut chewing habit in preschoolers Two rare case reports and literature review Int J Dent Health Concern 201511-5 (Permission given)
Oral tobacco use and cigar smoking
bull High prevalence tobacco use in any form is reported among school going adolescents aged 13ndash15 years in India (Arora and Reddy 2005) Smoking Chutta is relatively popular may begin in childhood in India
bull Acts as a stimulant euphoric
bull May sleep with tobacco mixture in mouth
Harmful effects halitosis brown black staining gingival recession if wad is held against gingivaleucoplakia oral squamous cell carcinoma
Tobacco use in children
PRACTICES RELATED TO PUBERTY AND GROOMING
Tooth filing tooth sharpening
Practiced -Nigeria Niger-Delta area (Ukeghesonand Akadiri ) Democratic Republic of Congo Thailand Indonesia
bull Perception Historically -spiritual reasons Contemporary times - aesthetic reasons
bull In Nigeria maxillary midline diastema is regarded as a symbol of beauty (Arigbede and Adesuwa 2012
bull Teeth filed- because represent negative emotions eg anger jealousy (Balinese Indonesia)
30 respondents would not mind having artificially created diastema (Omotosho and Kadri (2010)
Practices
bull Done in adolescence - fashionable
bull Manually done Usually incisors
Harmful effects
bull pain during process
bull Tooth discolouration (teeth -non vital)
bull Infection -pus discharge lip swelling
Tooth filing
Peri-apical x-ray of lower central incisor
Lacquering and staining of teethPerformed in Vietnam Laos Thailand Indonesia and Philippines
Perception For cosmetic reasons
bull Main ingredient dye dark-brown solution of ferric acetate called kanemizu (iron filings in vinegar)
bull Coating the teeth with this liquid helped to prevent tooth decay and enamel decay
bull Practice has slowly declined
Traditional gingival tattooinglips bull Practiced in Africarsquos Sahel region Woddebe
Fulani tribe Senegal Ethiopia middle eastern countries
Perception Reason aesthetic appeal superstition
bull Practices Done when females reach puberty
bull Kanuri females Borno State Nigeria tattooing lip gingiva usually performed thorns of Balanites aegyptiaca (Bukar et al 2004 )
bull Pigments -Mixture charcoal and seeds of Acacia nilotica vartomentosa
Lip plug lip plate
bull The lip plate (lip plug or lip disc) form of body modification
bull Amazonian tribes young males traditionally -rite of passage indicate status and prestige
bull Mursi of Ethiopia girls age 13 to 18
bull At puberty mother cuts her lower lip
bull Held open by a wooden plug - inserted into thereby stretching the lip
bull At times -combined with removal of two or four lower anterior incisal teeth
Lip plug lip plate
TRADITIONAL DENTAL SERVICES
bull Perceptions
Cause of illness determines treatment taken Practices
bull Yoruba community patronize traditional dentists (Oke Bankole et al 2011) Edo state
bull Services rendered include worm extraction tooth extraction drug prescription and offering sacrifices to deities
bull Charges based on the worm count
Northern Nigeria called Serdia Toothache associated with dandruff
Cameroon traditional healers perform atraumatic tooth extraction Agbor et al (2011)
bull Leaves stems of Dichrocephala integrifolia
bull Tooth pulled out fingerssharp instrument
bull No pain Plant has anaesthetic properties
bull Dangers infection sepsis infection with hepatitis B Human Immunodeficiency Virus
bull Jewish Unlikely keep Friday appointment with the dentist for their children
bull Routine appointments on Fridays avoided (Scambler et al )
The traditional healer harvesting the medicinal plant in Cameroon
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J Ethnobiol Ethnomed 2011 715
Tooth extraction by a traditional dentist
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J EthnobiolEthnomed 2011 715
bull Health is a consequence of an individualrsquos lifestyle
bull Essential to Identify cultural factors that are harmful and those that are beneficial
bull As paediatric dentists we should discourage the unhealthy practices through rigorous health education and promote the adoption of healthy practices
bull Need for multicentric research on the cultural influence of the family and peers regarding oral health of children
bull Bankole OO Lawal FB Ibiyemi O (2017) Dispelling myths associated with natalneonatal teeth ldquoAdunnirdquo a health education video in a native Nigerian language Annals of Ibadan Postgraduate Medicine15(2)137-141
Thank you for listening
CLEFT LIP AND PALATE(CLP)
bull One of the most prevalent oro-facial deformities
bull Prevalence 1 out of every 500 to 1000 live births (Cooper et al2006)
bull Myriads of problems - discrimination prejudice abandonment
bull Tendency towards social withdrawal
bull Attitudes of patients families and community towards CLP crucial in the treatment outcomes and social emotional development of the patients (Chan et al2006)
A baby with cleft lip and palate
Before intervention After intervention
Perceived causes of CLP (Globally - Among Indians Chinese )
bull Starvation in pregnancy
bull Staring at solar eclipse during pregnancy
bull Will of God Fate (el-Shazly et al 2010)
bull Punishment for past sinswrongdoings
bull Use of scissors or other sharp objects during pregnancy ( Ross 2007)
In Africa Perception Effect
Worms in a pregnant woman lsquos stomach if
starved of food
Consuming poisoned rabbit meat
Fate Will of God (Olasoji et al 2007) Nodelayed
treatment
Reincarnation of ldquoAbikurdquo (Unpublished data)
Transference of spirits of unborn babies
Family stigma
Work of evil spirits result of being cursed Consult traditional
healers
Penalty for previous sins
wrongdoing contravening taboos
Practices bull Use of animals hoofs as dummy for child to suck -
improve shape musculature and speech ndash Similar naso alveolar moulding
bull Blood letting to lsquorestore balance Hazardous Risk of excessive blood loss infection
bull Give to charity as atonement repentance for past sins and wrongdoings
bull Fast praypilgrimage bathing in consecrated river to cleanse away sins
bull Psychological support
Loh J and Ascoli M Cross-cultural attitudes and perceptions towards cleft lip and
palate deformities World cultural research review 127-134 ( 2011)
MALOCCLUSION bull Proclined teeth (ldquoEyin Shamgarrdquo) in South
Western Nigeria
bull Perceived causes Carelessness of mother in application of teething concoctions to bath baby
bull Child opening mouth when sleeping (Unpublished work)
bull Jewish community study poor teeth in parents grandparents seen their children (Scambler et al 2010)
Practices Childrsquos lips continually pulled together by parents
TONGUE TIE (ANKYLOGLOSSIA)Perception
Among some tribes in Port Harcourt it is believed that most babies are born with tongue tie (Opara and Eke 2013)
Also among Ishan in Edo State
bull Perceived effects speech difficulties (stammering) inability to cry well difficulty breast feeding poor hearing
Tongue tie Practices
bull Culture in south south Nigeria supports routine clipping of frenulum in all newborns (Opara and Eke 2013)
bull Done between ages 0-1 month
bull Carried out by nurses traditional birth assistants using scissors or finger nails
bull (368) mothers in Port Harcourt had babies treated for tongue tie (Opara and Eke 2013)
bull Complications bleeding infection and soft tissue injuries
TEETHINGbull Eruption of teeth -important milestone
bull Myriads of symptoms are erroneously linked to the teething process ( Adam and Abhulimhen-Iyoha (2015)
bull Passive immunity decreases
bull Children exposed to a wide variety of illnesses
bull Danger is that mothers may not seek medical consultation for some childhood illnesses (Igeand Olubukola 2013 )
bull May lead to increased child mortality
Perceived Teething SymptomsSymptoms Egypt
El-gilany
and Abusaad
(2017)
Sudan
Awadkamil
(2012)
Kenya
James et
al 2015
Nigeria
Bankole et al
(2017)
Fever 832 866 764 692
Diarrhea 51 833 739 807
Boils 644
Weight loss 473
Cough 608
Vomiting 147
Conjunctivitis 201
Practices Teething Remedies Remedies Opeoduand Denloye2014
Kenya (James et al 2015
Bankole et al 2017)
Analgesics 634 677
Teething powder
syrup
435 655 420313
Antibiotic 142
Sedatives 46
Traditional
Concoction herbs
15 481
Teething soap etc 750
Other Folk RemediesSource httpswwwlifelovelizcom20150108traditional-
teething-remedies-around-world
Caribbean Hang raw egg over where baby sleeps
India Ayurvedic Remedy with cloves
Chinese Traditional Chinese Medicine (TCM) Acupuncture Acupressure
Japanese Wooden Teething Ring
France Sophie the giraffe - teething toy
Baltic Amber Teething Necklace Dangers strangulation aspiration beads
German Zwieback Toast
bull Acupressure
bull Massaging two important acupoints called the ldquotwo gatesrdquo or Large Intestine 4 (Li 4) and Liver 3 (Liv 3) can ease babyrsquos teething pain
bull It is simple effective and easy to do anywhere
bull Shonishin ndashJapanese needleless therapybull Source www bonnchirocomshonishin-needle-less-acupuncture-for-infants-and-
toddlers
Health education to the nurses and Community health officers at Ibadan Nigeria
Photoposter
Educational tool (In collaboration with WHO) In English and 3 major Nigerian languages
bull Effectiveness tested (Bankole et al 2005)
bull More effective as instructional tool in interactive atmosphere than just pasted on walls
TIMING OF ERUPTION Natalneonatal teeth
Associated with erroneous cultural beliefs among community nurses and
traditional birth attendants (TBA)
Britain ndashHeroes
China ndashBearers of misfortune
Natal tooth
Perceptions regarding natalneonatal teeth in infants
Traditional birth
attendaants
Bankole et al
(2013
Igbo Ora
Community
Unpublished
PERCEIVED CAUSES
Evil spirits evil child Abiku 319 487
Mothers contravened taboos 92 35
Prolonged maternal gestation 49
EFFECT ON THE FAMILY
Curse 74 106
Abomination 245 360
Embarrassment 11 360
Practices regarding natalneonatal teeth
Traditional birth
attendants
Bankole et al 2003)
Practices
Immediate extraction
Spiritual cleansing
356 Pain infection HIV
hepatitis B tetanus
Get rid of child 49 Infanticide
EFFECT ON CHILD
Strange odd behavior 313 Stigmatization
Evil spiritual powers 411 Stigmatization
Mental retardation
dull
31
With Traditional Birth Attendants at Ibadan South East Local government area
REVERSAL OF ERUPTION SEQUENCE
bull African ethnographies - infants whose upper teeth erupt before their lower teeth have been killed because of such ldquodevelopmental anomaliesrdquo
bull Considered a bad omen and sign of misfortune among Hamar Ethiopia Benin Rebublic
bull Reversal of eruption sequence of primary incisors in infants in Yoruba community has led to unpleasant circumstances
Reversal of eruption sequence
Reversal of eruption sequence
TraditionalBirth Attendants
Bankole and Lawal (2018)
PERCEIVED CAUSES
Evil spirits 218 476
Contravening taboos 80 26
EFFECT ON THE FAMILY
Curse 135 214Abomination 276 218
Embarrassment 233 114
Practices regarding reversal of eruption sequence of the anterior primary teeth
Practices Bankole and
Lawal(2018 )Effect
Immediate extraction 337 Pain infection HJV
hepatitis B infection
tetanus
HideGet rid of child 613 Infanticide
EFFECT ON CHILD
Strange behavior 227 Stigmatization
Evil powers 417 Stigmatization
Mental retardation 25
Dr Bankole and Dr Lawal with the Traditional Birth Attendants at the Ibadan South West LGA
DIETDental caries has escalated in developing countries
bull Misconception Food and drinks refined processed or modern is best and associated with affluence (Aderinokun et al 2011)
bull Parents donrsquot want their children to be deprived of what they lacked when young
bull This has led to a cultural shift in diet
bull Some African American believe motherrsquos diet during pregnancy cause dental caries in the child
bull Somali refugees Hutterites and Latino immigrant caregivers believed genetics plays a role in development early childhood caries (Prowse 2014)
Practices
bull YorubaHausa community common snacks have assumed local flavours several shapes coloursof sweets sold
bull Natural foods fruits are being sweetened Oke Bankole et al 2011 )
bull Nomadic Fulani sugary diet in between their meals sweetened drinks in bottles Sippy cups (827) and (716) give pacifiers dipped in sweet liquids Reduce temper tantrums with sweets Bankole et al 2015
Infant feeding practices
bull Babies with sweetened drinks in bottles pacifiers dipped in sweet liquidsputting infant to bed with a bottle of sweetened liquid Reported among Mexican Americans and Puerto Ricans Hong Kong Saudi mothers Al-Zahrani et al 2014
bull High risk factors contributing development of early childhood caries in infants
Diet
bull Perception
Animals such as pig are unclean
bull Practices
bull Hindus donrsquot eat beef Muslims donrsquot eat pork
bull Protective prevent taeniasis cystecercosis -edematous oral ulcers gingival bleeding lesions mimicking mucocles in children
(Alves et al 2011)
Dental Fluorosis bull In East and central African countries (tribal
areas of Tanzania Magadi a fluoride rich tronaused in cooking
bull Used as a tenderizer and preservative
bull High Fluoride Concentration 7900 ppm
bull Magadi use may suggest high prevalence of fluorosis in northern Tanzania (Kaseva 2006)
Oral Hygiene
Perceptions among mothers
bull Hausa Fulani- 142 - babyrsquos mouth should be cleaned before teeth erupt
bull Yoruba- Babyrsquos mouthtongue cleaned before teeth erupt to prevent thrush
bull Hausa Fulani- 635 - commencement tooth cleaning between 6 and 12 months of age (Bankole et al 2017)
bull Yoruba- chewing sticks should not be used at night Causes premature death of mother (Oke et al 2011)
Practices
Hausa Fulani- 594 cleaned infants teeth once daily
- 614 children start cleaning their teeth unsupervised before the age of six years
- 751 of supervision was carried out by the grandparents
- Sudan -343 mothers donrsquot clean childrenrsquos teeth below the age of 2 years (Abduljalil et al 2016)
-Hausa - mothers start cleaning childrenrsquos teeth when enough teeth to justify effort (Oke et al 2011)
Oral hygiene practices
Cleaning materials used in infancyearly childhood
CommunityTribe
GlycerinFresh tomato Hydrogen peroxideAluminum sulphateVerona Amygdalina (bitter leaf)Iyere (African black pepper)Alligator pepperCitrus lime Combinations
Yoruba - Nigeria (Aderinokun 2000)
Alum (Aluminum sulphate) Bitter leaf (Verona Amygdalina)
Iyere (African black pepper)
Citrus lime Alligator pepper
Oral hygiene practices
Tooth Cleaning materials
CommunityTribe Side effect
Salt and cotton wool
Hausa (Oke et al 2011)
Finger Nomadic Fulani
Wooden twigSalvadora persiccatwig (miswak) Neem tree Chewing stick
Nomadic Fulani ( Bankole et al 2017)
Somali
India (Kochar et al 2014)
Yoruba Senegal (Diouf 2013)
Improper use ndashgingival trauma
round ceramics omadic ulani
brasion sensiti it
and omadic ulani
shes ood charcoal
Somali (Beveridge
India Senegal
Tooth Cleaning materials
CommunityTribe Side effect
Ground ceramics Nomadic Fulani Tooth abrasion
Sand Nomadic Fulani
AshesWood
Charcoal
Somali India Senegal
Tooth abrasion
IMPORTANCE OF THE PRIMARY DENTITION IN CHILDREN
bull Primary teeth in children are sometimes not regarded as important
bull Mothers of preschool children in Mumbai -436 believed 192 were uncertain that there is no need to visit a dentist for treating milk teeth as they will soon fall off (Jain et al 2014)
COMMON DENTAL DISEASES
Dental Caries
bull Early childhood caries is a significant public health problem caries affecting children globally
bull In recent years in developing countries like Sub-Saharan Africa the prevalence is predicted to increase
bull Early childhood caries is largely untreated in a study in South Africa reported a caries prevalence of 716 and these 675 were untreated (Mohammed and Barnes 2018 )
Dental caries Perceived cause of dental
caries
Community tribe
Worms (resembling
maggots)
Borom bop (master of the
head)
Lagatas
Smaller version of pubu
Worms -removed from
ears
Yoruba Nomadic Fulani
Chinese (Dong et al 2007)
Senegalese ( Diouf et al 2003)
Brazil
Papua New Guinea
Indian (Nagaraj et al2014)
Dental caries -Care remedies Dental care remedies Community tribe Effect
Hydrochloric acid (Wet cell
battery liquid)
Aluminum Phosphate
(Alum)
Tobacco snuff
Charcoal and salt
Gentian violet
Atare (Alligator Pepper)
Yoruba Brazil
Kenya (Mulu Maryanne)
Yoruba (Oke et al 2011)
Chemical burns
mucosal ulceration
Erosion
Tetracycline capsule (topical)
Paracetamol (topical)
Hausa Nomadic Fulani
Hausa
Greyish brown tooth
discolouration
Mucosal ulceration
Traditional concoction
Dental are remedies Dental care remedies Community
tribe
Effect
White wineVinegar Powdered alum musk and frankincense
Chinese (Dong et al 2007)
Herbs traditional medicine
Aborigines (Wong 2005)
Nettles
Hot sweet potato
Wads hot leaves ginger
Residue smoking pipe
White sap of shrub used
to kill maggots
Insecticide ointment
Papua New
Guinea
Predisposition to
oral cancer
Toxic
Dental care remedies Dental care remedies Community Effect
Cooked meat
salt alcohol grease
deodorant
Iran
fingernail polish remover
black tar
Garlic Warm coconut milk
Brazil Toxic
Kawakawa Māori(Pepper Tree
Leaves) chewed
Harakeke -Korari Flax
the gum used for toothache
Maori
GingivitisPeriodontal disease
Perceptions
bull Bleeding gums caused by
bull Child stores food in pouch of mouth and does not clean teeth
Remedies for gingival periodontal disease
Remedies Community tribe
Effect
Aluminium phosphate (Alum ) + Lapalapa sap (Jatropha curcas)Warm water and salt Tomato and alum+polystrene foam or cotton woolHydrogen peroxide
Yoruba
Antibiotics NomadiFulani
Resistant strains Hyper sensitivityreactions
Herbs
ORAL HABITS Kola nut chewing
Common West Central Africa Symbol of hospitality Contains caffeine tannin
bull Helps students keep awakewithstand fatigue
Practices
bull One-year prevalence student use was 291 Erinfolami et al (2011)
bull Majority started at age 14 years or below
bull Dangers -insomnia nausea tooth discolourationcarcinogenic potential for development of oral cancer
Areca Nut Chewing Habitbull Areca nut is the seed of areca palm
bull Widely grown- Asia India Bangladesh Japan
bull Believed to help fatigue
bull Highest period of risk for first use is between 5 and 12 Farrand et al 2001
74 4-16 age group in Karachi indulged in the habit (Shah et al 2002)
Dangers Oral sub mucous fibrosis
bull Risk of oral cancer 99 times( Wollina et al 2004 ) Foreign body aspiration Severe tooth wear -- sensitivity root fractures
Mandibular arch with generalized staining in the deciduous dentition
Prajapati D Nayak R Nayak UA Shah PJ Areca nut chewing habit in preschoolers Two rare case reports and literature review Int J Dent Health Concern 201511-5 (Permission given)
Mandibular arch with generalized staining in the deciduous dentition
Prajapati D Nayak R Nayak UA Shah PJ Areca nut chewing habit in preschoolers Two rare case reports and literature review Int J Dent Health Concern 201511-5 (Permission given)
Oral tobacco use and cigar smoking
bull High prevalence tobacco use in any form is reported among school going adolescents aged 13ndash15 years in India (Arora and Reddy 2005) Smoking Chutta is relatively popular may begin in childhood in India
bull Acts as a stimulant euphoric
bull May sleep with tobacco mixture in mouth
Harmful effects halitosis brown black staining gingival recession if wad is held against gingivaleucoplakia oral squamous cell carcinoma
Tobacco use in children
PRACTICES RELATED TO PUBERTY AND GROOMING
Tooth filing tooth sharpening
Practiced -Nigeria Niger-Delta area (Ukeghesonand Akadiri ) Democratic Republic of Congo Thailand Indonesia
bull Perception Historically -spiritual reasons Contemporary times - aesthetic reasons
bull In Nigeria maxillary midline diastema is regarded as a symbol of beauty (Arigbede and Adesuwa 2012
bull Teeth filed- because represent negative emotions eg anger jealousy (Balinese Indonesia)
30 respondents would not mind having artificially created diastema (Omotosho and Kadri (2010)
Practices
bull Done in adolescence - fashionable
bull Manually done Usually incisors
Harmful effects
bull pain during process
bull Tooth discolouration (teeth -non vital)
bull Infection -pus discharge lip swelling
Tooth filing
Peri-apical x-ray of lower central incisor
Lacquering and staining of teethPerformed in Vietnam Laos Thailand Indonesia and Philippines
Perception For cosmetic reasons
bull Main ingredient dye dark-brown solution of ferric acetate called kanemizu (iron filings in vinegar)
bull Coating the teeth with this liquid helped to prevent tooth decay and enamel decay
bull Practice has slowly declined
Traditional gingival tattooinglips bull Practiced in Africarsquos Sahel region Woddebe
Fulani tribe Senegal Ethiopia middle eastern countries
Perception Reason aesthetic appeal superstition
bull Practices Done when females reach puberty
bull Kanuri females Borno State Nigeria tattooing lip gingiva usually performed thorns of Balanites aegyptiaca (Bukar et al 2004 )
bull Pigments -Mixture charcoal and seeds of Acacia nilotica vartomentosa
Lip plug lip plate
bull The lip plate (lip plug or lip disc) form of body modification
bull Amazonian tribes young males traditionally -rite of passage indicate status and prestige
bull Mursi of Ethiopia girls age 13 to 18
bull At puberty mother cuts her lower lip
bull Held open by a wooden plug - inserted into thereby stretching the lip
bull At times -combined with removal of two or four lower anterior incisal teeth
Lip plug lip plate
TRADITIONAL DENTAL SERVICES
bull Perceptions
Cause of illness determines treatment taken Practices
bull Yoruba community patronize traditional dentists (Oke Bankole et al 2011) Edo state
bull Services rendered include worm extraction tooth extraction drug prescription and offering sacrifices to deities
bull Charges based on the worm count
Northern Nigeria called Serdia Toothache associated with dandruff
Cameroon traditional healers perform atraumatic tooth extraction Agbor et al (2011)
bull Leaves stems of Dichrocephala integrifolia
bull Tooth pulled out fingerssharp instrument
bull No pain Plant has anaesthetic properties
bull Dangers infection sepsis infection with hepatitis B Human Immunodeficiency Virus
bull Jewish Unlikely keep Friday appointment with the dentist for their children
bull Routine appointments on Fridays avoided (Scambler et al )
The traditional healer harvesting the medicinal plant in Cameroon
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J Ethnobiol Ethnomed 2011 715
Tooth extraction by a traditional dentist
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J EthnobiolEthnomed 2011 715
bull Health is a consequence of an individualrsquos lifestyle
bull Essential to Identify cultural factors that are harmful and those that are beneficial
bull As paediatric dentists we should discourage the unhealthy practices through rigorous health education and promote the adoption of healthy practices
bull Need for multicentric research on the cultural influence of the family and peers regarding oral health of children
bull Bankole OO Lawal FB Ibiyemi O (2017) Dispelling myths associated with natalneonatal teeth ldquoAdunnirdquo a health education video in a native Nigerian language Annals of Ibadan Postgraduate Medicine15(2)137-141
Thank you for listening
A baby with cleft lip and palate
Before intervention After intervention
Perceived causes of CLP (Globally - Among Indians Chinese )
bull Starvation in pregnancy
bull Staring at solar eclipse during pregnancy
bull Will of God Fate (el-Shazly et al 2010)
bull Punishment for past sinswrongdoings
bull Use of scissors or other sharp objects during pregnancy ( Ross 2007)
In Africa Perception Effect
Worms in a pregnant woman lsquos stomach if
starved of food
Consuming poisoned rabbit meat
Fate Will of God (Olasoji et al 2007) Nodelayed
treatment
Reincarnation of ldquoAbikurdquo (Unpublished data)
Transference of spirits of unborn babies
Family stigma
Work of evil spirits result of being cursed Consult traditional
healers
Penalty for previous sins
wrongdoing contravening taboos
Practices bull Use of animals hoofs as dummy for child to suck -
improve shape musculature and speech ndash Similar naso alveolar moulding
bull Blood letting to lsquorestore balance Hazardous Risk of excessive blood loss infection
bull Give to charity as atonement repentance for past sins and wrongdoings
bull Fast praypilgrimage bathing in consecrated river to cleanse away sins
bull Psychological support
Loh J and Ascoli M Cross-cultural attitudes and perceptions towards cleft lip and
palate deformities World cultural research review 127-134 ( 2011)
MALOCCLUSION bull Proclined teeth (ldquoEyin Shamgarrdquo) in South
Western Nigeria
bull Perceived causes Carelessness of mother in application of teething concoctions to bath baby
bull Child opening mouth when sleeping (Unpublished work)
bull Jewish community study poor teeth in parents grandparents seen their children (Scambler et al 2010)
Practices Childrsquos lips continually pulled together by parents
TONGUE TIE (ANKYLOGLOSSIA)Perception
Among some tribes in Port Harcourt it is believed that most babies are born with tongue tie (Opara and Eke 2013)
Also among Ishan in Edo State
bull Perceived effects speech difficulties (stammering) inability to cry well difficulty breast feeding poor hearing
Tongue tie Practices
bull Culture in south south Nigeria supports routine clipping of frenulum in all newborns (Opara and Eke 2013)
bull Done between ages 0-1 month
bull Carried out by nurses traditional birth assistants using scissors or finger nails
bull (368) mothers in Port Harcourt had babies treated for tongue tie (Opara and Eke 2013)
bull Complications bleeding infection and soft tissue injuries
TEETHINGbull Eruption of teeth -important milestone
bull Myriads of symptoms are erroneously linked to the teething process ( Adam and Abhulimhen-Iyoha (2015)
bull Passive immunity decreases
bull Children exposed to a wide variety of illnesses
bull Danger is that mothers may not seek medical consultation for some childhood illnesses (Igeand Olubukola 2013 )
bull May lead to increased child mortality
Perceived Teething SymptomsSymptoms Egypt
El-gilany
and Abusaad
(2017)
Sudan
Awadkamil
(2012)
Kenya
James et
al 2015
Nigeria
Bankole et al
(2017)
Fever 832 866 764 692
Diarrhea 51 833 739 807
Boils 644
Weight loss 473
Cough 608
Vomiting 147
Conjunctivitis 201
Practices Teething Remedies Remedies Opeoduand Denloye2014
Kenya (James et al 2015
Bankole et al 2017)
Analgesics 634 677
Teething powder
syrup
435 655 420313
Antibiotic 142
Sedatives 46
Traditional
Concoction herbs
15 481
Teething soap etc 750
Other Folk RemediesSource httpswwwlifelovelizcom20150108traditional-
teething-remedies-around-world
Caribbean Hang raw egg over where baby sleeps
India Ayurvedic Remedy with cloves
Chinese Traditional Chinese Medicine (TCM) Acupuncture Acupressure
Japanese Wooden Teething Ring
France Sophie the giraffe - teething toy
Baltic Amber Teething Necklace Dangers strangulation aspiration beads
German Zwieback Toast
bull Acupressure
bull Massaging two important acupoints called the ldquotwo gatesrdquo or Large Intestine 4 (Li 4) and Liver 3 (Liv 3) can ease babyrsquos teething pain
bull It is simple effective and easy to do anywhere
bull Shonishin ndashJapanese needleless therapybull Source www bonnchirocomshonishin-needle-less-acupuncture-for-infants-and-
toddlers
Health education to the nurses and Community health officers at Ibadan Nigeria
Photoposter
Educational tool (In collaboration with WHO) In English and 3 major Nigerian languages
bull Effectiveness tested (Bankole et al 2005)
bull More effective as instructional tool in interactive atmosphere than just pasted on walls
TIMING OF ERUPTION Natalneonatal teeth
Associated with erroneous cultural beliefs among community nurses and
traditional birth attendants (TBA)
Britain ndashHeroes
China ndashBearers of misfortune
Natal tooth
Perceptions regarding natalneonatal teeth in infants
Traditional birth
attendaants
Bankole et al
(2013
Igbo Ora
Community
Unpublished
PERCEIVED CAUSES
Evil spirits evil child Abiku 319 487
Mothers contravened taboos 92 35
Prolonged maternal gestation 49
EFFECT ON THE FAMILY
Curse 74 106
Abomination 245 360
Embarrassment 11 360
Practices regarding natalneonatal teeth
Traditional birth
attendants
Bankole et al 2003)
Practices
Immediate extraction
Spiritual cleansing
356 Pain infection HIV
hepatitis B tetanus
Get rid of child 49 Infanticide
EFFECT ON CHILD
Strange odd behavior 313 Stigmatization
Evil spiritual powers 411 Stigmatization
Mental retardation
dull
31
With Traditional Birth Attendants at Ibadan South East Local government area
REVERSAL OF ERUPTION SEQUENCE
bull African ethnographies - infants whose upper teeth erupt before their lower teeth have been killed because of such ldquodevelopmental anomaliesrdquo
bull Considered a bad omen and sign of misfortune among Hamar Ethiopia Benin Rebublic
bull Reversal of eruption sequence of primary incisors in infants in Yoruba community has led to unpleasant circumstances
Reversal of eruption sequence
Reversal of eruption sequence
TraditionalBirth Attendants
Bankole and Lawal (2018)
PERCEIVED CAUSES
Evil spirits 218 476
Contravening taboos 80 26
EFFECT ON THE FAMILY
Curse 135 214Abomination 276 218
Embarrassment 233 114
Practices regarding reversal of eruption sequence of the anterior primary teeth
Practices Bankole and
Lawal(2018 )Effect
Immediate extraction 337 Pain infection HJV
hepatitis B infection
tetanus
HideGet rid of child 613 Infanticide
EFFECT ON CHILD
Strange behavior 227 Stigmatization
Evil powers 417 Stigmatization
Mental retardation 25
Dr Bankole and Dr Lawal with the Traditional Birth Attendants at the Ibadan South West LGA
DIETDental caries has escalated in developing countries
bull Misconception Food and drinks refined processed or modern is best and associated with affluence (Aderinokun et al 2011)
bull Parents donrsquot want their children to be deprived of what they lacked when young
bull This has led to a cultural shift in diet
bull Some African American believe motherrsquos diet during pregnancy cause dental caries in the child
bull Somali refugees Hutterites and Latino immigrant caregivers believed genetics plays a role in development early childhood caries (Prowse 2014)
Practices
bull YorubaHausa community common snacks have assumed local flavours several shapes coloursof sweets sold
bull Natural foods fruits are being sweetened Oke Bankole et al 2011 )
bull Nomadic Fulani sugary diet in between their meals sweetened drinks in bottles Sippy cups (827) and (716) give pacifiers dipped in sweet liquids Reduce temper tantrums with sweets Bankole et al 2015
Infant feeding practices
bull Babies with sweetened drinks in bottles pacifiers dipped in sweet liquidsputting infant to bed with a bottle of sweetened liquid Reported among Mexican Americans and Puerto Ricans Hong Kong Saudi mothers Al-Zahrani et al 2014
bull High risk factors contributing development of early childhood caries in infants
Diet
bull Perception
Animals such as pig are unclean
bull Practices
bull Hindus donrsquot eat beef Muslims donrsquot eat pork
bull Protective prevent taeniasis cystecercosis -edematous oral ulcers gingival bleeding lesions mimicking mucocles in children
(Alves et al 2011)
Dental Fluorosis bull In East and central African countries (tribal
areas of Tanzania Magadi a fluoride rich tronaused in cooking
bull Used as a tenderizer and preservative
bull High Fluoride Concentration 7900 ppm
bull Magadi use may suggest high prevalence of fluorosis in northern Tanzania (Kaseva 2006)
Oral Hygiene
Perceptions among mothers
bull Hausa Fulani- 142 - babyrsquos mouth should be cleaned before teeth erupt
bull Yoruba- Babyrsquos mouthtongue cleaned before teeth erupt to prevent thrush
bull Hausa Fulani- 635 - commencement tooth cleaning between 6 and 12 months of age (Bankole et al 2017)
bull Yoruba- chewing sticks should not be used at night Causes premature death of mother (Oke et al 2011)
Practices
Hausa Fulani- 594 cleaned infants teeth once daily
- 614 children start cleaning their teeth unsupervised before the age of six years
- 751 of supervision was carried out by the grandparents
- Sudan -343 mothers donrsquot clean childrenrsquos teeth below the age of 2 years (Abduljalil et al 2016)
-Hausa - mothers start cleaning childrenrsquos teeth when enough teeth to justify effort (Oke et al 2011)
Oral hygiene practices
Cleaning materials used in infancyearly childhood
CommunityTribe
GlycerinFresh tomato Hydrogen peroxideAluminum sulphateVerona Amygdalina (bitter leaf)Iyere (African black pepper)Alligator pepperCitrus lime Combinations
Yoruba - Nigeria (Aderinokun 2000)
Alum (Aluminum sulphate) Bitter leaf (Verona Amygdalina)
Iyere (African black pepper)
Citrus lime Alligator pepper
Oral hygiene practices
Tooth Cleaning materials
CommunityTribe Side effect
Salt and cotton wool
Hausa (Oke et al 2011)
Finger Nomadic Fulani
Wooden twigSalvadora persiccatwig (miswak) Neem tree Chewing stick
Nomadic Fulani ( Bankole et al 2017)
Somali
India (Kochar et al 2014)
Yoruba Senegal (Diouf 2013)
Improper use ndashgingival trauma
round ceramics omadic ulani
brasion sensiti it
and omadic ulani
shes ood charcoal
Somali (Beveridge
India Senegal
Tooth Cleaning materials
CommunityTribe Side effect
Ground ceramics Nomadic Fulani Tooth abrasion
Sand Nomadic Fulani
AshesWood
Charcoal
Somali India Senegal
Tooth abrasion
IMPORTANCE OF THE PRIMARY DENTITION IN CHILDREN
bull Primary teeth in children are sometimes not regarded as important
bull Mothers of preschool children in Mumbai -436 believed 192 were uncertain that there is no need to visit a dentist for treating milk teeth as they will soon fall off (Jain et al 2014)
COMMON DENTAL DISEASES
Dental Caries
bull Early childhood caries is a significant public health problem caries affecting children globally
bull In recent years in developing countries like Sub-Saharan Africa the prevalence is predicted to increase
bull Early childhood caries is largely untreated in a study in South Africa reported a caries prevalence of 716 and these 675 were untreated (Mohammed and Barnes 2018 )
Dental caries Perceived cause of dental
caries
Community tribe
Worms (resembling
maggots)
Borom bop (master of the
head)
Lagatas
Smaller version of pubu
Worms -removed from
ears
Yoruba Nomadic Fulani
Chinese (Dong et al 2007)
Senegalese ( Diouf et al 2003)
Brazil
Papua New Guinea
Indian (Nagaraj et al2014)
Dental caries -Care remedies Dental care remedies Community tribe Effect
Hydrochloric acid (Wet cell
battery liquid)
Aluminum Phosphate
(Alum)
Tobacco snuff
Charcoal and salt
Gentian violet
Atare (Alligator Pepper)
Yoruba Brazil
Kenya (Mulu Maryanne)
Yoruba (Oke et al 2011)
Chemical burns
mucosal ulceration
Erosion
Tetracycline capsule (topical)
Paracetamol (topical)
Hausa Nomadic Fulani
Hausa
Greyish brown tooth
discolouration
Mucosal ulceration
Traditional concoction
Dental are remedies Dental care remedies Community
tribe
Effect
White wineVinegar Powdered alum musk and frankincense
Chinese (Dong et al 2007)
Herbs traditional medicine
Aborigines (Wong 2005)
Nettles
Hot sweet potato
Wads hot leaves ginger
Residue smoking pipe
White sap of shrub used
to kill maggots
Insecticide ointment
Papua New
Guinea
Predisposition to
oral cancer
Toxic
Dental care remedies Dental care remedies Community Effect
Cooked meat
salt alcohol grease
deodorant
Iran
fingernail polish remover
black tar
Garlic Warm coconut milk
Brazil Toxic
Kawakawa Māori(Pepper Tree
Leaves) chewed
Harakeke -Korari Flax
the gum used for toothache
Maori
GingivitisPeriodontal disease
Perceptions
bull Bleeding gums caused by
bull Child stores food in pouch of mouth and does not clean teeth
Remedies for gingival periodontal disease
Remedies Community tribe
Effect
Aluminium phosphate (Alum ) + Lapalapa sap (Jatropha curcas)Warm water and salt Tomato and alum+polystrene foam or cotton woolHydrogen peroxide
Yoruba
Antibiotics NomadiFulani
Resistant strains Hyper sensitivityreactions
Herbs
ORAL HABITS Kola nut chewing
Common West Central Africa Symbol of hospitality Contains caffeine tannin
bull Helps students keep awakewithstand fatigue
Practices
bull One-year prevalence student use was 291 Erinfolami et al (2011)
bull Majority started at age 14 years or below
bull Dangers -insomnia nausea tooth discolourationcarcinogenic potential for development of oral cancer
Areca Nut Chewing Habitbull Areca nut is the seed of areca palm
bull Widely grown- Asia India Bangladesh Japan
bull Believed to help fatigue
bull Highest period of risk for first use is between 5 and 12 Farrand et al 2001
74 4-16 age group in Karachi indulged in the habit (Shah et al 2002)
Dangers Oral sub mucous fibrosis
bull Risk of oral cancer 99 times( Wollina et al 2004 ) Foreign body aspiration Severe tooth wear -- sensitivity root fractures
Mandibular arch with generalized staining in the deciduous dentition
Prajapati D Nayak R Nayak UA Shah PJ Areca nut chewing habit in preschoolers Two rare case reports and literature review Int J Dent Health Concern 201511-5 (Permission given)
Mandibular arch with generalized staining in the deciduous dentition
Prajapati D Nayak R Nayak UA Shah PJ Areca nut chewing habit in preschoolers Two rare case reports and literature review Int J Dent Health Concern 201511-5 (Permission given)
Oral tobacco use and cigar smoking
bull High prevalence tobacco use in any form is reported among school going adolescents aged 13ndash15 years in India (Arora and Reddy 2005) Smoking Chutta is relatively popular may begin in childhood in India
bull Acts as a stimulant euphoric
bull May sleep with tobacco mixture in mouth
Harmful effects halitosis brown black staining gingival recession if wad is held against gingivaleucoplakia oral squamous cell carcinoma
Tobacco use in children
PRACTICES RELATED TO PUBERTY AND GROOMING
Tooth filing tooth sharpening
Practiced -Nigeria Niger-Delta area (Ukeghesonand Akadiri ) Democratic Republic of Congo Thailand Indonesia
bull Perception Historically -spiritual reasons Contemporary times - aesthetic reasons
bull In Nigeria maxillary midline diastema is regarded as a symbol of beauty (Arigbede and Adesuwa 2012
bull Teeth filed- because represent negative emotions eg anger jealousy (Balinese Indonesia)
30 respondents would not mind having artificially created diastema (Omotosho and Kadri (2010)
Practices
bull Done in adolescence - fashionable
bull Manually done Usually incisors
Harmful effects
bull pain during process
bull Tooth discolouration (teeth -non vital)
bull Infection -pus discharge lip swelling
Tooth filing
Peri-apical x-ray of lower central incisor
Lacquering and staining of teethPerformed in Vietnam Laos Thailand Indonesia and Philippines
Perception For cosmetic reasons
bull Main ingredient dye dark-brown solution of ferric acetate called kanemizu (iron filings in vinegar)
bull Coating the teeth with this liquid helped to prevent tooth decay and enamel decay
bull Practice has slowly declined
Traditional gingival tattooinglips bull Practiced in Africarsquos Sahel region Woddebe
Fulani tribe Senegal Ethiopia middle eastern countries
Perception Reason aesthetic appeal superstition
bull Practices Done when females reach puberty
bull Kanuri females Borno State Nigeria tattooing lip gingiva usually performed thorns of Balanites aegyptiaca (Bukar et al 2004 )
bull Pigments -Mixture charcoal and seeds of Acacia nilotica vartomentosa
Lip plug lip plate
bull The lip plate (lip plug or lip disc) form of body modification
bull Amazonian tribes young males traditionally -rite of passage indicate status and prestige
bull Mursi of Ethiopia girls age 13 to 18
bull At puberty mother cuts her lower lip
bull Held open by a wooden plug - inserted into thereby stretching the lip
bull At times -combined with removal of two or four lower anterior incisal teeth
Lip plug lip plate
TRADITIONAL DENTAL SERVICES
bull Perceptions
Cause of illness determines treatment taken Practices
bull Yoruba community patronize traditional dentists (Oke Bankole et al 2011) Edo state
bull Services rendered include worm extraction tooth extraction drug prescription and offering sacrifices to deities
bull Charges based on the worm count
Northern Nigeria called Serdia Toothache associated with dandruff
Cameroon traditional healers perform atraumatic tooth extraction Agbor et al (2011)
bull Leaves stems of Dichrocephala integrifolia
bull Tooth pulled out fingerssharp instrument
bull No pain Plant has anaesthetic properties
bull Dangers infection sepsis infection with hepatitis B Human Immunodeficiency Virus
bull Jewish Unlikely keep Friday appointment with the dentist for their children
bull Routine appointments on Fridays avoided (Scambler et al )
The traditional healer harvesting the medicinal plant in Cameroon
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J Ethnobiol Ethnomed 2011 715
Tooth extraction by a traditional dentist
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J EthnobiolEthnomed 2011 715
bull Health is a consequence of an individualrsquos lifestyle
bull Essential to Identify cultural factors that are harmful and those that are beneficial
bull As paediatric dentists we should discourage the unhealthy practices through rigorous health education and promote the adoption of healthy practices
bull Need for multicentric research on the cultural influence of the family and peers regarding oral health of children
bull Bankole OO Lawal FB Ibiyemi O (2017) Dispelling myths associated with natalneonatal teeth ldquoAdunnirdquo a health education video in a native Nigerian language Annals of Ibadan Postgraduate Medicine15(2)137-141
Thank you for listening
Perceived causes of CLP (Globally - Among Indians Chinese )
bull Starvation in pregnancy
bull Staring at solar eclipse during pregnancy
bull Will of God Fate (el-Shazly et al 2010)
bull Punishment for past sinswrongdoings
bull Use of scissors or other sharp objects during pregnancy ( Ross 2007)
In Africa Perception Effect
Worms in a pregnant woman lsquos stomach if
starved of food
Consuming poisoned rabbit meat
Fate Will of God (Olasoji et al 2007) Nodelayed
treatment
Reincarnation of ldquoAbikurdquo (Unpublished data)
Transference of spirits of unborn babies
Family stigma
Work of evil spirits result of being cursed Consult traditional
healers
Penalty for previous sins
wrongdoing contravening taboos
Practices bull Use of animals hoofs as dummy for child to suck -
improve shape musculature and speech ndash Similar naso alveolar moulding
bull Blood letting to lsquorestore balance Hazardous Risk of excessive blood loss infection
bull Give to charity as atonement repentance for past sins and wrongdoings
bull Fast praypilgrimage bathing in consecrated river to cleanse away sins
bull Psychological support
Loh J and Ascoli M Cross-cultural attitudes and perceptions towards cleft lip and
palate deformities World cultural research review 127-134 ( 2011)
MALOCCLUSION bull Proclined teeth (ldquoEyin Shamgarrdquo) in South
Western Nigeria
bull Perceived causes Carelessness of mother in application of teething concoctions to bath baby
bull Child opening mouth when sleeping (Unpublished work)
bull Jewish community study poor teeth in parents grandparents seen their children (Scambler et al 2010)
Practices Childrsquos lips continually pulled together by parents
TONGUE TIE (ANKYLOGLOSSIA)Perception
Among some tribes in Port Harcourt it is believed that most babies are born with tongue tie (Opara and Eke 2013)
Also among Ishan in Edo State
bull Perceived effects speech difficulties (stammering) inability to cry well difficulty breast feeding poor hearing
Tongue tie Practices
bull Culture in south south Nigeria supports routine clipping of frenulum in all newborns (Opara and Eke 2013)
bull Done between ages 0-1 month
bull Carried out by nurses traditional birth assistants using scissors or finger nails
bull (368) mothers in Port Harcourt had babies treated for tongue tie (Opara and Eke 2013)
bull Complications bleeding infection and soft tissue injuries
TEETHINGbull Eruption of teeth -important milestone
bull Myriads of symptoms are erroneously linked to the teething process ( Adam and Abhulimhen-Iyoha (2015)
bull Passive immunity decreases
bull Children exposed to a wide variety of illnesses
bull Danger is that mothers may not seek medical consultation for some childhood illnesses (Igeand Olubukola 2013 )
bull May lead to increased child mortality
Perceived Teething SymptomsSymptoms Egypt
El-gilany
and Abusaad
(2017)
Sudan
Awadkamil
(2012)
Kenya
James et
al 2015
Nigeria
Bankole et al
(2017)
Fever 832 866 764 692
Diarrhea 51 833 739 807
Boils 644
Weight loss 473
Cough 608
Vomiting 147
Conjunctivitis 201
Practices Teething Remedies Remedies Opeoduand Denloye2014
Kenya (James et al 2015
Bankole et al 2017)
Analgesics 634 677
Teething powder
syrup
435 655 420313
Antibiotic 142
Sedatives 46
Traditional
Concoction herbs
15 481
Teething soap etc 750
Other Folk RemediesSource httpswwwlifelovelizcom20150108traditional-
teething-remedies-around-world
Caribbean Hang raw egg over where baby sleeps
India Ayurvedic Remedy with cloves
Chinese Traditional Chinese Medicine (TCM) Acupuncture Acupressure
Japanese Wooden Teething Ring
France Sophie the giraffe - teething toy
Baltic Amber Teething Necklace Dangers strangulation aspiration beads
German Zwieback Toast
bull Acupressure
bull Massaging two important acupoints called the ldquotwo gatesrdquo or Large Intestine 4 (Li 4) and Liver 3 (Liv 3) can ease babyrsquos teething pain
bull It is simple effective and easy to do anywhere
bull Shonishin ndashJapanese needleless therapybull Source www bonnchirocomshonishin-needle-less-acupuncture-for-infants-and-
toddlers
Health education to the nurses and Community health officers at Ibadan Nigeria
Photoposter
Educational tool (In collaboration with WHO) In English and 3 major Nigerian languages
bull Effectiveness tested (Bankole et al 2005)
bull More effective as instructional tool in interactive atmosphere than just pasted on walls
TIMING OF ERUPTION Natalneonatal teeth
Associated with erroneous cultural beliefs among community nurses and
traditional birth attendants (TBA)
Britain ndashHeroes
China ndashBearers of misfortune
Natal tooth
Perceptions regarding natalneonatal teeth in infants
Traditional birth
attendaants
Bankole et al
(2013
Igbo Ora
Community
Unpublished
PERCEIVED CAUSES
Evil spirits evil child Abiku 319 487
Mothers contravened taboos 92 35
Prolonged maternal gestation 49
EFFECT ON THE FAMILY
Curse 74 106
Abomination 245 360
Embarrassment 11 360
Practices regarding natalneonatal teeth
Traditional birth
attendants
Bankole et al 2003)
Practices
Immediate extraction
Spiritual cleansing
356 Pain infection HIV
hepatitis B tetanus
Get rid of child 49 Infanticide
EFFECT ON CHILD
Strange odd behavior 313 Stigmatization
Evil spiritual powers 411 Stigmatization
Mental retardation
dull
31
With Traditional Birth Attendants at Ibadan South East Local government area
REVERSAL OF ERUPTION SEQUENCE
bull African ethnographies - infants whose upper teeth erupt before their lower teeth have been killed because of such ldquodevelopmental anomaliesrdquo
bull Considered a bad omen and sign of misfortune among Hamar Ethiopia Benin Rebublic
bull Reversal of eruption sequence of primary incisors in infants in Yoruba community has led to unpleasant circumstances
Reversal of eruption sequence
Reversal of eruption sequence
TraditionalBirth Attendants
Bankole and Lawal (2018)
PERCEIVED CAUSES
Evil spirits 218 476
Contravening taboos 80 26
EFFECT ON THE FAMILY
Curse 135 214Abomination 276 218
Embarrassment 233 114
Practices regarding reversal of eruption sequence of the anterior primary teeth
Practices Bankole and
Lawal(2018 )Effect
Immediate extraction 337 Pain infection HJV
hepatitis B infection
tetanus
HideGet rid of child 613 Infanticide
EFFECT ON CHILD
Strange behavior 227 Stigmatization
Evil powers 417 Stigmatization
Mental retardation 25
Dr Bankole and Dr Lawal with the Traditional Birth Attendants at the Ibadan South West LGA
DIETDental caries has escalated in developing countries
bull Misconception Food and drinks refined processed or modern is best and associated with affluence (Aderinokun et al 2011)
bull Parents donrsquot want their children to be deprived of what they lacked when young
bull This has led to a cultural shift in diet
bull Some African American believe motherrsquos diet during pregnancy cause dental caries in the child
bull Somali refugees Hutterites and Latino immigrant caregivers believed genetics plays a role in development early childhood caries (Prowse 2014)
Practices
bull YorubaHausa community common snacks have assumed local flavours several shapes coloursof sweets sold
bull Natural foods fruits are being sweetened Oke Bankole et al 2011 )
bull Nomadic Fulani sugary diet in between their meals sweetened drinks in bottles Sippy cups (827) and (716) give pacifiers dipped in sweet liquids Reduce temper tantrums with sweets Bankole et al 2015
Infant feeding practices
bull Babies with sweetened drinks in bottles pacifiers dipped in sweet liquidsputting infant to bed with a bottle of sweetened liquid Reported among Mexican Americans and Puerto Ricans Hong Kong Saudi mothers Al-Zahrani et al 2014
bull High risk factors contributing development of early childhood caries in infants
Diet
bull Perception
Animals such as pig are unclean
bull Practices
bull Hindus donrsquot eat beef Muslims donrsquot eat pork
bull Protective prevent taeniasis cystecercosis -edematous oral ulcers gingival bleeding lesions mimicking mucocles in children
(Alves et al 2011)
Dental Fluorosis bull In East and central African countries (tribal
areas of Tanzania Magadi a fluoride rich tronaused in cooking
bull Used as a tenderizer and preservative
bull High Fluoride Concentration 7900 ppm
bull Magadi use may suggest high prevalence of fluorosis in northern Tanzania (Kaseva 2006)
Oral Hygiene
Perceptions among mothers
bull Hausa Fulani- 142 - babyrsquos mouth should be cleaned before teeth erupt
bull Yoruba- Babyrsquos mouthtongue cleaned before teeth erupt to prevent thrush
bull Hausa Fulani- 635 - commencement tooth cleaning between 6 and 12 months of age (Bankole et al 2017)
bull Yoruba- chewing sticks should not be used at night Causes premature death of mother (Oke et al 2011)
Practices
Hausa Fulani- 594 cleaned infants teeth once daily
- 614 children start cleaning their teeth unsupervised before the age of six years
- 751 of supervision was carried out by the grandparents
- Sudan -343 mothers donrsquot clean childrenrsquos teeth below the age of 2 years (Abduljalil et al 2016)
-Hausa - mothers start cleaning childrenrsquos teeth when enough teeth to justify effort (Oke et al 2011)
Oral hygiene practices
Cleaning materials used in infancyearly childhood
CommunityTribe
GlycerinFresh tomato Hydrogen peroxideAluminum sulphateVerona Amygdalina (bitter leaf)Iyere (African black pepper)Alligator pepperCitrus lime Combinations
Yoruba - Nigeria (Aderinokun 2000)
Alum (Aluminum sulphate) Bitter leaf (Verona Amygdalina)
Iyere (African black pepper)
Citrus lime Alligator pepper
Oral hygiene practices
Tooth Cleaning materials
CommunityTribe Side effect
Salt and cotton wool
Hausa (Oke et al 2011)
Finger Nomadic Fulani
Wooden twigSalvadora persiccatwig (miswak) Neem tree Chewing stick
Nomadic Fulani ( Bankole et al 2017)
Somali
India (Kochar et al 2014)
Yoruba Senegal (Diouf 2013)
Improper use ndashgingival trauma
round ceramics omadic ulani
brasion sensiti it
and omadic ulani
shes ood charcoal
Somali (Beveridge
India Senegal
Tooth Cleaning materials
CommunityTribe Side effect
Ground ceramics Nomadic Fulani Tooth abrasion
Sand Nomadic Fulani
AshesWood
Charcoal
Somali India Senegal
Tooth abrasion
IMPORTANCE OF THE PRIMARY DENTITION IN CHILDREN
bull Primary teeth in children are sometimes not regarded as important
bull Mothers of preschool children in Mumbai -436 believed 192 were uncertain that there is no need to visit a dentist for treating milk teeth as they will soon fall off (Jain et al 2014)
COMMON DENTAL DISEASES
Dental Caries
bull Early childhood caries is a significant public health problem caries affecting children globally
bull In recent years in developing countries like Sub-Saharan Africa the prevalence is predicted to increase
bull Early childhood caries is largely untreated in a study in South Africa reported a caries prevalence of 716 and these 675 were untreated (Mohammed and Barnes 2018 )
Dental caries Perceived cause of dental
caries
Community tribe
Worms (resembling
maggots)
Borom bop (master of the
head)
Lagatas
Smaller version of pubu
Worms -removed from
ears
Yoruba Nomadic Fulani
Chinese (Dong et al 2007)
Senegalese ( Diouf et al 2003)
Brazil
Papua New Guinea
Indian (Nagaraj et al2014)
Dental caries -Care remedies Dental care remedies Community tribe Effect
Hydrochloric acid (Wet cell
battery liquid)
Aluminum Phosphate
(Alum)
Tobacco snuff
Charcoal and salt
Gentian violet
Atare (Alligator Pepper)
Yoruba Brazil
Kenya (Mulu Maryanne)
Yoruba (Oke et al 2011)
Chemical burns
mucosal ulceration
Erosion
Tetracycline capsule (topical)
Paracetamol (topical)
Hausa Nomadic Fulani
Hausa
Greyish brown tooth
discolouration
Mucosal ulceration
Traditional concoction
Dental are remedies Dental care remedies Community
tribe
Effect
White wineVinegar Powdered alum musk and frankincense
Chinese (Dong et al 2007)
Herbs traditional medicine
Aborigines (Wong 2005)
Nettles
Hot sweet potato
Wads hot leaves ginger
Residue smoking pipe
White sap of shrub used
to kill maggots
Insecticide ointment
Papua New
Guinea
Predisposition to
oral cancer
Toxic
Dental care remedies Dental care remedies Community Effect
Cooked meat
salt alcohol grease
deodorant
Iran
fingernail polish remover
black tar
Garlic Warm coconut milk
Brazil Toxic
Kawakawa Māori(Pepper Tree
Leaves) chewed
Harakeke -Korari Flax
the gum used for toothache
Maori
GingivitisPeriodontal disease
Perceptions
bull Bleeding gums caused by
bull Child stores food in pouch of mouth and does not clean teeth
Remedies for gingival periodontal disease
Remedies Community tribe
Effect
Aluminium phosphate (Alum ) + Lapalapa sap (Jatropha curcas)Warm water and salt Tomato and alum+polystrene foam or cotton woolHydrogen peroxide
Yoruba
Antibiotics NomadiFulani
Resistant strains Hyper sensitivityreactions
Herbs
ORAL HABITS Kola nut chewing
Common West Central Africa Symbol of hospitality Contains caffeine tannin
bull Helps students keep awakewithstand fatigue
Practices
bull One-year prevalence student use was 291 Erinfolami et al (2011)
bull Majority started at age 14 years or below
bull Dangers -insomnia nausea tooth discolourationcarcinogenic potential for development of oral cancer
Areca Nut Chewing Habitbull Areca nut is the seed of areca palm
bull Widely grown- Asia India Bangladesh Japan
bull Believed to help fatigue
bull Highest period of risk for first use is between 5 and 12 Farrand et al 2001
74 4-16 age group in Karachi indulged in the habit (Shah et al 2002)
Dangers Oral sub mucous fibrosis
bull Risk of oral cancer 99 times( Wollina et al 2004 ) Foreign body aspiration Severe tooth wear -- sensitivity root fractures
Mandibular arch with generalized staining in the deciduous dentition
Prajapati D Nayak R Nayak UA Shah PJ Areca nut chewing habit in preschoolers Two rare case reports and literature review Int J Dent Health Concern 201511-5 (Permission given)
Mandibular arch with generalized staining in the deciduous dentition
Prajapati D Nayak R Nayak UA Shah PJ Areca nut chewing habit in preschoolers Two rare case reports and literature review Int J Dent Health Concern 201511-5 (Permission given)
Oral tobacco use and cigar smoking
bull High prevalence tobacco use in any form is reported among school going adolescents aged 13ndash15 years in India (Arora and Reddy 2005) Smoking Chutta is relatively popular may begin in childhood in India
bull Acts as a stimulant euphoric
bull May sleep with tobacco mixture in mouth
Harmful effects halitosis brown black staining gingival recession if wad is held against gingivaleucoplakia oral squamous cell carcinoma
Tobacco use in children
PRACTICES RELATED TO PUBERTY AND GROOMING
Tooth filing tooth sharpening
Practiced -Nigeria Niger-Delta area (Ukeghesonand Akadiri ) Democratic Republic of Congo Thailand Indonesia
bull Perception Historically -spiritual reasons Contemporary times - aesthetic reasons
bull In Nigeria maxillary midline diastema is regarded as a symbol of beauty (Arigbede and Adesuwa 2012
bull Teeth filed- because represent negative emotions eg anger jealousy (Balinese Indonesia)
30 respondents would not mind having artificially created diastema (Omotosho and Kadri (2010)
Practices
bull Done in adolescence - fashionable
bull Manually done Usually incisors
Harmful effects
bull pain during process
bull Tooth discolouration (teeth -non vital)
bull Infection -pus discharge lip swelling
Tooth filing
Peri-apical x-ray of lower central incisor
Lacquering and staining of teethPerformed in Vietnam Laos Thailand Indonesia and Philippines
Perception For cosmetic reasons
bull Main ingredient dye dark-brown solution of ferric acetate called kanemizu (iron filings in vinegar)
bull Coating the teeth with this liquid helped to prevent tooth decay and enamel decay
bull Practice has slowly declined
Traditional gingival tattooinglips bull Practiced in Africarsquos Sahel region Woddebe
Fulani tribe Senegal Ethiopia middle eastern countries
Perception Reason aesthetic appeal superstition
bull Practices Done when females reach puberty
bull Kanuri females Borno State Nigeria tattooing lip gingiva usually performed thorns of Balanites aegyptiaca (Bukar et al 2004 )
bull Pigments -Mixture charcoal and seeds of Acacia nilotica vartomentosa
Lip plug lip plate
bull The lip plate (lip plug or lip disc) form of body modification
bull Amazonian tribes young males traditionally -rite of passage indicate status and prestige
bull Mursi of Ethiopia girls age 13 to 18
bull At puberty mother cuts her lower lip
bull Held open by a wooden plug - inserted into thereby stretching the lip
bull At times -combined with removal of two or four lower anterior incisal teeth
Lip plug lip plate
TRADITIONAL DENTAL SERVICES
bull Perceptions
Cause of illness determines treatment taken Practices
bull Yoruba community patronize traditional dentists (Oke Bankole et al 2011) Edo state
bull Services rendered include worm extraction tooth extraction drug prescription and offering sacrifices to deities
bull Charges based on the worm count
Northern Nigeria called Serdia Toothache associated with dandruff
Cameroon traditional healers perform atraumatic tooth extraction Agbor et al (2011)
bull Leaves stems of Dichrocephala integrifolia
bull Tooth pulled out fingerssharp instrument
bull No pain Plant has anaesthetic properties
bull Dangers infection sepsis infection with hepatitis B Human Immunodeficiency Virus
bull Jewish Unlikely keep Friday appointment with the dentist for their children
bull Routine appointments on Fridays avoided (Scambler et al )
The traditional healer harvesting the medicinal plant in Cameroon
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J Ethnobiol Ethnomed 2011 715
Tooth extraction by a traditional dentist
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J EthnobiolEthnomed 2011 715
bull Health is a consequence of an individualrsquos lifestyle
bull Essential to Identify cultural factors that are harmful and those that are beneficial
bull As paediatric dentists we should discourage the unhealthy practices through rigorous health education and promote the adoption of healthy practices
bull Need for multicentric research on the cultural influence of the family and peers regarding oral health of children
bull Bankole OO Lawal FB Ibiyemi O (2017) Dispelling myths associated with natalneonatal teeth ldquoAdunnirdquo a health education video in a native Nigerian language Annals of Ibadan Postgraduate Medicine15(2)137-141
Thank you for listening
In Africa Perception Effect
Worms in a pregnant woman lsquos stomach if
starved of food
Consuming poisoned rabbit meat
Fate Will of God (Olasoji et al 2007) Nodelayed
treatment
Reincarnation of ldquoAbikurdquo (Unpublished data)
Transference of spirits of unborn babies
Family stigma
Work of evil spirits result of being cursed Consult traditional
healers
Penalty for previous sins
wrongdoing contravening taboos
Practices bull Use of animals hoofs as dummy for child to suck -
improve shape musculature and speech ndash Similar naso alveolar moulding
bull Blood letting to lsquorestore balance Hazardous Risk of excessive blood loss infection
bull Give to charity as atonement repentance for past sins and wrongdoings
bull Fast praypilgrimage bathing in consecrated river to cleanse away sins
bull Psychological support
Loh J and Ascoli M Cross-cultural attitudes and perceptions towards cleft lip and
palate deformities World cultural research review 127-134 ( 2011)
MALOCCLUSION bull Proclined teeth (ldquoEyin Shamgarrdquo) in South
Western Nigeria
bull Perceived causes Carelessness of mother in application of teething concoctions to bath baby
bull Child opening mouth when sleeping (Unpublished work)
bull Jewish community study poor teeth in parents grandparents seen their children (Scambler et al 2010)
Practices Childrsquos lips continually pulled together by parents
TONGUE TIE (ANKYLOGLOSSIA)Perception
Among some tribes in Port Harcourt it is believed that most babies are born with tongue tie (Opara and Eke 2013)
Also among Ishan in Edo State
bull Perceived effects speech difficulties (stammering) inability to cry well difficulty breast feeding poor hearing
Tongue tie Practices
bull Culture in south south Nigeria supports routine clipping of frenulum in all newborns (Opara and Eke 2013)
bull Done between ages 0-1 month
bull Carried out by nurses traditional birth assistants using scissors or finger nails
bull (368) mothers in Port Harcourt had babies treated for tongue tie (Opara and Eke 2013)
bull Complications bleeding infection and soft tissue injuries
TEETHINGbull Eruption of teeth -important milestone
bull Myriads of symptoms are erroneously linked to the teething process ( Adam and Abhulimhen-Iyoha (2015)
bull Passive immunity decreases
bull Children exposed to a wide variety of illnesses
bull Danger is that mothers may not seek medical consultation for some childhood illnesses (Igeand Olubukola 2013 )
bull May lead to increased child mortality
Perceived Teething SymptomsSymptoms Egypt
El-gilany
and Abusaad
(2017)
Sudan
Awadkamil
(2012)
Kenya
James et
al 2015
Nigeria
Bankole et al
(2017)
Fever 832 866 764 692
Diarrhea 51 833 739 807
Boils 644
Weight loss 473
Cough 608
Vomiting 147
Conjunctivitis 201
Practices Teething Remedies Remedies Opeoduand Denloye2014
Kenya (James et al 2015
Bankole et al 2017)
Analgesics 634 677
Teething powder
syrup
435 655 420313
Antibiotic 142
Sedatives 46
Traditional
Concoction herbs
15 481
Teething soap etc 750
Other Folk RemediesSource httpswwwlifelovelizcom20150108traditional-
teething-remedies-around-world
Caribbean Hang raw egg over where baby sleeps
India Ayurvedic Remedy with cloves
Chinese Traditional Chinese Medicine (TCM) Acupuncture Acupressure
Japanese Wooden Teething Ring
France Sophie the giraffe - teething toy
Baltic Amber Teething Necklace Dangers strangulation aspiration beads
German Zwieback Toast
bull Acupressure
bull Massaging two important acupoints called the ldquotwo gatesrdquo or Large Intestine 4 (Li 4) and Liver 3 (Liv 3) can ease babyrsquos teething pain
bull It is simple effective and easy to do anywhere
bull Shonishin ndashJapanese needleless therapybull Source www bonnchirocomshonishin-needle-less-acupuncture-for-infants-and-
toddlers
Health education to the nurses and Community health officers at Ibadan Nigeria
Photoposter
Educational tool (In collaboration with WHO) In English and 3 major Nigerian languages
bull Effectiveness tested (Bankole et al 2005)
bull More effective as instructional tool in interactive atmosphere than just pasted on walls
TIMING OF ERUPTION Natalneonatal teeth
Associated with erroneous cultural beliefs among community nurses and
traditional birth attendants (TBA)
Britain ndashHeroes
China ndashBearers of misfortune
Natal tooth
Perceptions regarding natalneonatal teeth in infants
Traditional birth
attendaants
Bankole et al
(2013
Igbo Ora
Community
Unpublished
PERCEIVED CAUSES
Evil spirits evil child Abiku 319 487
Mothers contravened taboos 92 35
Prolonged maternal gestation 49
EFFECT ON THE FAMILY
Curse 74 106
Abomination 245 360
Embarrassment 11 360
Practices regarding natalneonatal teeth
Traditional birth
attendants
Bankole et al 2003)
Practices
Immediate extraction
Spiritual cleansing
356 Pain infection HIV
hepatitis B tetanus
Get rid of child 49 Infanticide
EFFECT ON CHILD
Strange odd behavior 313 Stigmatization
Evil spiritual powers 411 Stigmatization
Mental retardation
dull
31
With Traditional Birth Attendants at Ibadan South East Local government area
REVERSAL OF ERUPTION SEQUENCE
bull African ethnographies - infants whose upper teeth erupt before their lower teeth have been killed because of such ldquodevelopmental anomaliesrdquo
bull Considered a bad omen and sign of misfortune among Hamar Ethiopia Benin Rebublic
bull Reversal of eruption sequence of primary incisors in infants in Yoruba community has led to unpleasant circumstances
Reversal of eruption sequence
Reversal of eruption sequence
TraditionalBirth Attendants
Bankole and Lawal (2018)
PERCEIVED CAUSES
Evil spirits 218 476
Contravening taboos 80 26
EFFECT ON THE FAMILY
Curse 135 214Abomination 276 218
Embarrassment 233 114
Practices regarding reversal of eruption sequence of the anterior primary teeth
Practices Bankole and
Lawal(2018 )Effect
Immediate extraction 337 Pain infection HJV
hepatitis B infection
tetanus
HideGet rid of child 613 Infanticide
EFFECT ON CHILD
Strange behavior 227 Stigmatization
Evil powers 417 Stigmatization
Mental retardation 25
Dr Bankole and Dr Lawal with the Traditional Birth Attendants at the Ibadan South West LGA
DIETDental caries has escalated in developing countries
bull Misconception Food and drinks refined processed or modern is best and associated with affluence (Aderinokun et al 2011)
bull Parents donrsquot want their children to be deprived of what they lacked when young
bull This has led to a cultural shift in diet
bull Some African American believe motherrsquos diet during pregnancy cause dental caries in the child
bull Somali refugees Hutterites and Latino immigrant caregivers believed genetics plays a role in development early childhood caries (Prowse 2014)
Practices
bull YorubaHausa community common snacks have assumed local flavours several shapes coloursof sweets sold
bull Natural foods fruits are being sweetened Oke Bankole et al 2011 )
bull Nomadic Fulani sugary diet in between their meals sweetened drinks in bottles Sippy cups (827) and (716) give pacifiers dipped in sweet liquids Reduce temper tantrums with sweets Bankole et al 2015
Infant feeding practices
bull Babies with sweetened drinks in bottles pacifiers dipped in sweet liquidsputting infant to bed with a bottle of sweetened liquid Reported among Mexican Americans and Puerto Ricans Hong Kong Saudi mothers Al-Zahrani et al 2014
bull High risk factors contributing development of early childhood caries in infants
Diet
bull Perception
Animals such as pig are unclean
bull Practices
bull Hindus donrsquot eat beef Muslims donrsquot eat pork
bull Protective prevent taeniasis cystecercosis -edematous oral ulcers gingival bleeding lesions mimicking mucocles in children
(Alves et al 2011)
Dental Fluorosis bull In East and central African countries (tribal
areas of Tanzania Magadi a fluoride rich tronaused in cooking
bull Used as a tenderizer and preservative
bull High Fluoride Concentration 7900 ppm
bull Magadi use may suggest high prevalence of fluorosis in northern Tanzania (Kaseva 2006)
Oral Hygiene
Perceptions among mothers
bull Hausa Fulani- 142 - babyrsquos mouth should be cleaned before teeth erupt
bull Yoruba- Babyrsquos mouthtongue cleaned before teeth erupt to prevent thrush
bull Hausa Fulani- 635 - commencement tooth cleaning between 6 and 12 months of age (Bankole et al 2017)
bull Yoruba- chewing sticks should not be used at night Causes premature death of mother (Oke et al 2011)
Practices
Hausa Fulani- 594 cleaned infants teeth once daily
- 614 children start cleaning their teeth unsupervised before the age of six years
- 751 of supervision was carried out by the grandparents
- Sudan -343 mothers donrsquot clean childrenrsquos teeth below the age of 2 years (Abduljalil et al 2016)
-Hausa - mothers start cleaning childrenrsquos teeth when enough teeth to justify effort (Oke et al 2011)
Oral hygiene practices
Cleaning materials used in infancyearly childhood
CommunityTribe
GlycerinFresh tomato Hydrogen peroxideAluminum sulphateVerona Amygdalina (bitter leaf)Iyere (African black pepper)Alligator pepperCitrus lime Combinations
Yoruba - Nigeria (Aderinokun 2000)
Alum (Aluminum sulphate) Bitter leaf (Verona Amygdalina)
Iyere (African black pepper)
Citrus lime Alligator pepper
Oral hygiene practices
Tooth Cleaning materials
CommunityTribe Side effect
Salt and cotton wool
Hausa (Oke et al 2011)
Finger Nomadic Fulani
Wooden twigSalvadora persiccatwig (miswak) Neem tree Chewing stick
Nomadic Fulani ( Bankole et al 2017)
Somali
India (Kochar et al 2014)
Yoruba Senegal (Diouf 2013)
Improper use ndashgingival trauma
round ceramics omadic ulani
brasion sensiti it
and omadic ulani
shes ood charcoal
Somali (Beveridge
India Senegal
Tooth Cleaning materials
CommunityTribe Side effect
Ground ceramics Nomadic Fulani Tooth abrasion
Sand Nomadic Fulani
AshesWood
Charcoal
Somali India Senegal
Tooth abrasion
IMPORTANCE OF THE PRIMARY DENTITION IN CHILDREN
bull Primary teeth in children are sometimes not regarded as important
bull Mothers of preschool children in Mumbai -436 believed 192 were uncertain that there is no need to visit a dentist for treating milk teeth as they will soon fall off (Jain et al 2014)
COMMON DENTAL DISEASES
Dental Caries
bull Early childhood caries is a significant public health problem caries affecting children globally
bull In recent years in developing countries like Sub-Saharan Africa the prevalence is predicted to increase
bull Early childhood caries is largely untreated in a study in South Africa reported a caries prevalence of 716 and these 675 were untreated (Mohammed and Barnes 2018 )
Dental caries Perceived cause of dental
caries
Community tribe
Worms (resembling
maggots)
Borom bop (master of the
head)
Lagatas
Smaller version of pubu
Worms -removed from
ears
Yoruba Nomadic Fulani
Chinese (Dong et al 2007)
Senegalese ( Diouf et al 2003)
Brazil
Papua New Guinea
Indian (Nagaraj et al2014)
Dental caries -Care remedies Dental care remedies Community tribe Effect
Hydrochloric acid (Wet cell
battery liquid)
Aluminum Phosphate
(Alum)
Tobacco snuff
Charcoal and salt
Gentian violet
Atare (Alligator Pepper)
Yoruba Brazil
Kenya (Mulu Maryanne)
Yoruba (Oke et al 2011)
Chemical burns
mucosal ulceration
Erosion
Tetracycline capsule (topical)
Paracetamol (topical)
Hausa Nomadic Fulani
Hausa
Greyish brown tooth
discolouration
Mucosal ulceration
Traditional concoction
Dental are remedies Dental care remedies Community
tribe
Effect
White wineVinegar Powdered alum musk and frankincense
Chinese (Dong et al 2007)
Herbs traditional medicine
Aborigines (Wong 2005)
Nettles
Hot sweet potato
Wads hot leaves ginger
Residue smoking pipe
White sap of shrub used
to kill maggots
Insecticide ointment
Papua New
Guinea
Predisposition to
oral cancer
Toxic
Dental care remedies Dental care remedies Community Effect
Cooked meat
salt alcohol grease
deodorant
Iran
fingernail polish remover
black tar
Garlic Warm coconut milk
Brazil Toxic
Kawakawa Māori(Pepper Tree
Leaves) chewed
Harakeke -Korari Flax
the gum used for toothache
Maori
GingivitisPeriodontal disease
Perceptions
bull Bleeding gums caused by
bull Child stores food in pouch of mouth and does not clean teeth
Remedies for gingival periodontal disease
Remedies Community tribe
Effect
Aluminium phosphate (Alum ) + Lapalapa sap (Jatropha curcas)Warm water and salt Tomato and alum+polystrene foam or cotton woolHydrogen peroxide
Yoruba
Antibiotics NomadiFulani
Resistant strains Hyper sensitivityreactions
Herbs
ORAL HABITS Kola nut chewing
Common West Central Africa Symbol of hospitality Contains caffeine tannin
bull Helps students keep awakewithstand fatigue
Practices
bull One-year prevalence student use was 291 Erinfolami et al (2011)
bull Majority started at age 14 years or below
bull Dangers -insomnia nausea tooth discolourationcarcinogenic potential for development of oral cancer
Areca Nut Chewing Habitbull Areca nut is the seed of areca palm
bull Widely grown- Asia India Bangladesh Japan
bull Believed to help fatigue
bull Highest period of risk for first use is between 5 and 12 Farrand et al 2001
74 4-16 age group in Karachi indulged in the habit (Shah et al 2002)
Dangers Oral sub mucous fibrosis
bull Risk of oral cancer 99 times( Wollina et al 2004 ) Foreign body aspiration Severe tooth wear -- sensitivity root fractures
Mandibular arch with generalized staining in the deciduous dentition
Prajapati D Nayak R Nayak UA Shah PJ Areca nut chewing habit in preschoolers Two rare case reports and literature review Int J Dent Health Concern 201511-5 (Permission given)
Mandibular arch with generalized staining in the deciduous dentition
Prajapati D Nayak R Nayak UA Shah PJ Areca nut chewing habit in preschoolers Two rare case reports and literature review Int J Dent Health Concern 201511-5 (Permission given)
Oral tobacco use and cigar smoking
bull High prevalence tobacco use in any form is reported among school going adolescents aged 13ndash15 years in India (Arora and Reddy 2005) Smoking Chutta is relatively popular may begin in childhood in India
bull Acts as a stimulant euphoric
bull May sleep with tobacco mixture in mouth
Harmful effects halitosis brown black staining gingival recession if wad is held against gingivaleucoplakia oral squamous cell carcinoma
Tobacco use in children
PRACTICES RELATED TO PUBERTY AND GROOMING
Tooth filing tooth sharpening
Practiced -Nigeria Niger-Delta area (Ukeghesonand Akadiri ) Democratic Republic of Congo Thailand Indonesia
bull Perception Historically -spiritual reasons Contemporary times - aesthetic reasons
bull In Nigeria maxillary midline diastema is regarded as a symbol of beauty (Arigbede and Adesuwa 2012
bull Teeth filed- because represent negative emotions eg anger jealousy (Balinese Indonesia)
30 respondents would not mind having artificially created diastema (Omotosho and Kadri (2010)
Practices
bull Done in adolescence - fashionable
bull Manually done Usually incisors
Harmful effects
bull pain during process
bull Tooth discolouration (teeth -non vital)
bull Infection -pus discharge lip swelling
Tooth filing
Peri-apical x-ray of lower central incisor
Lacquering and staining of teethPerformed in Vietnam Laos Thailand Indonesia and Philippines
Perception For cosmetic reasons
bull Main ingredient dye dark-brown solution of ferric acetate called kanemizu (iron filings in vinegar)
bull Coating the teeth with this liquid helped to prevent tooth decay and enamel decay
bull Practice has slowly declined
Traditional gingival tattooinglips bull Practiced in Africarsquos Sahel region Woddebe
Fulani tribe Senegal Ethiopia middle eastern countries
Perception Reason aesthetic appeal superstition
bull Practices Done when females reach puberty
bull Kanuri females Borno State Nigeria tattooing lip gingiva usually performed thorns of Balanites aegyptiaca (Bukar et al 2004 )
bull Pigments -Mixture charcoal and seeds of Acacia nilotica vartomentosa
Lip plug lip plate
bull The lip plate (lip plug or lip disc) form of body modification
bull Amazonian tribes young males traditionally -rite of passage indicate status and prestige
bull Mursi of Ethiopia girls age 13 to 18
bull At puberty mother cuts her lower lip
bull Held open by a wooden plug - inserted into thereby stretching the lip
bull At times -combined with removal of two or four lower anterior incisal teeth
Lip plug lip plate
TRADITIONAL DENTAL SERVICES
bull Perceptions
Cause of illness determines treatment taken Practices
bull Yoruba community patronize traditional dentists (Oke Bankole et al 2011) Edo state
bull Services rendered include worm extraction tooth extraction drug prescription and offering sacrifices to deities
bull Charges based on the worm count
Northern Nigeria called Serdia Toothache associated with dandruff
Cameroon traditional healers perform atraumatic tooth extraction Agbor et al (2011)
bull Leaves stems of Dichrocephala integrifolia
bull Tooth pulled out fingerssharp instrument
bull No pain Plant has anaesthetic properties
bull Dangers infection sepsis infection with hepatitis B Human Immunodeficiency Virus
bull Jewish Unlikely keep Friday appointment with the dentist for their children
bull Routine appointments on Fridays avoided (Scambler et al )
The traditional healer harvesting the medicinal plant in Cameroon
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J Ethnobiol Ethnomed 2011 715
Tooth extraction by a traditional dentist
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J EthnobiolEthnomed 2011 715
bull Health is a consequence of an individualrsquos lifestyle
bull Essential to Identify cultural factors that are harmful and those that are beneficial
bull As paediatric dentists we should discourage the unhealthy practices through rigorous health education and promote the adoption of healthy practices
bull Need for multicentric research on the cultural influence of the family and peers regarding oral health of children
bull Bankole OO Lawal FB Ibiyemi O (2017) Dispelling myths associated with natalneonatal teeth ldquoAdunnirdquo a health education video in a native Nigerian language Annals of Ibadan Postgraduate Medicine15(2)137-141
Thank you for listening
Practices bull Use of animals hoofs as dummy for child to suck -
improve shape musculature and speech ndash Similar naso alveolar moulding
bull Blood letting to lsquorestore balance Hazardous Risk of excessive blood loss infection
bull Give to charity as atonement repentance for past sins and wrongdoings
bull Fast praypilgrimage bathing in consecrated river to cleanse away sins
bull Psychological support
Loh J and Ascoli M Cross-cultural attitudes and perceptions towards cleft lip and
palate deformities World cultural research review 127-134 ( 2011)
MALOCCLUSION bull Proclined teeth (ldquoEyin Shamgarrdquo) in South
Western Nigeria
bull Perceived causes Carelessness of mother in application of teething concoctions to bath baby
bull Child opening mouth when sleeping (Unpublished work)
bull Jewish community study poor teeth in parents grandparents seen their children (Scambler et al 2010)
Practices Childrsquos lips continually pulled together by parents
TONGUE TIE (ANKYLOGLOSSIA)Perception
Among some tribes in Port Harcourt it is believed that most babies are born with tongue tie (Opara and Eke 2013)
Also among Ishan in Edo State
bull Perceived effects speech difficulties (stammering) inability to cry well difficulty breast feeding poor hearing
Tongue tie Practices
bull Culture in south south Nigeria supports routine clipping of frenulum in all newborns (Opara and Eke 2013)
bull Done between ages 0-1 month
bull Carried out by nurses traditional birth assistants using scissors or finger nails
bull (368) mothers in Port Harcourt had babies treated for tongue tie (Opara and Eke 2013)
bull Complications bleeding infection and soft tissue injuries
TEETHINGbull Eruption of teeth -important milestone
bull Myriads of symptoms are erroneously linked to the teething process ( Adam and Abhulimhen-Iyoha (2015)
bull Passive immunity decreases
bull Children exposed to a wide variety of illnesses
bull Danger is that mothers may not seek medical consultation for some childhood illnesses (Igeand Olubukola 2013 )
bull May lead to increased child mortality
Perceived Teething SymptomsSymptoms Egypt
El-gilany
and Abusaad
(2017)
Sudan
Awadkamil
(2012)
Kenya
James et
al 2015
Nigeria
Bankole et al
(2017)
Fever 832 866 764 692
Diarrhea 51 833 739 807
Boils 644
Weight loss 473
Cough 608
Vomiting 147
Conjunctivitis 201
Practices Teething Remedies Remedies Opeoduand Denloye2014
Kenya (James et al 2015
Bankole et al 2017)
Analgesics 634 677
Teething powder
syrup
435 655 420313
Antibiotic 142
Sedatives 46
Traditional
Concoction herbs
15 481
Teething soap etc 750
Other Folk RemediesSource httpswwwlifelovelizcom20150108traditional-
teething-remedies-around-world
Caribbean Hang raw egg over where baby sleeps
India Ayurvedic Remedy with cloves
Chinese Traditional Chinese Medicine (TCM) Acupuncture Acupressure
Japanese Wooden Teething Ring
France Sophie the giraffe - teething toy
Baltic Amber Teething Necklace Dangers strangulation aspiration beads
German Zwieback Toast
bull Acupressure
bull Massaging two important acupoints called the ldquotwo gatesrdquo or Large Intestine 4 (Li 4) and Liver 3 (Liv 3) can ease babyrsquos teething pain
bull It is simple effective and easy to do anywhere
bull Shonishin ndashJapanese needleless therapybull Source www bonnchirocomshonishin-needle-less-acupuncture-for-infants-and-
toddlers
Health education to the nurses and Community health officers at Ibadan Nigeria
Photoposter
Educational tool (In collaboration with WHO) In English and 3 major Nigerian languages
bull Effectiveness tested (Bankole et al 2005)
bull More effective as instructional tool in interactive atmosphere than just pasted on walls
TIMING OF ERUPTION Natalneonatal teeth
Associated with erroneous cultural beliefs among community nurses and
traditional birth attendants (TBA)
Britain ndashHeroes
China ndashBearers of misfortune
Natal tooth
Perceptions regarding natalneonatal teeth in infants
Traditional birth
attendaants
Bankole et al
(2013
Igbo Ora
Community
Unpublished
PERCEIVED CAUSES
Evil spirits evil child Abiku 319 487
Mothers contravened taboos 92 35
Prolonged maternal gestation 49
EFFECT ON THE FAMILY
Curse 74 106
Abomination 245 360
Embarrassment 11 360
Practices regarding natalneonatal teeth
Traditional birth
attendants
Bankole et al 2003)
Practices
Immediate extraction
Spiritual cleansing
356 Pain infection HIV
hepatitis B tetanus
Get rid of child 49 Infanticide
EFFECT ON CHILD
Strange odd behavior 313 Stigmatization
Evil spiritual powers 411 Stigmatization
Mental retardation
dull
31
With Traditional Birth Attendants at Ibadan South East Local government area
REVERSAL OF ERUPTION SEQUENCE
bull African ethnographies - infants whose upper teeth erupt before their lower teeth have been killed because of such ldquodevelopmental anomaliesrdquo
bull Considered a bad omen and sign of misfortune among Hamar Ethiopia Benin Rebublic
bull Reversal of eruption sequence of primary incisors in infants in Yoruba community has led to unpleasant circumstances
Reversal of eruption sequence
Reversal of eruption sequence
TraditionalBirth Attendants
Bankole and Lawal (2018)
PERCEIVED CAUSES
Evil spirits 218 476
Contravening taboos 80 26
EFFECT ON THE FAMILY
Curse 135 214Abomination 276 218
Embarrassment 233 114
Practices regarding reversal of eruption sequence of the anterior primary teeth
Practices Bankole and
Lawal(2018 )Effect
Immediate extraction 337 Pain infection HJV
hepatitis B infection
tetanus
HideGet rid of child 613 Infanticide
EFFECT ON CHILD
Strange behavior 227 Stigmatization
Evil powers 417 Stigmatization
Mental retardation 25
Dr Bankole and Dr Lawal with the Traditional Birth Attendants at the Ibadan South West LGA
DIETDental caries has escalated in developing countries
bull Misconception Food and drinks refined processed or modern is best and associated with affluence (Aderinokun et al 2011)
bull Parents donrsquot want their children to be deprived of what they lacked when young
bull This has led to a cultural shift in diet
bull Some African American believe motherrsquos diet during pregnancy cause dental caries in the child
bull Somali refugees Hutterites and Latino immigrant caregivers believed genetics plays a role in development early childhood caries (Prowse 2014)
Practices
bull YorubaHausa community common snacks have assumed local flavours several shapes coloursof sweets sold
bull Natural foods fruits are being sweetened Oke Bankole et al 2011 )
bull Nomadic Fulani sugary diet in between their meals sweetened drinks in bottles Sippy cups (827) and (716) give pacifiers dipped in sweet liquids Reduce temper tantrums with sweets Bankole et al 2015
Infant feeding practices
bull Babies with sweetened drinks in bottles pacifiers dipped in sweet liquidsputting infant to bed with a bottle of sweetened liquid Reported among Mexican Americans and Puerto Ricans Hong Kong Saudi mothers Al-Zahrani et al 2014
bull High risk factors contributing development of early childhood caries in infants
Diet
bull Perception
Animals such as pig are unclean
bull Practices
bull Hindus donrsquot eat beef Muslims donrsquot eat pork
bull Protective prevent taeniasis cystecercosis -edematous oral ulcers gingival bleeding lesions mimicking mucocles in children
(Alves et al 2011)
Dental Fluorosis bull In East and central African countries (tribal
areas of Tanzania Magadi a fluoride rich tronaused in cooking
bull Used as a tenderizer and preservative
bull High Fluoride Concentration 7900 ppm
bull Magadi use may suggest high prevalence of fluorosis in northern Tanzania (Kaseva 2006)
Oral Hygiene
Perceptions among mothers
bull Hausa Fulani- 142 - babyrsquos mouth should be cleaned before teeth erupt
bull Yoruba- Babyrsquos mouthtongue cleaned before teeth erupt to prevent thrush
bull Hausa Fulani- 635 - commencement tooth cleaning between 6 and 12 months of age (Bankole et al 2017)
bull Yoruba- chewing sticks should not be used at night Causes premature death of mother (Oke et al 2011)
Practices
Hausa Fulani- 594 cleaned infants teeth once daily
- 614 children start cleaning their teeth unsupervised before the age of six years
- 751 of supervision was carried out by the grandparents
- Sudan -343 mothers donrsquot clean childrenrsquos teeth below the age of 2 years (Abduljalil et al 2016)
-Hausa - mothers start cleaning childrenrsquos teeth when enough teeth to justify effort (Oke et al 2011)
Oral hygiene practices
Cleaning materials used in infancyearly childhood
CommunityTribe
GlycerinFresh tomato Hydrogen peroxideAluminum sulphateVerona Amygdalina (bitter leaf)Iyere (African black pepper)Alligator pepperCitrus lime Combinations
Yoruba - Nigeria (Aderinokun 2000)
Alum (Aluminum sulphate) Bitter leaf (Verona Amygdalina)
Iyere (African black pepper)
Citrus lime Alligator pepper
Oral hygiene practices
Tooth Cleaning materials
CommunityTribe Side effect
Salt and cotton wool
Hausa (Oke et al 2011)
Finger Nomadic Fulani
Wooden twigSalvadora persiccatwig (miswak) Neem tree Chewing stick
Nomadic Fulani ( Bankole et al 2017)
Somali
India (Kochar et al 2014)
Yoruba Senegal (Diouf 2013)
Improper use ndashgingival trauma
round ceramics omadic ulani
brasion sensiti it
and omadic ulani
shes ood charcoal
Somali (Beveridge
India Senegal
Tooth Cleaning materials
CommunityTribe Side effect
Ground ceramics Nomadic Fulani Tooth abrasion
Sand Nomadic Fulani
AshesWood
Charcoal
Somali India Senegal
Tooth abrasion
IMPORTANCE OF THE PRIMARY DENTITION IN CHILDREN
bull Primary teeth in children are sometimes not regarded as important
bull Mothers of preschool children in Mumbai -436 believed 192 were uncertain that there is no need to visit a dentist for treating milk teeth as they will soon fall off (Jain et al 2014)
COMMON DENTAL DISEASES
Dental Caries
bull Early childhood caries is a significant public health problem caries affecting children globally
bull In recent years in developing countries like Sub-Saharan Africa the prevalence is predicted to increase
bull Early childhood caries is largely untreated in a study in South Africa reported a caries prevalence of 716 and these 675 were untreated (Mohammed and Barnes 2018 )
Dental caries Perceived cause of dental
caries
Community tribe
Worms (resembling
maggots)
Borom bop (master of the
head)
Lagatas
Smaller version of pubu
Worms -removed from
ears
Yoruba Nomadic Fulani
Chinese (Dong et al 2007)
Senegalese ( Diouf et al 2003)
Brazil
Papua New Guinea
Indian (Nagaraj et al2014)
Dental caries -Care remedies Dental care remedies Community tribe Effect
Hydrochloric acid (Wet cell
battery liquid)
Aluminum Phosphate
(Alum)
Tobacco snuff
Charcoal and salt
Gentian violet
Atare (Alligator Pepper)
Yoruba Brazil
Kenya (Mulu Maryanne)
Yoruba (Oke et al 2011)
Chemical burns
mucosal ulceration
Erosion
Tetracycline capsule (topical)
Paracetamol (topical)
Hausa Nomadic Fulani
Hausa
Greyish brown tooth
discolouration
Mucosal ulceration
Traditional concoction
Dental are remedies Dental care remedies Community
tribe
Effect
White wineVinegar Powdered alum musk and frankincense
Chinese (Dong et al 2007)
Herbs traditional medicine
Aborigines (Wong 2005)
Nettles
Hot sweet potato
Wads hot leaves ginger
Residue smoking pipe
White sap of shrub used
to kill maggots
Insecticide ointment
Papua New
Guinea
Predisposition to
oral cancer
Toxic
Dental care remedies Dental care remedies Community Effect
Cooked meat
salt alcohol grease
deodorant
Iran
fingernail polish remover
black tar
Garlic Warm coconut milk
Brazil Toxic
Kawakawa Māori(Pepper Tree
Leaves) chewed
Harakeke -Korari Flax
the gum used for toothache
Maori
GingivitisPeriodontal disease
Perceptions
bull Bleeding gums caused by
bull Child stores food in pouch of mouth and does not clean teeth
Remedies for gingival periodontal disease
Remedies Community tribe
Effect
Aluminium phosphate (Alum ) + Lapalapa sap (Jatropha curcas)Warm water and salt Tomato and alum+polystrene foam or cotton woolHydrogen peroxide
Yoruba
Antibiotics NomadiFulani
Resistant strains Hyper sensitivityreactions
Herbs
ORAL HABITS Kola nut chewing
Common West Central Africa Symbol of hospitality Contains caffeine tannin
bull Helps students keep awakewithstand fatigue
Practices
bull One-year prevalence student use was 291 Erinfolami et al (2011)
bull Majority started at age 14 years or below
bull Dangers -insomnia nausea tooth discolourationcarcinogenic potential for development of oral cancer
Areca Nut Chewing Habitbull Areca nut is the seed of areca palm
bull Widely grown- Asia India Bangladesh Japan
bull Believed to help fatigue
bull Highest period of risk for first use is between 5 and 12 Farrand et al 2001
74 4-16 age group in Karachi indulged in the habit (Shah et al 2002)
Dangers Oral sub mucous fibrosis
bull Risk of oral cancer 99 times( Wollina et al 2004 ) Foreign body aspiration Severe tooth wear -- sensitivity root fractures
Mandibular arch with generalized staining in the deciduous dentition
Prajapati D Nayak R Nayak UA Shah PJ Areca nut chewing habit in preschoolers Two rare case reports and literature review Int J Dent Health Concern 201511-5 (Permission given)
Mandibular arch with generalized staining in the deciduous dentition
Prajapati D Nayak R Nayak UA Shah PJ Areca nut chewing habit in preschoolers Two rare case reports and literature review Int J Dent Health Concern 201511-5 (Permission given)
Oral tobacco use and cigar smoking
bull High prevalence tobacco use in any form is reported among school going adolescents aged 13ndash15 years in India (Arora and Reddy 2005) Smoking Chutta is relatively popular may begin in childhood in India
bull Acts as a stimulant euphoric
bull May sleep with tobacco mixture in mouth
Harmful effects halitosis brown black staining gingival recession if wad is held against gingivaleucoplakia oral squamous cell carcinoma
Tobacco use in children
PRACTICES RELATED TO PUBERTY AND GROOMING
Tooth filing tooth sharpening
Practiced -Nigeria Niger-Delta area (Ukeghesonand Akadiri ) Democratic Republic of Congo Thailand Indonesia
bull Perception Historically -spiritual reasons Contemporary times - aesthetic reasons
bull In Nigeria maxillary midline diastema is regarded as a symbol of beauty (Arigbede and Adesuwa 2012
bull Teeth filed- because represent negative emotions eg anger jealousy (Balinese Indonesia)
30 respondents would not mind having artificially created diastema (Omotosho and Kadri (2010)
Practices
bull Done in adolescence - fashionable
bull Manually done Usually incisors
Harmful effects
bull pain during process
bull Tooth discolouration (teeth -non vital)
bull Infection -pus discharge lip swelling
Tooth filing
Peri-apical x-ray of lower central incisor
Lacquering and staining of teethPerformed in Vietnam Laos Thailand Indonesia and Philippines
Perception For cosmetic reasons
bull Main ingredient dye dark-brown solution of ferric acetate called kanemizu (iron filings in vinegar)
bull Coating the teeth with this liquid helped to prevent tooth decay and enamel decay
bull Practice has slowly declined
Traditional gingival tattooinglips bull Practiced in Africarsquos Sahel region Woddebe
Fulani tribe Senegal Ethiopia middle eastern countries
Perception Reason aesthetic appeal superstition
bull Practices Done when females reach puberty
bull Kanuri females Borno State Nigeria tattooing lip gingiva usually performed thorns of Balanites aegyptiaca (Bukar et al 2004 )
bull Pigments -Mixture charcoal and seeds of Acacia nilotica vartomentosa
Lip plug lip plate
bull The lip plate (lip plug or lip disc) form of body modification
bull Amazonian tribes young males traditionally -rite of passage indicate status and prestige
bull Mursi of Ethiopia girls age 13 to 18
bull At puberty mother cuts her lower lip
bull Held open by a wooden plug - inserted into thereby stretching the lip
bull At times -combined with removal of two or four lower anterior incisal teeth
Lip plug lip plate
TRADITIONAL DENTAL SERVICES
bull Perceptions
Cause of illness determines treatment taken Practices
bull Yoruba community patronize traditional dentists (Oke Bankole et al 2011) Edo state
bull Services rendered include worm extraction tooth extraction drug prescription and offering sacrifices to deities
bull Charges based on the worm count
Northern Nigeria called Serdia Toothache associated with dandruff
Cameroon traditional healers perform atraumatic tooth extraction Agbor et al (2011)
bull Leaves stems of Dichrocephala integrifolia
bull Tooth pulled out fingerssharp instrument
bull No pain Plant has anaesthetic properties
bull Dangers infection sepsis infection with hepatitis B Human Immunodeficiency Virus
bull Jewish Unlikely keep Friday appointment with the dentist for their children
bull Routine appointments on Fridays avoided (Scambler et al )
The traditional healer harvesting the medicinal plant in Cameroon
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J Ethnobiol Ethnomed 2011 715
Tooth extraction by a traditional dentist
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J EthnobiolEthnomed 2011 715
bull Health is a consequence of an individualrsquos lifestyle
bull Essential to Identify cultural factors that are harmful and those that are beneficial
bull As paediatric dentists we should discourage the unhealthy practices through rigorous health education and promote the adoption of healthy practices
bull Need for multicentric research on the cultural influence of the family and peers regarding oral health of children
bull Bankole OO Lawal FB Ibiyemi O (2017) Dispelling myths associated with natalneonatal teeth ldquoAdunnirdquo a health education video in a native Nigerian language Annals of Ibadan Postgraduate Medicine15(2)137-141
Thank you for listening
MALOCCLUSION bull Proclined teeth (ldquoEyin Shamgarrdquo) in South
Western Nigeria
bull Perceived causes Carelessness of mother in application of teething concoctions to bath baby
bull Child opening mouth when sleeping (Unpublished work)
bull Jewish community study poor teeth in parents grandparents seen their children (Scambler et al 2010)
Practices Childrsquos lips continually pulled together by parents
TONGUE TIE (ANKYLOGLOSSIA)Perception
Among some tribes in Port Harcourt it is believed that most babies are born with tongue tie (Opara and Eke 2013)
Also among Ishan in Edo State
bull Perceived effects speech difficulties (stammering) inability to cry well difficulty breast feeding poor hearing
Tongue tie Practices
bull Culture in south south Nigeria supports routine clipping of frenulum in all newborns (Opara and Eke 2013)
bull Done between ages 0-1 month
bull Carried out by nurses traditional birth assistants using scissors or finger nails
bull (368) mothers in Port Harcourt had babies treated for tongue tie (Opara and Eke 2013)
bull Complications bleeding infection and soft tissue injuries
TEETHINGbull Eruption of teeth -important milestone
bull Myriads of symptoms are erroneously linked to the teething process ( Adam and Abhulimhen-Iyoha (2015)
bull Passive immunity decreases
bull Children exposed to a wide variety of illnesses
bull Danger is that mothers may not seek medical consultation for some childhood illnesses (Igeand Olubukola 2013 )
bull May lead to increased child mortality
Perceived Teething SymptomsSymptoms Egypt
El-gilany
and Abusaad
(2017)
Sudan
Awadkamil
(2012)
Kenya
James et
al 2015
Nigeria
Bankole et al
(2017)
Fever 832 866 764 692
Diarrhea 51 833 739 807
Boils 644
Weight loss 473
Cough 608
Vomiting 147
Conjunctivitis 201
Practices Teething Remedies Remedies Opeoduand Denloye2014
Kenya (James et al 2015
Bankole et al 2017)
Analgesics 634 677
Teething powder
syrup
435 655 420313
Antibiotic 142
Sedatives 46
Traditional
Concoction herbs
15 481
Teething soap etc 750
Other Folk RemediesSource httpswwwlifelovelizcom20150108traditional-
teething-remedies-around-world
Caribbean Hang raw egg over where baby sleeps
India Ayurvedic Remedy with cloves
Chinese Traditional Chinese Medicine (TCM) Acupuncture Acupressure
Japanese Wooden Teething Ring
France Sophie the giraffe - teething toy
Baltic Amber Teething Necklace Dangers strangulation aspiration beads
German Zwieback Toast
bull Acupressure
bull Massaging two important acupoints called the ldquotwo gatesrdquo or Large Intestine 4 (Li 4) and Liver 3 (Liv 3) can ease babyrsquos teething pain
bull It is simple effective and easy to do anywhere
bull Shonishin ndashJapanese needleless therapybull Source www bonnchirocomshonishin-needle-less-acupuncture-for-infants-and-
toddlers
Health education to the nurses and Community health officers at Ibadan Nigeria
Photoposter
Educational tool (In collaboration with WHO) In English and 3 major Nigerian languages
bull Effectiveness tested (Bankole et al 2005)
bull More effective as instructional tool in interactive atmosphere than just pasted on walls
TIMING OF ERUPTION Natalneonatal teeth
Associated with erroneous cultural beliefs among community nurses and
traditional birth attendants (TBA)
Britain ndashHeroes
China ndashBearers of misfortune
Natal tooth
Perceptions regarding natalneonatal teeth in infants
Traditional birth
attendaants
Bankole et al
(2013
Igbo Ora
Community
Unpublished
PERCEIVED CAUSES
Evil spirits evil child Abiku 319 487
Mothers contravened taboos 92 35
Prolonged maternal gestation 49
EFFECT ON THE FAMILY
Curse 74 106
Abomination 245 360
Embarrassment 11 360
Practices regarding natalneonatal teeth
Traditional birth
attendants
Bankole et al 2003)
Practices
Immediate extraction
Spiritual cleansing
356 Pain infection HIV
hepatitis B tetanus
Get rid of child 49 Infanticide
EFFECT ON CHILD
Strange odd behavior 313 Stigmatization
Evil spiritual powers 411 Stigmatization
Mental retardation
dull
31
With Traditional Birth Attendants at Ibadan South East Local government area
REVERSAL OF ERUPTION SEQUENCE
bull African ethnographies - infants whose upper teeth erupt before their lower teeth have been killed because of such ldquodevelopmental anomaliesrdquo
bull Considered a bad omen and sign of misfortune among Hamar Ethiopia Benin Rebublic
bull Reversal of eruption sequence of primary incisors in infants in Yoruba community has led to unpleasant circumstances
Reversal of eruption sequence
Reversal of eruption sequence
TraditionalBirth Attendants
Bankole and Lawal (2018)
PERCEIVED CAUSES
Evil spirits 218 476
Contravening taboos 80 26
EFFECT ON THE FAMILY
Curse 135 214Abomination 276 218
Embarrassment 233 114
Practices regarding reversal of eruption sequence of the anterior primary teeth
Practices Bankole and
Lawal(2018 )Effect
Immediate extraction 337 Pain infection HJV
hepatitis B infection
tetanus
HideGet rid of child 613 Infanticide
EFFECT ON CHILD
Strange behavior 227 Stigmatization
Evil powers 417 Stigmatization
Mental retardation 25
Dr Bankole and Dr Lawal with the Traditional Birth Attendants at the Ibadan South West LGA
DIETDental caries has escalated in developing countries
bull Misconception Food and drinks refined processed or modern is best and associated with affluence (Aderinokun et al 2011)
bull Parents donrsquot want their children to be deprived of what they lacked when young
bull This has led to a cultural shift in diet
bull Some African American believe motherrsquos diet during pregnancy cause dental caries in the child
bull Somali refugees Hutterites and Latino immigrant caregivers believed genetics plays a role in development early childhood caries (Prowse 2014)
Practices
bull YorubaHausa community common snacks have assumed local flavours several shapes coloursof sweets sold
bull Natural foods fruits are being sweetened Oke Bankole et al 2011 )
bull Nomadic Fulani sugary diet in between their meals sweetened drinks in bottles Sippy cups (827) and (716) give pacifiers dipped in sweet liquids Reduce temper tantrums with sweets Bankole et al 2015
Infant feeding practices
bull Babies with sweetened drinks in bottles pacifiers dipped in sweet liquidsputting infant to bed with a bottle of sweetened liquid Reported among Mexican Americans and Puerto Ricans Hong Kong Saudi mothers Al-Zahrani et al 2014
bull High risk factors contributing development of early childhood caries in infants
Diet
bull Perception
Animals such as pig are unclean
bull Practices
bull Hindus donrsquot eat beef Muslims donrsquot eat pork
bull Protective prevent taeniasis cystecercosis -edematous oral ulcers gingival bleeding lesions mimicking mucocles in children
(Alves et al 2011)
Dental Fluorosis bull In East and central African countries (tribal
areas of Tanzania Magadi a fluoride rich tronaused in cooking
bull Used as a tenderizer and preservative
bull High Fluoride Concentration 7900 ppm
bull Magadi use may suggest high prevalence of fluorosis in northern Tanzania (Kaseva 2006)
Oral Hygiene
Perceptions among mothers
bull Hausa Fulani- 142 - babyrsquos mouth should be cleaned before teeth erupt
bull Yoruba- Babyrsquos mouthtongue cleaned before teeth erupt to prevent thrush
bull Hausa Fulani- 635 - commencement tooth cleaning between 6 and 12 months of age (Bankole et al 2017)
bull Yoruba- chewing sticks should not be used at night Causes premature death of mother (Oke et al 2011)
Practices
Hausa Fulani- 594 cleaned infants teeth once daily
- 614 children start cleaning their teeth unsupervised before the age of six years
- 751 of supervision was carried out by the grandparents
- Sudan -343 mothers donrsquot clean childrenrsquos teeth below the age of 2 years (Abduljalil et al 2016)
-Hausa - mothers start cleaning childrenrsquos teeth when enough teeth to justify effort (Oke et al 2011)
Oral hygiene practices
Cleaning materials used in infancyearly childhood
CommunityTribe
GlycerinFresh tomato Hydrogen peroxideAluminum sulphateVerona Amygdalina (bitter leaf)Iyere (African black pepper)Alligator pepperCitrus lime Combinations
Yoruba - Nigeria (Aderinokun 2000)
Alum (Aluminum sulphate) Bitter leaf (Verona Amygdalina)
Iyere (African black pepper)
Citrus lime Alligator pepper
Oral hygiene practices
Tooth Cleaning materials
CommunityTribe Side effect
Salt and cotton wool
Hausa (Oke et al 2011)
Finger Nomadic Fulani
Wooden twigSalvadora persiccatwig (miswak) Neem tree Chewing stick
Nomadic Fulani ( Bankole et al 2017)
Somali
India (Kochar et al 2014)
Yoruba Senegal (Diouf 2013)
Improper use ndashgingival trauma
round ceramics omadic ulani
brasion sensiti it
and omadic ulani
shes ood charcoal
Somali (Beveridge
India Senegal
Tooth Cleaning materials
CommunityTribe Side effect
Ground ceramics Nomadic Fulani Tooth abrasion
Sand Nomadic Fulani
AshesWood
Charcoal
Somali India Senegal
Tooth abrasion
IMPORTANCE OF THE PRIMARY DENTITION IN CHILDREN
bull Primary teeth in children are sometimes not regarded as important
bull Mothers of preschool children in Mumbai -436 believed 192 were uncertain that there is no need to visit a dentist for treating milk teeth as they will soon fall off (Jain et al 2014)
COMMON DENTAL DISEASES
Dental Caries
bull Early childhood caries is a significant public health problem caries affecting children globally
bull In recent years in developing countries like Sub-Saharan Africa the prevalence is predicted to increase
bull Early childhood caries is largely untreated in a study in South Africa reported a caries prevalence of 716 and these 675 were untreated (Mohammed and Barnes 2018 )
Dental caries Perceived cause of dental
caries
Community tribe
Worms (resembling
maggots)
Borom bop (master of the
head)
Lagatas
Smaller version of pubu
Worms -removed from
ears
Yoruba Nomadic Fulani
Chinese (Dong et al 2007)
Senegalese ( Diouf et al 2003)
Brazil
Papua New Guinea
Indian (Nagaraj et al2014)
Dental caries -Care remedies Dental care remedies Community tribe Effect
Hydrochloric acid (Wet cell
battery liquid)
Aluminum Phosphate
(Alum)
Tobacco snuff
Charcoal and salt
Gentian violet
Atare (Alligator Pepper)
Yoruba Brazil
Kenya (Mulu Maryanne)
Yoruba (Oke et al 2011)
Chemical burns
mucosal ulceration
Erosion
Tetracycline capsule (topical)
Paracetamol (topical)
Hausa Nomadic Fulani
Hausa
Greyish brown tooth
discolouration
Mucosal ulceration
Traditional concoction
Dental are remedies Dental care remedies Community
tribe
Effect
White wineVinegar Powdered alum musk and frankincense
Chinese (Dong et al 2007)
Herbs traditional medicine
Aborigines (Wong 2005)
Nettles
Hot sweet potato
Wads hot leaves ginger
Residue smoking pipe
White sap of shrub used
to kill maggots
Insecticide ointment
Papua New
Guinea
Predisposition to
oral cancer
Toxic
Dental care remedies Dental care remedies Community Effect
Cooked meat
salt alcohol grease
deodorant
Iran
fingernail polish remover
black tar
Garlic Warm coconut milk
Brazil Toxic
Kawakawa Māori(Pepper Tree
Leaves) chewed
Harakeke -Korari Flax
the gum used for toothache
Maori
GingivitisPeriodontal disease
Perceptions
bull Bleeding gums caused by
bull Child stores food in pouch of mouth and does not clean teeth
Remedies for gingival periodontal disease
Remedies Community tribe
Effect
Aluminium phosphate (Alum ) + Lapalapa sap (Jatropha curcas)Warm water and salt Tomato and alum+polystrene foam or cotton woolHydrogen peroxide
Yoruba
Antibiotics NomadiFulani
Resistant strains Hyper sensitivityreactions
Herbs
ORAL HABITS Kola nut chewing
Common West Central Africa Symbol of hospitality Contains caffeine tannin
bull Helps students keep awakewithstand fatigue
Practices
bull One-year prevalence student use was 291 Erinfolami et al (2011)
bull Majority started at age 14 years or below
bull Dangers -insomnia nausea tooth discolourationcarcinogenic potential for development of oral cancer
Areca Nut Chewing Habitbull Areca nut is the seed of areca palm
bull Widely grown- Asia India Bangladesh Japan
bull Believed to help fatigue
bull Highest period of risk for first use is between 5 and 12 Farrand et al 2001
74 4-16 age group in Karachi indulged in the habit (Shah et al 2002)
Dangers Oral sub mucous fibrosis
bull Risk of oral cancer 99 times( Wollina et al 2004 ) Foreign body aspiration Severe tooth wear -- sensitivity root fractures
Mandibular arch with generalized staining in the deciduous dentition
Prajapati D Nayak R Nayak UA Shah PJ Areca nut chewing habit in preschoolers Two rare case reports and literature review Int J Dent Health Concern 201511-5 (Permission given)
Mandibular arch with generalized staining in the deciduous dentition
Prajapati D Nayak R Nayak UA Shah PJ Areca nut chewing habit in preschoolers Two rare case reports and literature review Int J Dent Health Concern 201511-5 (Permission given)
Oral tobacco use and cigar smoking
bull High prevalence tobacco use in any form is reported among school going adolescents aged 13ndash15 years in India (Arora and Reddy 2005) Smoking Chutta is relatively popular may begin in childhood in India
bull Acts as a stimulant euphoric
bull May sleep with tobacco mixture in mouth
Harmful effects halitosis brown black staining gingival recession if wad is held against gingivaleucoplakia oral squamous cell carcinoma
Tobacco use in children
PRACTICES RELATED TO PUBERTY AND GROOMING
Tooth filing tooth sharpening
Practiced -Nigeria Niger-Delta area (Ukeghesonand Akadiri ) Democratic Republic of Congo Thailand Indonesia
bull Perception Historically -spiritual reasons Contemporary times - aesthetic reasons
bull In Nigeria maxillary midline diastema is regarded as a symbol of beauty (Arigbede and Adesuwa 2012
bull Teeth filed- because represent negative emotions eg anger jealousy (Balinese Indonesia)
30 respondents would not mind having artificially created diastema (Omotosho and Kadri (2010)
Practices
bull Done in adolescence - fashionable
bull Manually done Usually incisors
Harmful effects
bull pain during process
bull Tooth discolouration (teeth -non vital)
bull Infection -pus discharge lip swelling
Tooth filing
Peri-apical x-ray of lower central incisor
Lacquering and staining of teethPerformed in Vietnam Laos Thailand Indonesia and Philippines
Perception For cosmetic reasons
bull Main ingredient dye dark-brown solution of ferric acetate called kanemizu (iron filings in vinegar)
bull Coating the teeth with this liquid helped to prevent tooth decay and enamel decay
bull Practice has slowly declined
Traditional gingival tattooinglips bull Practiced in Africarsquos Sahel region Woddebe
Fulani tribe Senegal Ethiopia middle eastern countries
Perception Reason aesthetic appeal superstition
bull Practices Done when females reach puberty
bull Kanuri females Borno State Nigeria tattooing lip gingiva usually performed thorns of Balanites aegyptiaca (Bukar et al 2004 )
bull Pigments -Mixture charcoal and seeds of Acacia nilotica vartomentosa
Lip plug lip plate
bull The lip plate (lip plug or lip disc) form of body modification
bull Amazonian tribes young males traditionally -rite of passage indicate status and prestige
bull Mursi of Ethiopia girls age 13 to 18
bull At puberty mother cuts her lower lip
bull Held open by a wooden plug - inserted into thereby stretching the lip
bull At times -combined with removal of two or four lower anterior incisal teeth
Lip plug lip plate
TRADITIONAL DENTAL SERVICES
bull Perceptions
Cause of illness determines treatment taken Practices
bull Yoruba community patronize traditional dentists (Oke Bankole et al 2011) Edo state
bull Services rendered include worm extraction tooth extraction drug prescription and offering sacrifices to deities
bull Charges based on the worm count
Northern Nigeria called Serdia Toothache associated with dandruff
Cameroon traditional healers perform atraumatic tooth extraction Agbor et al (2011)
bull Leaves stems of Dichrocephala integrifolia
bull Tooth pulled out fingerssharp instrument
bull No pain Plant has anaesthetic properties
bull Dangers infection sepsis infection with hepatitis B Human Immunodeficiency Virus
bull Jewish Unlikely keep Friday appointment with the dentist for their children
bull Routine appointments on Fridays avoided (Scambler et al )
The traditional healer harvesting the medicinal plant in Cameroon
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J Ethnobiol Ethnomed 2011 715
Tooth extraction by a traditional dentist
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J EthnobiolEthnomed 2011 715
bull Health is a consequence of an individualrsquos lifestyle
bull Essential to Identify cultural factors that are harmful and those that are beneficial
bull As paediatric dentists we should discourage the unhealthy practices through rigorous health education and promote the adoption of healthy practices
bull Need for multicentric research on the cultural influence of the family and peers regarding oral health of children
bull Bankole OO Lawal FB Ibiyemi O (2017) Dispelling myths associated with natalneonatal teeth ldquoAdunnirdquo a health education video in a native Nigerian language Annals of Ibadan Postgraduate Medicine15(2)137-141
Thank you for listening
TONGUE TIE (ANKYLOGLOSSIA)Perception
Among some tribes in Port Harcourt it is believed that most babies are born with tongue tie (Opara and Eke 2013)
Also among Ishan in Edo State
bull Perceived effects speech difficulties (stammering) inability to cry well difficulty breast feeding poor hearing
Tongue tie Practices
bull Culture in south south Nigeria supports routine clipping of frenulum in all newborns (Opara and Eke 2013)
bull Done between ages 0-1 month
bull Carried out by nurses traditional birth assistants using scissors or finger nails
bull (368) mothers in Port Harcourt had babies treated for tongue tie (Opara and Eke 2013)
bull Complications bleeding infection and soft tissue injuries
TEETHINGbull Eruption of teeth -important milestone
bull Myriads of symptoms are erroneously linked to the teething process ( Adam and Abhulimhen-Iyoha (2015)
bull Passive immunity decreases
bull Children exposed to a wide variety of illnesses
bull Danger is that mothers may not seek medical consultation for some childhood illnesses (Igeand Olubukola 2013 )
bull May lead to increased child mortality
Perceived Teething SymptomsSymptoms Egypt
El-gilany
and Abusaad
(2017)
Sudan
Awadkamil
(2012)
Kenya
James et
al 2015
Nigeria
Bankole et al
(2017)
Fever 832 866 764 692
Diarrhea 51 833 739 807
Boils 644
Weight loss 473
Cough 608
Vomiting 147
Conjunctivitis 201
Practices Teething Remedies Remedies Opeoduand Denloye2014
Kenya (James et al 2015
Bankole et al 2017)
Analgesics 634 677
Teething powder
syrup
435 655 420313
Antibiotic 142
Sedatives 46
Traditional
Concoction herbs
15 481
Teething soap etc 750
Other Folk RemediesSource httpswwwlifelovelizcom20150108traditional-
teething-remedies-around-world
Caribbean Hang raw egg over where baby sleeps
India Ayurvedic Remedy with cloves
Chinese Traditional Chinese Medicine (TCM) Acupuncture Acupressure
Japanese Wooden Teething Ring
France Sophie the giraffe - teething toy
Baltic Amber Teething Necklace Dangers strangulation aspiration beads
German Zwieback Toast
bull Acupressure
bull Massaging two important acupoints called the ldquotwo gatesrdquo or Large Intestine 4 (Li 4) and Liver 3 (Liv 3) can ease babyrsquos teething pain
bull It is simple effective and easy to do anywhere
bull Shonishin ndashJapanese needleless therapybull Source www bonnchirocomshonishin-needle-less-acupuncture-for-infants-and-
toddlers
Health education to the nurses and Community health officers at Ibadan Nigeria
Photoposter
Educational tool (In collaboration with WHO) In English and 3 major Nigerian languages
bull Effectiveness tested (Bankole et al 2005)
bull More effective as instructional tool in interactive atmosphere than just pasted on walls
TIMING OF ERUPTION Natalneonatal teeth
Associated with erroneous cultural beliefs among community nurses and
traditional birth attendants (TBA)
Britain ndashHeroes
China ndashBearers of misfortune
Natal tooth
Perceptions regarding natalneonatal teeth in infants
Traditional birth
attendaants
Bankole et al
(2013
Igbo Ora
Community
Unpublished
PERCEIVED CAUSES
Evil spirits evil child Abiku 319 487
Mothers contravened taboos 92 35
Prolonged maternal gestation 49
EFFECT ON THE FAMILY
Curse 74 106
Abomination 245 360
Embarrassment 11 360
Practices regarding natalneonatal teeth
Traditional birth
attendants
Bankole et al 2003)
Practices
Immediate extraction
Spiritual cleansing
356 Pain infection HIV
hepatitis B tetanus
Get rid of child 49 Infanticide
EFFECT ON CHILD
Strange odd behavior 313 Stigmatization
Evil spiritual powers 411 Stigmatization
Mental retardation
dull
31
With Traditional Birth Attendants at Ibadan South East Local government area
REVERSAL OF ERUPTION SEQUENCE
bull African ethnographies - infants whose upper teeth erupt before their lower teeth have been killed because of such ldquodevelopmental anomaliesrdquo
bull Considered a bad omen and sign of misfortune among Hamar Ethiopia Benin Rebublic
bull Reversal of eruption sequence of primary incisors in infants in Yoruba community has led to unpleasant circumstances
Reversal of eruption sequence
Reversal of eruption sequence
TraditionalBirth Attendants
Bankole and Lawal (2018)
PERCEIVED CAUSES
Evil spirits 218 476
Contravening taboos 80 26
EFFECT ON THE FAMILY
Curse 135 214Abomination 276 218
Embarrassment 233 114
Practices regarding reversal of eruption sequence of the anterior primary teeth
Practices Bankole and
Lawal(2018 )Effect
Immediate extraction 337 Pain infection HJV
hepatitis B infection
tetanus
HideGet rid of child 613 Infanticide
EFFECT ON CHILD
Strange behavior 227 Stigmatization
Evil powers 417 Stigmatization
Mental retardation 25
Dr Bankole and Dr Lawal with the Traditional Birth Attendants at the Ibadan South West LGA
DIETDental caries has escalated in developing countries
bull Misconception Food and drinks refined processed or modern is best and associated with affluence (Aderinokun et al 2011)
bull Parents donrsquot want their children to be deprived of what they lacked when young
bull This has led to a cultural shift in diet
bull Some African American believe motherrsquos diet during pregnancy cause dental caries in the child
bull Somali refugees Hutterites and Latino immigrant caregivers believed genetics plays a role in development early childhood caries (Prowse 2014)
Practices
bull YorubaHausa community common snacks have assumed local flavours several shapes coloursof sweets sold
bull Natural foods fruits are being sweetened Oke Bankole et al 2011 )
bull Nomadic Fulani sugary diet in between their meals sweetened drinks in bottles Sippy cups (827) and (716) give pacifiers dipped in sweet liquids Reduce temper tantrums with sweets Bankole et al 2015
Infant feeding practices
bull Babies with sweetened drinks in bottles pacifiers dipped in sweet liquidsputting infant to bed with a bottle of sweetened liquid Reported among Mexican Americans and Puerto Ricans Hong Kong Saudi mothers Al-Zahrani et al 2014
bull High risk factors contributing development of early childhood caries in infants
Diet
bull Perception
Animals such as pig are unclean
bull Practices
bull Hindus donrsquot eat beef Muslims donrsquot eat pork
bull Protective prevent taeniasis cystecercosis -edematous oral ulcers gingival bleeding lesions mimicking mucocles in children
(Alves et al 2011)
Dental Fluorosis bull In East and central African countries (tribal
areas of Tanzania Magadi a fluoride rich tronaused in cooking
bull Used as a tenderizer and preservative
bull High Fluoride Concentration 7900 ppm
bull Magadi use may suggest high prevalence of fluorosis in northern Tanzania (Kaseva 2006)
Oral Hygiene
Perceptions among mothers
bull Hausa Fulani- 142 - babyrsquos mouth should be cleaned before teeth erupt
bull Yoruba- Babyrsquos mouthtongue cleaned before teeth erupt to prevent thrush
bull Hausa Fulani- 635 - commencement tooth cleaning between 6 and 12 months of age (Bankole et al 2017)
bull Yoruba- chewing sticks should not be used at night Causes premature death of mother (Oke et al 2011)
Practices
Hausa Fulani- 594 cleaned infants teeth once daily
- 614 children start cleaning their teeth unsupervised before the age of six years
- 751 of supervision was carried out by the grandparents
- Sudan -343 mothers donrsquot clean childrenrsquos teeth below the age of 2 years (Abduljalil et al 2016)
-Hausa - mothers start cleaning childrenrsquos teeth when enough teeth to justify effort (Oke et al 2011)
Oral hygiene practices
Cleaning materials used in infancyearly childhood
CommunityTribe
GlycerinFresh tomato Hydrogen peroxideAluminum sulphateVerona Amygdalina (bitter leaf)Iyere (African black pepper)Alligator pepperCitrus lime Combinations
Yoruba - Nigeria (Aderinokun 2000)
Alum (Aluminum sulphate) Bitter leaf (Verona Amygdalina)
Iyere (African black pepper)
Citrus lime Alligator pepper
Oral hygiene practices
Tooth Cleaning materials
CommunityTribe Side effect
Salt and cotton wool
Hausa (Oke et al 2011)
Finger Nomadic Fulani
Wooden twigSalvadora persiccatwig (miswak) Neem tree Chewing stick
Nomadic Fulani ( Bankole et al 2017)
Somali
India (Kochar et al 2014)
Yoruba Senegal (Diouf 2013)
Improper use ndashgingival trauma
round ceramics omadic ulani
brasion sensiti it
and omadic ulani
shes ood charcoal
Somali (Beveridge
India Senegal
Tooth Cleaning materials
CommunityTribe Side effect
Ground ceramics Nomadic Fulani Tooth abrasion
Sand Nomadic Fulani
AshesWood
Charcoal
Somali India Senegal
Tooth abrasion
IMPORTANCE OF THE PRIMARY DENTITION IN CHILDREN
bull Primary teeth in children are sometimes not regarded as important
bull Mothers of preschool children in Mumbai -436 believed 192 were uncertain that there is no need to visit a dentist for treating milk teeth as they will soon fall off (Jain et al 2014)
COMMON DENTAL DISEASES
Dental Caries
bull Early childhood caries is a significant public health problem caries affecting children globally
bull In recent years in developing countries like Sub-Saharan Africa the prevalence is predicted to increase
bull Early childhood caries is largely untreated in a study in South Africa reported a caries prevalence of 716 and these 675 were untreated (Mohammed and Barnes 2018 )
Dental caries Perceived cause of dental
caries
Community tribe
Worms (resembling
maggots)
Borom bop (master of the
head)
Lagatas
Smaller version of pubu
Worms -removed from
ears
Yoruba Nomadic Fulani
Chinese (Dong et al 2007)
Senegalese ( Diouf et al 2003)
Brazil
Papua New Guinea
Indian (Nagaraj et al2014)
Dental caries -Care remedies Dental care remedies Community tribe Effect
Hydrochloric acid (Wet cell
battery liquid)
Aluminum Phosphate
(Alum)
Tobacco snuff
Charcoal and salt
Gentian violet
Atare (Alligator Pepper)
Yoruba Brazil
Kenya (Mulu Maryanne)
Yoruba (Oke et al 2011)
Chemical burns
mucosal ulceration
Erosion
Tetracycline capsule (topical)
Paracetamol (topical)
Hausa Nomadic Fulani
Hausa
Greyish brown tooth
discolouration
Mucosal ulceration
Traditional concoction
Dental are remedies Dental care remedies Community
tribe
Effect
White wineVinegar Powdered alum musk and frankincense
Chinese (Dong et al 2007)
Herbs traditional medicine
Aborigines (Wong 2005)
Nettles
Hot sweet potato
Wads hot leaves ginger
Residue smoking pipe
White sap of shrub used
to kill maggots
Insecticide ointment
Papua New
Guinea
Predisposition to
oral cancer
Toxic
Dental care remedies Dental care remedies Community Effect
Cooked meat
salt alcohol grease
deodorant
Iran
fingernail polish remover
black tar
Garlic Warm coconut milk
Brazil Toxic
Kawakawa Māori(Pepper Tree
Leaves) chewed
Harakeke -Korari Flax
the gum used for toothache
Maori
GingivitisPeriodontal disease
Perceptions
bull Bleeding gums caused by
bull Child stores food in pouch of mouth and does not clean teeth
Remedies for gingival periodontal disease
Remedies Community tribe
Effect
Aluminium phosphate (Alum ) + Lapalapa sap (Jatropha curcas)Warm water and salt Tomato and alum+polystrene foam or cotton woolHydrogen peroxide
Yoruba
Antibiotics NomadiFulani
Resistant strains Hyper sensitivityreactions
Herbs
ORAL HABITS Kola nut chewing
Common West Central Africa Symbol of hospitality Contains caffeine tannin
bull Helps students keep awakewithstand fatigue
Practices
bull One-year prevalence student use was 291 Erinfolami et al (2011)
bull Majority started at age 14 years or below
bull Dangers -insomnia nausea tooth discolourationcarcinogenic potential for development of oral cancer
Areca Nut Chewing Habitbull Areca nut is the seed of areca palm
bull Widely grown- Asia India Bangladesh Japan
bull Believed to help fatigue
bull Highest period of risk for first use is between 5 and 12 Farrand et al 2001
74 4-16 age group in Karachi indulged in the habit (Shah et al 2002)
Dangers Oral sub mucous fibrosis
bull Risk of oral cancer 99 times( Wollina et al 2004 ) Foreign body aspiration Severe tooth wear -- sensitivity root fractures
Mandibular arch with generalized staining in the deciduous dentition
Prajapati D Nayak R Nayak UA Shah PJ Areca nut chewing habit in preschoolers Two rare case reports and literature review Int J Dent Health Concern 201511-5 (Permission given)
Mandibular arch with generalized staining in the deciduous dentition
Prajapati D Nayak R Nayak UA Shah PJ Areca nut chewing habit in preschoolers Two rare case reports and literature review Int J Dent Health Concern 201511-5 (Permission given)
Oral tobacco use and cigar smoking
bull High prevalence tobacco use in any form is reported among school going adolescents aged 13ndash15 years in India (Arora and Reddy 2005) Smoking Chutta is relatively popular may begin in childhood in India
bull Acts as a stimulant euphoric
bull May sleep with tobacco mixture in mouth
Harmful effects halitosis brown black staining gingival recession if wad is held against gingivaleucoplakia oral squamous cell carcinoma
Tobacco use in children
PRACTICES RELATED TO PUBERTY AND GROOMING
Tooth filing tooth sharpening
Practiced -Nigeria Niger-Delta area (Ukeghesonand Akadiri ) Democratic Republic of Congo Thailand Indonesia
bull Perception Historically -spiritual reasons Contemporary times - aesthetic reasons
bull In Nigeria maxillary midline diastema is regarded as a symbol of beauty (Arigbede and Adesuwa 2012
bull Teeth filed- because represent negative emotions eg anger jealousy (Balinese Indonesia)
30 respondents would not mind having artificially created diastema (Omotosho and Kadri (2010)
Practices
bull Done in adolescence - fashionable
bull Manually done Usually incisors
Harmful effects
bull pain during process
bull Tooth discolouration (teeth -non vital)
bull Infection -pus discharge lip swelling
Tooth filing
Peri-apical x-ray of lower central incisor
Lacquering and staining of teethPerformed in Vietnam Laos Thailand Indonesia and Philippines
Perception For cosmetic reasons
bull Main ingredient dye dark-brown solution of ferric acetate called kanemizu (iron filings in vinegar)
bull Coating the teeth with this liquid helped to prevent tooth decay and enamel decay
bull Practice has slowly declined
Traditional gingival tattooinglips bull Practiced in Africarsquos Sahel region Woddebe
Fulani tribe Senegal Ethiopia middle eastern countries
Perception Reason aesthetic appeal superstition
bull Practices Done when females reach puberty
bull Kanuri females Borno State Nigeria tattooing lip gingiva usually performed thorns of Balanites aegyptiaca (Bukar et al 2004 )
bull Pigments -Mixture charcoal and seeds of Acacia nilotica vartomentosa
Lip plug lip plate
bull The lip plate (lip plug or lip disc) form of body modification
bull Amazonian tribes young males traditionally -rite of passage indicate status and prestige
bull Mursi of Ethiopia girls age 13 to 18
bull At puberty mother cuts her lower lip
bull Held open by a wooden plug - inserted into thereby stretching the lip
bull At times -combined with removal of two or four lower anterior incisal teeth
Lip plug lip plate
TRADITIONAL DENTAL SERVICES
bull Perceptions
Cause of illness determines treatment taken Practices
bull Yoruba community patronize traditional dentists (Oke Bankole et al 2011) Edo state
bull Services rendered include worm extraction tooth extraction drug prescription and offering sacrifices to deities
bull Charges based on the worm count
Northern Nigeria called Serdia Toothache associated with dandruff
Cameroon traditional healers perform atraumatic tooth extraction Agbor et al (2011)
bull Leaves stems of Dichrocephala integrifolia
bull Tooth pulled out fingerssharp instrument
bull No pain Plant has anaesthetic properties
bull Dangers infection sepsis infection with hepatitis B Human Immunodeficiency Virus
bull Jewish Unlikely keep Friday appointment with the dentist for their children
bull Routine appointments on Fridays avoided (Scambler et al )
The traditional healer harvesting the medicinal plant in Cameroon
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J Ethnobiol Ethnomed 2011 715
Tooth extraction by a traditional dentist
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J EthnobiolEthnomed 2011 715
bull Health is a consequence of an individualrsquos lifestyle
bull Essential to Identify cultural factors that are harmful and those that are beneficial
bull As paediatric dentists we should discourage the unhealthy practices through rigorous health education and promote the adoption of healthy practices
bull Need for multicentric research on the cultural influence of the family and peers regarding oral health of children
bull Bankole OO Lawal FB Ibiyemi O (2017) Dispelling myths associated with natalneonatal teeth ldquoAdunnirdquo a health education video in a native Nigerian language Annals of Ibadan Postgraduate Medicine15(2)137-141
Thank you for listening
Tongue tie Practices
bull Culture in south south Nigeria supports routine clipping of frenulum in all newborns (Opara and Eke 2013)
bull Done between ages 0-1 month
bull Carried out by nurses traditional birth assistants using scissors or finger nails
bull (368) mothers in Port Harcourt had babies treated for tongue tie (Opara and Eke 2013)
bull Complications bleeding infection and soft tissue injuries
TEETHINGbull Eruption of teeth -important milestone
bull Myriads of symptoms are erroneously linked to the teething process ( Adam and Abhulimhen-Iyoha (2015)
bull Passive immunity decreases
bull Children exposed to a wide variety of illnesses
bull Danger is that mothers may not seek medical consultation for some childhood illnesses (Igeand Olubukola 2013 )
bull May lead to increased child mortality
Perceived Teething SymptomsSymptoms Egypt
El-gilany
and Abusaad
(2017)
Sudan
Awadkamil
(2012)
Kenya
James et
al 2015
Nigeria
Bankole et al
(2017)
Fever 832 866 764 692
Diarrhea 51 833 739 807
Boils 644
Weight loss 473
Cough 608
Vomiting 147
Conjunctivitis 201
Practices Teething Remedies Remedies Opeoduand Denloye2014
Kenya (James et al 2015
Bankole et al 2017)
Analgesics 634 677
Teething powder
syrup
435 655 420313
Antibiotic 142
Sedatives 46
Traditional
Concoction herbs
15 481
Teething soap etc 750
Other Folk RemediesSource httpswwwlifelovelizcom20150108traditional-
teething-remedies-around-world
Caribbean Hang raw egg over where baby sleeps
India Ayurvedic Remedy with cloves
Chinese Traditional Chinese Medicine (TCM) Acupuncture Acupressure
Japanese Wooden Teething Ring
France Sophie the giraffe - teething toy
Baltic Amber Teething Necklace Dangers strangulation aspiration beads
German Zwieback Toast
bull Acupressure
bull Massaging two important acupoints called the ldquotwo gatesrdquo or Large Intestine 4 (Li 4) and Liver 3 (Liv 3) can ease babyrsquos teething pain
bull It is simple effective and easy to do anywhere
bull Shonishin ndashJapanese needleless therapybull Source www bonnchirocomshonishin-needle-less-acupuncture-for-infants-and-
toddlers
Health education to the nurses and Community health officers at Ibadan Nigeria
Photoposter
Educational tool (In collaboration with WHO) In English and 3 major Nigerian languages
bull Effectiveness tested (Bankole et al 2005)
bull More effective as instructional tool in interactive atmosphere than just pasted on walls
TIMING OF ERUPTION Natalneonatal teeth
Associated with erroneous cultural beliefs among community nurses and
traditional birth attendants (TBA)
Britain ndashHeroes
China ndashBearers of misfortune
Natal tooth
Perceptions regarding natalneonatal teeth in infants
Traditional birth
attendaants
Bankole et al
(2013
Igbo Ora
Community
Unpublished
PERCEIVED CAUSES
Evil spirits evil child Abiku 319 487
Mothers contravened taboos 92 35
Prolonged maternal gestation 49
EFFECT ON THE FAMILY
Curse 74 106
Abomination 245 360
Embarrassment 11 360
Practices regarding natalneonatal teeth
Traditional birth
attendants
Bankole et al 2003)
Practices
Immediate extraction
Spiritual cleansing
356 Pain infection HIV
hepatitis B tetanus
Get rid of child 49 Infanticide
EFFECT ON CHILD
Strange odd behavior 313 Stigmatization
Evil spiritual powers 411 Stigmatization
Mental retardation
dull
31
With Traditional Birth Attendants at Ibadan South East Local government area
REVERSAL OF ERUPTION SEQUENCE
bull African ethnographies - infants whose upper teeth erupt before their lower teeth have been killed because of such ldquodevelopmental anomaliesrdquo
bull Considered a bad omen and sign of misfortune among Hamar Ethiopia Benin Rebublic
bull Reversal of eruption sequence of primary incisors in infants in Yoruba community has led to unpleasant circumstances
Reversal of eruption sequence
Reversal of eruption sequence
TraditionalBirth Attendants
Bankole and Lawal (2018)
PERCEIVED CAUSES
Evil spirits 218 476
Contravening taboos 80 26
EFFECT ON THE FAMILY
Curse 135 214Abomination 276 218
Embarrassment 233 114
Practices regarding reversal of eruption sequence of the anterior primary teeth
Practices Bankole and
Lawal(2018 )Effect
Immediate extraction 337 Pain infection HJV
hepatitis B infection
tetanus
HideGet rid of child 613 Infanticide
EFFECT ON CHILD
Strange behavior 227 Stigmatization
Evil powers 417 Stigmatization
Mental retardation 25
Dr Bankole and Dr Lawal with the Traditional Birth Attendants at the Ibadan South West LGA
DIETDental caries has escalated in developing countries
bull Misconception Food and drinks refined processed or modern is best and associated with affluence (Aderinokun et al 2011)
bull Parents donrsquot want their children to be deprived of what they lacked when young
bull This has led to a cultural shift in diet
bull Some African American believe motherrsquos diet during pregnancy cause dental caries in the child
bull Somali refugees Hutterites and Latino immigrant caregivers believed genetics plays a role in development early childhood caries (Prowse 2014)
Practices
bull YorubaHausa community common snacks have assumed local flavours several shapes coloursof sweets sold
bull Natural foods fruits are being sweetened Oke Bankole et al 2011 )
bull Nomadic Fulani sugary diet in between their meals sweetened drinks in bottles Sippy cups (827) and (716) give pacifiers dipped in sweet liquids Reduce temper tantrums with sweets Bankole et al 2015
Infant feeding practices
bull Babies with sweetened drinks in bottles pacifiers dipped in sweet liquidsputting infant to bed with a bottle of sweetened liquid Reported among Mexican Americans and Puerto Ricans Hong Kong Saudi mothers Al-Zahrani et al 2014
bull High risk factors contributing development of early childhood caries in infants
Diet
bull Perception
Animals such as pig are unclean
bull Practices
bull Hindus donrsquot eat beef Muslims donrsquot eat pork
bull Protective prevent taeniasis cystecercosis -edematous oral ulcers gingival bleeding lesions mimicking mucocles in children
(Alves et al 2011)
Dental Fluorosis bull In East and central African countries (tribal
areas of Tanzania Magadi a fluoride rich tronaused in cooking
bull Used as a tenderizer and preservative
bull High Fluoride Concentration 7900 ppm
bull Magadi use may suggest high prevalence of fluorosis in northern Tanzania (Kaseva 2006)
Oral Hygiene
Perceptions among mothers
bull Hausa Fulani- 142 - babyrsquos mouth should be cleaned before teeth erupt
bull Yoruba- Babyrsquos mouthtongue cleaned before teeth erupt to prevent thrush
bull Hausa Fulani- 635 - commencement tooth cleaning between 6 and 12 months of age (Bankole et al 2017)
bull Yoruba- chewing sticks should not be used at night Causes premature death of mother (Oke et al 2011)
Practices
Hausa Fulani- 594 cleaned infants teeth once daily
- 614 children start cleaning their teeth unsupervised before the age of six years
- 751 of supervision was carried out by the grandparents
- Sudan -343 mothers donrsquot clean childrenrsquos teeth below the age of 2 years (Abduljalil et al 2016)
-Hausa - mothers start cleaning childrenrsquos teeth when enough teeth to justify effort (Oke et al 2011)
Oral hygiene practices
Cleaning materials used in infancyearly childhood
CommunityTribe
GlycerinFresh tomato Hydrogen peroxideAluminum sulphateVerona Amygdalina (bitter leaf)Iyere (African black pepper)Alligator pepperCitrus lime Combinations
Yoruba - Nigeria (Aderinokun 2000)
Alum (Aluminum sulphate) Bitter leaf (Verona Amygdalina)
Iyere (African black pepper)
Citrus lime Alligator pepper
Oral hygiene practices
Tooth Cleaning materials
CommunityTribe Side effect
Salt and cotton wool
Hausa (Oke et al 2011)
Finger Nomadic Fulani
Wooden twigSalvadora persiccatwig (miswak) Neem tree Chewing stick
Nomadic Fulani ( Bankole et al 2017)
Somali
India (Kochar et al 2014)
Yoruba Senegal (Diouf 2013)
Improper use ndashgingival trauma
round ceramics omadic ulani
brasion sensiti it
and omadic ulani
shes ood charcoal
Somali (Beveridge
India Senegal
Tooth Cleaning materials
CommunityTribe Side effect
Ground ceramics Nomadic Fulani Tooth abrasion
Sand Nomadic Fulani
AshesWood
Charcoal
Somali India Senegal
Tooth abrasion
IMPORTANCE OF THE PRIMARY DENTITION IN CHILDREN
bull Primary teeth in children are sometimes not regarded as important
bull Mothers of preschool children in Mumbai -436 believed 192 were uncertain that there is no need to visit a dentist for treating milk teeth as they will soon fall off (Jain et al 2014)
COMMON DENTAL DISEASES
Dental Caries
bull Early childhood caries is a significant public health problem caries affecting children globally
bull In recent years in developing countries like Sub-Saharan Africa the prevalence is predicted to increase
bull Early childhood caries is largely untreated in a study in South Africa reported a caries prevalence of 716 and these 675 were untreated (Mohammed and Barnes 2018 )
Dental caries Perceived cause of dental
caries
Community tribe
Worms (resembling
maggots)
Borom bop (master of the
head)
Lagatas
Smaller version of pubu
Worms -removed from
ears
Yoruba Nomadic Fulani
Chinese (Dong et al 2007)
Senegalese ( Diouf et al 2003)
Brazil
Papua New Guinea
Indian (Nagaraj et al2014)
Dental caries -Care remedies Dental care remedies Community tribe Effect
Hydrochloric acid (Wet cell
battery liquid)
Aluminum Phosphate
(Alum)
Tobacco snuff
Charcoal and salt
Gentian violet
Atare (Alligator Pepper)
Yoruba Brazil
Kenya (Mulu Maryanne)
Yoruba (Oke et al 2011)
Chemical burns
mucosal ulceration
Erosion
Tetracycline capsule (topical)
Paracetamol (topical)
Hausa Nomadic Fulani
Hausa
Greyish brown tooth
discolouration
Mucosal ulceration
Traditional concoction
Dental are remedies Dental care remedies Community
tribe
Effect
White wineVinegar Powdered alum musk and frankincense
Chinese (Dong et al 2007)
Herbs traditional medicine
Aborigines (Wong 2005)
Nettles
Hot sweet potato
Wads hot leaves ginger
Residue smoking pipe
White sap of shrub used
to kill maggots
Insecticide ointment
Papua New
Guinea
Predisposition to
oral cancer
Toxic
Dental care remedies Dental care remedies Community Effect
Cooked meat
salt alcohol grease
deodorant
Iran
fingernail polish remover
black tar
Garlic Warm coconut milk
Brazil Toxic
Kawakawa Māori(Pepper Tree
Leaves) chewed
Harakeke -Korari Flax
the gum used for toothache
Maori
GingivitisPeriodontal disease
Perceptions
bull Bleeding gums caused by
bull Child stores food in pouch of mouth and does not clean teeth
Remedies for gingival periodontal disease
Remedies Community tribe
Effect
Aluminium phosphate (Alum ) + Lapalapa sap (Jatropha curcas)Warm water and salt Tomato and alum+polystrene foam or cotton woolHydrogen peroxide
Yoruba
Antibiotics NomadiFulani
Resistant strains Hyper sensitivityreactions
Herbs
ORAL HABITS Kola nut chewing
Common West Central Africa Symbol of hospitality Contains caffeine tannin
bull Helps students keep awakewithstand fatigue
Practices
bull One-year prevalence student use was 291 Erinfolami et al (2011)
bull Majority started at age 14 years or below
bull Dangers -insomnia nausea tooth discolourationcarcinogenic potential for development of oral cancer
Areca Nut Chewing Habitbull Areca nut is the seed of areca palm
bull Widely grown- Asia India Bangladesh Japan
bull Believed to help fatigue
bull Highest period of risk for first use is between 5 and 12 Farrand et al 2001
74 4-16 age group in Karachi indulged in the habit (Shah et al 2002)
Dangers Oral sub mucous fibrosis
bull Risk of oral cancer 99 times( Wollina et al 2004 ) Foreign body aspiration Severe tooth wear -- sensitivity root fractures
Mandibular arch with generalized staining in the deciduous dentition
Prajapati D Nayak R Nayak UA Shah PJ Areca nut chewing habit in preschoolers Two rare case reports and literature review Int J Dent Health Concern 201511-5 (Permission given)
Mandibular arch with generalized staining in the deciduous dentition
Prajapati D Nayak R Nayak UA Shah PJ Areca nut chewing habit in preschoolers Two rare case reports and literature review Int J Dent Health Concern 201511-5 (Permission given)
Oral tobacco use and cigar smoking
bull High prevalence tobacco use in any form is reported among school going adolescents aged 13ndash15 years in India (Arora and Reddy 2005) Smoking Chutta is relatively popular may begin in childhood in India
bull Acts as a stimulant euphoric
bull May sleep with tobacco mixture in mouth
Harmful effects halitosis brown black staining gingival recession if wad is held against gingivaleucoplakia oral squamous cell carcinoma
Tobacco use in children
PRACTICES RELATED TO PUBERTY AND GROOMING
Tooth filing tooth sharpening
Practiced -Nigeria Niger-Delta area (Ukeghesonand Akadiri ) Democratic Republic of Congo Thailand Indonesia
bull Perception Historically -spiritual reasons Contemporary times - aesthetic reasons
bull In Nigeria maxillary midline diastema is regarded as a symbol of beauty (Arigbede and Adesuwa 2012
bull Teeth filed- because represent negative emotions eg anger jealousy (Balinese Indonesia)
30 respondents would not mind having artificially created diastema (Omotosho and Kadri (2010)
Practices
bull Done in adolescence - fashionable
bull Manually done Usually incisors
Harmful effects
bull pain during process
bull Tooth discolouration (teeth -non vital)
bull Infection -pus discharge lip swelling
Tooth filing
Peri-apical x-ray of lower central incisor
Lacquering and staining of teethPerformed in Vietnam Laos Thailand Indonesia and Philippines
Perception For cosmetic reasons
bull Main ingredient dye dark-brown solution of ferric acetate called kanemizu (iron filings in vinegar)
bull Coating the teeth with this liquid helped to prevent tooth decay and enamel decay
bull Practice has slowly declined
Traditional gingival tattooinglips bull Practiced in Africarsquos Sahel region Woddebe
Fulani tribe Senegal Ethiopia middle eastern countries
Perception Reason aesthetic appeal superstition
bull Practices Done when females reach puberty
bull Kanuri females Borno State Nigeria tattooing lip gingiva usually performed thorns of Balanites aegyptiaca (Bukar et al 2004 )
bull Pigments -Mixture charcoal and seeds of Acacia nilotica vartomentosa
Lip plug lip plate
bull The lip plate (lip plug or lip disc) form of body modification
bull Amazonian tribes young males traditionally -rite of passage indicate status and prestige
bull Mursi of Ethiopia girls age 13 to 18
bull At puberty mother cuts her lower lip
bull Held open by a wooden plug - inserted into thereby stretching the lip
bull At times -combined with removal of two or four lower anterior incisal teeth
Lip plug lip plate
TRADITIONAL DENTAL SERVICES
bull Perceptions
Cause of illness determines treatment taken Practices
bull Yoruba community patronize traditional dentists (Oke Bankole et al 2011) Edo state
bull Services rendered include worm extraction tooth extraction drug prescription and offering sacrifices to deities
bull Charges based on the worm count
Northern Nigeria called Serdia Toothache associated with dandruff
Cameroon traditional healers perform atraumatic tooth extraction Agbor et al (2011)
bull Leaves stems of Dichrocephala integrifolia
bull Tooth pulled out fingerssharp instrument
bull No pain Plant has anaesthetic properties
bull Dangers infection sepsis infection with hepatitis B Human Immunodeficiency Virus
bull Jewish Unlikely keep Friday appointment with the dentist for their children
bull Routine appointments on Fridays avoided (Scambler et al )
The traditional healer harvesting the medicinal plant in Cameroon
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J Ethnobiol Ethnomed 2011 715
Tooth extraction by a traditional dentist
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J EthnobiolEthnomed 2011 715
bull Health is a consequence of an individualrsquos lifestyle
bull Essential to Identify cultural factors that are harmful and those that are beneficial
bull As paediatric dentists we should discourage the unhealthy practices through rigorous health education and promote the adoption of healthy practices
bull Need for multicentric research on the cultural influence of the family and peers regarding oral health of children
bull Bankole OO Lawal FB Ibiyemi O (2017) Dispelling myths associated with natalneonatal teeth ldquoAdunnirdquo a health education video in a native Nigerian language Annals of Ibadan Postgraduate Medicine15(2)137-141
Thank you for listening
TEETHINGbull Eruption of teeth -important milestone
bull Myriads of symptoms are erroneously linked to the teething process ( Adam and Abhulimhen-Iyoha (2015)
bull Passive immunity decreases
bull Children exposed to a wide variety of illnesses
bull Danger is that mothers may not seek medical consultation for some childhood illnesses (Igeand Olubukola 2013 )
bull May lead to increased child mortality
Perceived Teething SymptomsSymptoms Egypt
El-gilany
and Abusaad
(2017)
Sudan
Awadkamil
(2012)
Kenya
James et
al 2015
Nigeria
Bankole et al
(2017)
Fever 832 866 764 692
Diarrhea 51 833 739 807
Boils 644
Weight loss 473
Cough 608
Vomiting 147
Conjunctivitis 201
Practices Teething Remedies Remedies Opeoduand Denloye2014
Kenya (James et al 2015
Bankole et al 2017)
Analgesics 634 677
Teething powder
syrup
435 655 420313
Antibiotic 142
Sedatives 46
Traditional
Concoction herbs
15 481
Teething soap etc 750
Other Folk RemediesSource httpswwwlifelovelizcom20150108traditional-
teething-remedies-around-world
Caribbean Hang raw egg over where baby sleeps
India Ayurvedic Remedy with cloves
Chinese Traditional Chinese Medicine (TCM) Acupuncture Acupressure
Japanese Wooden Teething Ring
France Sophie the giraffe - teething toy
Baltic Amber Teething Necklace Dangers strangulation aspiration beads
German Zwieback Toast
bull Acupressure
bull Massaging two important acupoints called the ldquotwo gatesrdquo or Large Intestine 4 (Li 4) and Liver 3 (Liv 3) can ease babyrsquos teething pain
bull It is simple effective and easy to do anywhere
bull Shonishin ndashJapanese needleless therapybull Source www bonnchirocomshonishin-needle-less-acupuncture-for-infants-and-
toddlers
Health education to the nurses and Community health officers at Ibadan Nigeria
Photoposter
Educational tool (In collaboration with WHO) In English and 3 major Nigerian languages
bull Effectiveness tested (Bankole et al 2005)
bull More effective as instructional tool in interactive atmosphere than just pasted on walls
TIMING OF ERUPTION Natalneonatal teeth
Associated with erroneous cultural beliefs among community nurses and
traditional birth attendants (TBA)
Britain ndashHeroes
China ndashBearers of misfortune
Natal tooth
Perceptions regarding natalneonatal teeth in infants
Traditional birth
attendaants
Bankole et al
(2013
Igbo Ora
Community
Unpublished
PERCEIVED CAUSES
Evil spirits evil child Abiku 319 487
Mothers contravened taboos 92 35
Prolonged maternal gestation 49
EFFECT ON THE FAMILY
Curse 74 106
Abomination 245 360
Embarrassment 11 360
Practices regarding natalneonatal teeth
Traditional birth
attendants
Bankole et al 2003)
Practices
Immediate extraction
Spiritual cleansing
356 Pain infection HIV
hepatitis B tetanus
Get rid of child 49 Infanticide
EFFECT ON CHILD
Strange odd behavior 313 Stigmatization
Evil spiritual powers 411 Stigmatization
Mental retardation
dull
31
With Traditional Birth Attendants at Ibadan South East Local government area
REVERSAL OF ERUPTION SEQUENCE
bull African ethnographies - infants whose upper teeth erupt before their lower teeth have been killed because of such ldquodevelopmental anomaliesrdquo
bull Considered a bad omen and sign of misfortune among Hamar Ethiopia Benin Rebublic
bull Reversal of eruption sequence of primary incisors in infants in Yoruba community has led to unpleasant circumstances
Reversal of eruption sequence
Reversal of eruption sequence
TraditionalBirth Attendants
Bankole and Lawal (2018)
PERCEIVED CAUSES
Evil spirits 218 476
Contravening taboos 80 26
EFFECT ON THE FAMILY
Curse 135 214Abomination 276 218
Embarrassment 233 114
Practices regarding reversal of eruption sequence of the anterior primary teeth
Practices Bankole and
Lawal(2018 )Effect
Immediate extraction 337 Pain infection HJV
hepatitis B infection
tetanus
HideGet rid of child 613 Infanticide
EFFECT ON CHILD
Strange behavior 227 Stigmatization
Evil powers 417 Stigmatization
Mental retardation 25
Dr Bankole and Dr Lawal with the Traditional Birth Attendants at the Ibadan South West LGA
DIETDental caries has escalated in developing countries
bull Misconception Food and drinks refined processed or modern is best and associated with affluence (Aderinokun et al 2011)
bull Parents donrsquot want their children to be deprived of what they lacked when young
bull This has led to a cultural shift in diet
bull Some African American believe motherrsquos diet during pregnancy cause dental caries in the child
bull Somali refugees Hutterites and Latino immigrant caregivers believed genetics plays a role in development early childhood caries (Prowse 2014)
Practices
bull YorubaHausa community common snacks have assumed local flavours several shapes coloursof sweets sold
bull Natural foods fruits are being sweetened Oke Bankole et al 2011 )
bull Nomadic Fulani sugary diet in between their meals sweetened drinks in bottles Sippy cups (827) and (716) give pacifiers dipped in sweet liquids Reduce temper tantrums with sweets Bankole et al 2015
Infant feeding practices
bull Babies with sweetened drinks in bottles pacifiers dipped in sweet liquidsputting infant to bed with a bottle of sweetened liquid Reported among Mexican Americans and Puerto Ricans Hong Kong Saudi mothers Al-Zahrani et al 2014
bull High risk factors contributing development of early childhood caries in infants
Diet
bull Perception
Animals such as pig are unclean
bull Practices
bull Hindus donrsquot eat beef Muslims donrsquot eat pork
bull Protective prevent taeniasis cystecercosis -edematous oral ulcers gingival bleeding lesions mimicking mucocles in children
(Alves et al 2011)
Dental Fluorosis bull In East and central African countries (tribal
areas of Tanzania Magadi a fluoride rich tronaused in cooking
bull Used as a tenderizer and preservative
bull High Fluoride Concentration 7900 ppm
bull Magadi use may suggest high prevalence of fluorosis in northern Tanzania (Kaseva 2006)
Oral Hygiene
Perceptions among mothers
bull Hausa Fulani- 142 - babyrsquos mouth should be cleaned before teeth erupt
bull Yoruba- Babyrsquos mouthtongue cleaned before teeth erupt to prevent thrush
bull Hausa Fulani- 635 - commencement tooth cleaning between 6 and 12 months of age (Bankole et al 2017)
bull Yoruba- chewing sticks should not be used at night Causes premature death of mother (Oke et al 2011)
Practices
Hausa Fulani- 594 cleaned infants teeth once daily
- 614 children start cleaning their teeth unsupervised before the age of six years
- 751 of supervision was carried out by the grandparents
- Sudan -343 mothers donrsquot clean childrenrsquos teeth below the age of 2 years (Abduljalil et al 2016)
-Hausa - mothers start cleaning childrenrsquos teeth when enough teeth to justify effort (Oke et al 2011)
Oral hygiene practices
Cleaning materials used in infancyearly childhood
CommunityTribe
GlycerinFresh tomato Hydrogen peroxideAluminum sulphateVerona Amygdalina (bitter leaf)Iyere (African black pepper)Alligator pepperCitrus lime Combinations
Yoruba - Nigeria (Aderinokun 2000)
Alum (Aluminum sulphate) Bitter leaf (Verona Amygdalina)
Iyere (African black pepper)
Citrus lime Alligator pepper
Oral hygiene practices
Tooth Cleaning materials
CommunityTribe Side effect
Salt and cotton wool
Hausa (Oke et al 2011)
Finger Nomadic Fulani
Wooden twigSalvadora persiccatwig (miswak) Neem tree Chewing stick
Nomadic Fulani ( Bankole et al 2017)
Somali
India (Kochar et al 2014)
Yoruba Senegal (Diouf 2013)
Improper use ndashgingival trauma
round ceramics omadic ulani
brasion sensiti it
and omadic ulani
shes ood charcoal
Somali (Beveridge
India Senegal
Tooth Cleaning materials
CommunityTribe Side effect
Ground ceramics Nomadic Fulani Tooth abrasion
Sand Nomadic Fulani
AshesWood
Charcoal
Somali India Senegal
Tooth abrasion
IMPORTANCE OF THE PRIMARY DENTITION IN CHILDREN
bull Primary teeth in children are sometimes not regarded as important
bull Mothers of preschool children in Mumbai -436 believed 192 were uncertain that there is no need to visit a dentist for treating milk teeth as they will soon fall off (Jain et al 2014)
COMMON DENTAL DISEASES
Dental Caries
bull Early childhood caries is a significant public health problem caries affecting children globally
bull In recent years in developing countries like Sub-Saharan Africa the prevalence is predicted to increase
bull Early childhood caries is largely untreated in a study in South Africa reported a caries prevalence of 716 and these 675 were untreated (Mohammed and Barnes 2018 )
Dental caries Perceived cause of dental
caries
Community tribe
Worms (resembling
maggots)
Borom bop (master of the
head)
Lagatas
Smaller version of pubu
Worms -removed from
ears
Yoruba Nomadic Fulani
Chinese (Dong et al 2007)
Senegalese ( Diouf et al 2003)
Brazil
Papua New Guinea
Indian (Nagaraj et al2014)
Dental caries -Care remedies Dental care remedies Community tribe Effect
Hydrochloric acid (Wet cell
battery liquid)
Aluminum Phosphate
(Alum)
Tobacco snuff
Charcoal and salt
Gentian violet
Atare (Alligator Pepper)
Yoruba Brazil
Kenya (Mulu Maryanne)
Yoruba (Oke et al 2011)
Chemical burns
mucosal ulceration
Erosion
Tetracycline capsule (topical)
Paracetamol (topical)
Hausa Nomadic Fulani
Hausa
Greyish brown tooth
discolouration
Mucosal ulceration
Traditional concoction
Dental are remedies Dental care remedies Community
tribe
Effect
White wineVinegar Powdered alum musk and frankincense
Chinese (Dong et al 2007)
Herbs traditional medicine
Aborigines (Wong 2005)
Nettles
Hot sweet potato
Wads hot leaves ginger
Residue smoking pipe
White sap of shrub used
to kill maggots
Insecticide ointment
Papua New
Guinea
Predisposition to
oral cancer
Toxic
Dental care remedies Dental care remedies Community Effect
Cooked meat
salt alcohol grease
deodorant
Iran
fingernail polish remover
black tar
Garlic Warm coconut milk
Brazil Toxic
Kawakawa Māori(Pepper Tree
Leaves) chewed
Harakeke -Korari Flax
the gum used for toothache
Maori
GingivitisPeriodontal disease
Perceptions
bull Bleeding gums caused by
bull Child stores food in pouch of mouth and does not clean teeth
Remedies for gingival periodontal disease
Remedies Community tribe
Effect
Aluminium phosphate (Alum ) + Lapalapa sap (Jatropha curcas)Warm water and salt Tomato and alum+polystrene foam or cotton woolHydrogen peroxide
Yoruba
Antibiotics NomadiFulani
Resistant strains Hyper sensitivityreactions
Herbs
ORAL HABITS Kola nut chewing
Common West Central Africa Symbol of hospitality Contains caffeine tannin
bull Helps students keep awakewithstand fatigue
Practices
bull One-year prevalence student use was 291 Erinfolami et al (2011)
bull Majority started at age 14 years or below
bull Dangers -insomnia nausea tooth discolourationcarcinogenic potential for development of oral cancer
Areca Nut Chewing Habitbull Areca nut is the seed of areca palm
bull Widely grown- Asia India Bangladesh Japan
bull Believed to help fatigue
bull Highest period of risk for first use is between 5 and 12 Farrand et al 2001
74 4-16 age group in Karachi indulged in the habit (Shah et al 2002)
Dangers Oral sub mucous fibrosis
bull Risk of oral cancer 99 times( Wollina et al 2004 ) Foreign body aspiration Severe tooth wear -- sensitivity root fractures
Mandibular arch with generalized staining in the deciduous dentition
Prajapati D Nayak R Nayak UA Shah PJ Areca nut chewing habit in preschoolers Two rare case reports and literature review Int J Dent Health Concern 201511-5 (Permission given)
Mandibular arch with generalized staining in the deciduous dentition
Prajapati D Nayak R Nayak UA Shah PJ Areca nut chewing habit in preschoolers Two rare case reports and literature review Int J Dent Health Concern 201511-5 (Permission given)
Oral tobacco use and cigar smoking
bull High prevalence tobacco use in any form is reported among school going adolescents aged 13ndash15 years in India (Arora and Reddy 2005) Smoking Chutta is relatively popular may begin in childhood in India
bull Acts as a stimulant euphoric
bull May sleep with tobacco mixture in mouth
Harmful effects halitosis brown black staining gingival recession if wad is held against gingivaleucoplakia oral squamous cell carcinoma
Tobacco use in children
PRACTICES RELATED TO PUBERTY AND GROOMING
Tooth filing tooth sharpening
Practiced -Nigeria Niger-Delta area (Ukeghesonand Akadiri ) Democratic Republic of Congo Thailand Indonesia
bull Perception Historically -spiritual reasons Contemporary times - aesthetic reasons
bull In Nigeria maxillary midline diastema is regarded as a symbol of beauty (Arigbede and Adesuwa 2012
bull Teeth filed- because represent negative emotions eg anger jealousy (Balinese Indonesia)
30 respondents would not mind having artificially created diastema (Omotosho and Kadri (2010)
Practices
bull Done in adolescence - fashionable
bull Manually done Usually incisors
Harmful effects
bull pain during process
bull Tooth discolouration (teeth -non vital)
bull Infection -pus discharge lip swelling
Tooth filing
Peri-apical x-ray of lower central incisor
Lacquering and staining of teethPerformed in Vietnam Laos Thailand Indonesia and Philippines
Perception For cosmetic reasons
bull Main ingredient dye dark-brown solution of ferric acetate called kanemizu (iron filings in vinegar)
bull Coating the teeth with this liquid helped to prevent tooth decay and enamel decay
bull Practice has slowly declined
Traditional gingival tattooinglips bull Practiced in Africarsquos Sahel region Woddebe
Fulani tribe Senegal Ethiopia middle eastern countries
Perception Reason aesthetic appeal superstition
bull Practices Done when females reach puberty
bull Kanuri females Borno State Nigeria tattooing lip gingiva usually performed thorns of Balanites aegyptiaca (Bukar et al 2004 )
bull Pigments -Mixture charcoal and seeds of Acacia nilotica vartomentosa
Lip plug lip plate
bull The lip plate (lip plug or lip disc) form of body modification
bull Amazonian tribes young males traditionally -rite of passage indicate status and prestige
bull Mursi of Ethiopia girls age 13 to 18
bull At puberty mother cuts her lower lip
bull Held open by a wooden plug - inserted into thereby stretching the lip
bull At times -combined with removal of two or four lower anterior incisal teeth
Lip plug lip plate
TRADITIONAL DENTAL SERVICES
bull Perceptions
Cause of illness determines treatment taken Practices
bull Yoruba community patronize traditional dentists (Oke Bankole et al 2011) Edo state
bull Services rendered include worm extraction tooth extraction drug prescription and offering sacrifices to deities
bull Charges based on the worm count
Northern Nigeria called Serdia Toothache associated with dandruff
Cameroon traditional healers perform atraumatic tooth extraction Agbor et al (2011)
bull Leaves stems of Dichrocephala integrifolia
bull Tooth pulled out fingerssharp instrument
bull No pain Plant has anaesthetic properties
bull Dangers infection sepsis infection with hepatitis B Human Immunodeficiency Virus
bull Jewish Unlikely keep Friday appointment with the dentist for their children
bull Routine appointments on Fridays avoided (Scambler et al )
The traditional healer harvesting the medicinal plant in Cameroon
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J Ethnobiol Ethnomed 2011 715
Tooth extraction by a traditional dentist
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J EthnobiolEthnomed 2011 715
bull Health is a consequence of an individualrsquos lifestyle
bull Essential to Identify cultural factors that are harmful and those that are beneficial
bull As paediatric dentists we should discourage the unhealthy practices through rigorous health education and promote the adoption of healthy practices
bull Need for multicentric research on the cultural influence of the family and peers regarding oral health of children
bull Bankole OO Lawal FB Ibiyemi O (2017) Dispelling myths associated with natalneonatal teeth ldquoAdunnirdquo a health education video in a native Nigerian language Annals of Ibadan Postgraduate Medicine15(2)137-141
Thank you for listening
Perceived Teething SymptomsSymptoms Egypt
El-gilany
and Abusaad
(2017)
Sudan
Awadkamil
(2012)
Kenya
James et
al 2015
Nigeria
Bankole et al
(2017)
Fever 832 866 764 692
Diarrhea 51 833 739 807
Boils 644
Weight loss 473
Cough 608
Vomiting 147
Conjunctivitis 201
Practices Teething Remedies Remedies Opeoduand Denloye2014
Kenya (James et al 2015
Bankole et al 2017)
Analgesics 634 677
Teething powder
syrup
435 655 420313
Antibiotic 142
Sedatives 46
Traditional
Concoction herbs
15 481
Teething soap etc 750
Other Folk RemediesSource httpswwwlifelovelizcom20150108traditional-
teething-remedies-around-world
Caribbean Hang raw egg over where baby sleeps
India Ayurvedic Remedy with cloves
Chinese Traditional Chinese Medicine (TCM) Acupuncture Acupressure
Japanese Wooden Teething Ring
France Sophie the giraffe - teething toy
Baltic Amber Teething Necklace Dangers strangulation aspiration beads
German Zwieback Toast
bull Acupressure
bull Massaging two important acupoints called the ldquotwo gatesrdquo or Large Intestine 4 (Li 4) and Liver 3 (Liv 3) can ease babyrsquos teething pain
bull It is simple effective and easy to do anywhere
bull Shonishin ndashJapanese needleless therapybull Source www bonnchirocomshonishin-needle-less-acupuncture-for-infants-and-
toddlers
Health education to the nurses and Community health officers at Ibadan Nigeria
Photoposter
Educational tool (In collaboration with WHO) In English and 3 major Nigerian languages
bull Effectiveness tested (Bankole et al 2005)
bull More effective as instructional tool in interactive atmosphere than just pasted on walls
TIMING OF ERUPTION Natalneonatal teeth
Associated with erroneous cultural beliefs among community nurses and
traditional birth attendants (TBA)
Britain ndashHeroes
China ndashBearers of misfortune
Natal tooth
Perceptions regarding natalneonatal teeth in infants
Traditional birth
attendaants
Bankole et al
(2013
Igbo Ora
Community
Unpublished
PERCEIVED CAUSES
Evil spirits evil child Abiku 319 487
Mothers contravened taboos 92 35
Prolonged maternal gestation 49
EFFECT ON THE FAMILY
Curse 74 106
Abomination 245 360
Embarrassment 11 360
Practices regarding natalneonatal teeth
Traditional birth
attendants
Bankole et al 2003)
Practices
Immediate extraction
Spiritual cleansing
356 Pain infection HIV
hepatitis B tetanus
Get rid of child 49 Infanticide
EFFECT ON CHILD
Strange odd behavior 313 Stigmatization
Evil spiritual powers 411 Stigmatization
Mental retardation
dull
31
With Traditional Birth Attendants at Ibadan South East Local government area
REVERSAL OF ERUPTION SEQUENCE
bull African ethnographies - infants whose upper teeth erupt before their lower teeth have been killed because of such ldquodevelopmental anomaliesrdquo
bull Considered a bad omen and sign of misfortune among Hamar Ethiopia Benin Rebublic
bull Reversal of eruption sequence of primary incisors in infants in Yoruba community has led to unpleasant circumstances
Reversal of eruption sequence
Reversal of eruption sequence
TraditionalBirth Attendants
Bankole and Lawal (2018)
PERCEIVED CAUSES
Evil spirits 218 476
Contravening taboos 80 26
EFFECT ON THE FAMILY
Curse 135 214Abomination 276 218
Embarrassment 233 114
Practices regarding reversal of eruption sequence of the anterior primary teeth
Practices Bankole and
Lawal(2018 )Effect
Immediate extraction 337 Pain infection HJV
hepatitis B infection
tetanus
HideGet rid of child 613 Infanticide
EFFECT ON CHILD
Strange behavior 227 Stigmatization
Evil powers 417 Stigmatization
Mental retardation 25
Dr Bankole and Dr Lawal with the Traditional Birth Attendants at the Ibadan South West LGA
DIETDental caries has escalated in developing countries
bull Misconception Food and drinks refined processed or modern is best and associated with affluence (Aderinokun et al 2011)
bull Parents donrsquot want their children to be deprived of what they lacked when young
bull This has led to a cultural shift in diet
bull Some African American believe motherrsquos diet during pregnancy cause dental caries in the child
bull Somali refugees Hutterites and Latino immigrant caregivers believed genetics plays a role in development early childhood caries (Prowse 2014)
Practices
bull YorubaHausa community common snacks have assumed local flavours several shapes coloursof sweets sold
bull Natural foods fruits are being sweetened Oke Bankole et al 2011 )
bull Nomadic Fulani sugary diet in between their meals sweetened drinks in bottles Sippy cups (827) and (716) give pacifiers dipped in sweet liquids Reduce temper tantrums with sweets Bankole et al 2015
Infant feeding practices
bull Babies with sweetened drinks in bottles pacifiers dipped in sweet liquidsputting infant to bed with a bottle of sweetened liquid Reported among Mexican Americans and Puerto Ricans Hong Kong Saudi mothers Al-Zahrani et al 2014
bull High risk factors contributing development of early childhood caries in infants
Diet
bull Perception
Animals such as pig are unclean
bull Practices
bull Hindus donrsquot eat beef Muslims donrsquot eat pork
bull Protective prevent taeniasis cystecercosis -edematous oral ulcers gingival bleeding lesions mimicking mucocles in children
(Alves et al 2011)
Dental Fluorosis bull In East and central African countries (tribal
areas of Tanzania Magadi a fluoride rich tronaused in cooking
bull Used as a tenderizer and preservative
bull High Fluoride Concentration 7900 ppm
bull Magadi use may suggest high prevalence of fluorosis in northern Tanzania (Kaseva 2006)
Oral Hygiene
Perceptions among mothers
bull Hausa Fulani- 142 - babyrsquos mouth should be cleaned before teeth erupt
bull Yoruba- Babyrsquos mouthtongue cleaned before teeth erupt to prevent thrush
bull Hausa Fulani- 635 - commencement tooth cleaning between 6 and 12 months of age (Bankole et al 2017)
bull Yoruba- chewing sticks should not be used at night Causes premature death of mother (Oke et al 2011)
Practices
Hausa Fulani- 594 cleaned infants teeth once daily
- 614 children start cleaning their teeth unsupervised before the age of six years
- 751 of supervision was carried out by the grandparents
- Sudan -343 mothers donrsquot clean childrenrsquos teeth below the age of 2 years (Abduljalil et al 2016)
-Hausa - mothers start cleaning childrenrsquos teeth when enough teeth to justify effort (Oke et al 2011)
Oral hygiene practices
Cleaning materials used in infancyearly childhood
CommunityTribe
GlycerinFresh tomato Hydrogen peroxideAluminum sulphateVerona Amygdalina (bitter leaf)Iyere (African black pepper)Alligator pepperCitrus lime Combinations
Yoruba - Nigeria (Aderinokun 2000)
Alum (Aluminum sulphate) Bitter leaf (Verona Amygdalina)
Iyere (African black pepper)
Citrus lime Alligator pepper
Oral hygiene practices
Tooth Cleaning materials
CommunityTribe Side effect
Salt and cotton wool
Hausa (Oke et al 2011)
Finger Nomadic Fulani
Wooden twigSalvadora persiccatwig (miswak) Neem tree Chewing stick
Nomadic Fulani ( Bankole et al 2017)
Somali
India (Kochar et al 2014)
Yoruba Senegal (Diouf 2013)
Improper use ndashgingival trauma
round ceramics omadic ulani
brasion sensiti it
and omadic ulani
shes ood charcoal
Somali (Beveridge
India Senegal
Tooth Cleaning materials
CommunityTribe Side effect
Ground ceramics Nomadic Fulani Tooth abrasion
Sand Nomadic Fulani
AshesWood
Charcoal
Somali India Senegal
Tooth abrasion
IMPORTANCE OF THE PRIMARY DENTITION IN CHILDREN
bull Primary teeth in children are sometimes not regarded as important
bull Mothers of preschool children in Mumbai -436 believed 192 were uncertain that there is no need to visit a dentist for treating milk teeth as they will soon fall off (Jain et al 2014)
COMMON DENTAL DISEASES
Dental Caries
bull Early childhood caries is a significant public health problem caries affecting children globally
bull In recent years in developing countries like Sub-Saharan Africa the prevalence is predicted to increase
bull Early childhood caries is largely untreated in a study in South Africa reported a caries prevalence of 716 and these 675 were untreated (Mohammed and Barnes 2018 )
Dental caries Perceived cause of dental
caries
Community tribe
Worms (resembling
maggots)
Borom bop (master of the
head)
Lagatas
Smaller version of pubu
Worms -removed from
ears
Yoruba Nomadic Fulani
Chinese (Dong et al 2007)
Senegalese ( Diouf et al 2003)
Brazil
Papua New Guinea
Indian (Nagaraj et al2014)
Dental caries -Care remedies Dental care remedies Community tribe Effect
Hydrochloric acid (Wet cell
battery liquid)
Aluminum Phosphate
(Alum)
Tobacco snuff
Charcoal and salt
Gentian violet
Atare (Alligator Pepper)
Yoruba Brazil
Kenya (Mulu Maryanne)
Yoruba (Oke et al 2011)
Chemical burns
mucosal ulceration
Erosion
Tetracycline capsule (topical)
Paracetamol (topical)
Hausa Nomadic Fulani
Hausa
Greyish brown tooth
discolouration
Mucosal ulceration
Traditional concoction
Dental are remedies Dental care remedies Community
tribe
Effect
White wineVinegar Powdered alum musk and frankincense
Chinese (Dong et al 2007)
Herbs traditional medicine
Aborigines (Wong 2005)
Nettles
Hot sweet potato
Wads hot leaves ginger
Residue smoking pipe
White sap of shrub used
to kill maggots
Insecticide ointment
Papua New
Guinea
Predisposition to
oral cancer
Toxic
Dental care remedies Dental care remedies Community Effect
Cooked meat
salt alcohol grease
deodorant
Iran
fingernail polish remover
black tar
Garlic Warm coconut milk
Brazil Toxic
Kawakawa Māori(Pepper Tree
Leaves) chewed
Harakeke -Korari Flax
the gum used for toothache
Maori
GingivitisPeriodontal disease
Perceptions
bull Bleeding gums caused by
bull Child stores food in pouch of mouth and does not clean teeth
Remedies for gingival periodontal disease
Remedies Community tribe
Effect
Aluminium phosphate (Alum ) + Lapalapa sap (Jatropha curcas)Warm water and salt Tomato and alum+polystrene foam or cotton woolHydrogen peroxide
Yoruba
Antibiotics NomadiFulani
Resistant strains Hyper sensitivityreactions
Herbs
ORAL HABITS Kola nut chewing
Common West Central Africa Symbol of hospitality Contains caffeine tannin
bull Helps students keep awakewithstand fatigue
Practices
bull One-year prevalence student use was 291 Erinfolami et al (2011)
bull Majority started at age 14 years or below
bull Dangers -insomnia nausea tooth discolourationcarcinogenic potential for development of oral cancer
Areca Nut Chewing Habitbull Areca nut is the seed of areca palm
bull Widely grown- Asia India Bangladesh Japan
bull Believed to help fatigue
bull Highest period of risk for first use is between 5 and 12 Farrand et al 2001
74 4-16 age group in Karachi indulged in the habit (Shah et al 2002)
Dangers Oral sub mucous fibrosis
bull Risk of oral cancer 99 times( Wollina et al 2004 ) Foreign body aspiration Severe tooth wear -- sensitivity root fractures
Mandibular arch with generalized staining in the deciduous dentition
Prajapati D Nayak R Nayak UA Shah PJ Areca nut chewing habit in preschoolers Two rare case reports and literature review Int J Dent Health Concern 201511-5 (Permission given)
Mandibular arch with generalized staining in the deciduous dentition
Prajapati D Nayak R Nayak UA Shah PJ Areca nut chewing habit in preschoolers Two rare case reports and literature review Int J Dent Health Concern 201511-5 (Permission given)
Oral tobacco use and cigar smoking
bull High prevalence tobacco use in any form is reported among school going adolescents aged 13ndash15 years in India (Arora and Reddy 2005) Smoking Chutta is relatively popular may begin in childhood in India
bull Acts as a stimulant euphoric
bull May sleep with tobacco mixture in mouth
Harmful effects halitosis brown black staining gingival recession if wad is held against gingivaleucoplakia oral squamous cell carcinoma
Tobacco use in children
PRACTICES RELATED TO PUBERTY AND GROOMING
Tooth filing tooth sharpening
Practiced -Nigeria Niger-Delta area (Ukeghesonand Akadiri ) Democratic Republic of Congo Thailand Indonesia
bull Perception Historically -spiritual reasons Contemporary times - aesthetic reasons
bull In Nigeria maxillary midline diastema is regarded as a symbol of beauty (Arigbede and Adesuwa 2012
bull Teeth filed- because represent negative emotions eg anger jealousy (Balinese Indonesia)
30 respondents would not mind having artificially created diastema (Omotosho and Kadri (2010)
Practices
bull Done in adolescence - fashionable
bull Manually done Usually incisors
Harmful effects
bull pain during process
bull Tooth discolouration (teeth -non vital)
bull Infection -pus discharge lip swelling
Tooth filing
Peri-apical x-ray of lower central incisor
Lacquering and staining of teethPerformed in Vietnam Laos Thailand Indonesia and Philippines
Perception For cosmetic reasons
bull Main ingredient dye dark-brown solution of ferric acetate called kanemizu (iron filings in vinegar)
bull Coating the teeth with this liquid helped to prevent tooth decay and enamel decay
bull Practice has slowly declined
Traditional gingival tattooinglips bull Practiced in Africarsquos Sahel region Woddebe
Fulani tribe Senegal Ethiopia middle eastern countries
Perception Reason aesthetic appeal superstition
bull Practices Done when females reach puberty
bull Kanuri females Borno State Nigeria tattooing lip gingiva usually performed thorns of Balanites aegyptiaca (Bukar et al 2004 )
bull Pigments -Mixture charcoal and seeds of Acacia nilotica vartomentosa
Lip plug lip plate
bull The lip plate (lip plug or lip disc) form of body modification
bull Amazonian tribes young males traditionally -rite of passage indicate status and prestige
bull Mursi of Ethiopia girls age 13 to 18
bull At puberty mother cuts her lower lip
bull Held open by a wooden plug - inserted into thereby stretching the lip
bull At times -combined with removal of two or four lower anterior incisal teeth
Lip plug lip plate
TRADITIONAL DENTAL SERVICES
bull Perceptions
Cause of illness determines treatment taken Practices
bull Yoruba community patronize traditional dentists (Oke Bankole et al 2011) Edo state
bull Services rendered include worm extraction tooth extraction drug prescription and offering sacrifices to deities
bull Charges based on the worm count
Northern Nigeria called Serdia Toothache associated with dandruff
Cameroon traditional healers perform atraumatic tooth extraction Agbor et al (2011)
bull Leaves stems of Dichrocephala integrifolia
bull Tooth pulled out fingerssharp instrument
bull No pain Plant has anaesthetic properties
bull Dangers infection sepsis infection with hepatitis B Human Immunodeficiency Virus
bull Jewish Unlikely keep Friday appointment with the dentist for their children
bull Routine appointments on Fridays avoided (Scambler et al )
The traditional healer harvesting the medicinal plant in Cameroon
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J Ethnobiol Ethnomed 2011 715
Tooth extraction by a traditional dentist
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J EthnobiolEthnomed 2011 715
bull Health is a consequence of an individualrsquos lifestyle
bull Essential to Identify cultural factors that are harmful and those that are beneficial
bull As paediatric dentists we should discourage the unhealthy practices through rigorous health education and promote the adoption of healthy practices
bull Need for multicentric research on the cultural influence of the family and peers regarding oral health of children
bull Bankole OO Lawal FB Ibiyemi O (2017) Dispelling myths associated with natalneonatal teeth ldquoAdunnirdquo a health education video in a native Nigerian language Annals of Ibadan Postgraduate Medicine15(2)137-141
Thank you for listening
Practices Teething Remedies Remedies Opeoduand Denloye2014
Kenya (James et al 2015
Bankole et al 2017)
Analgesics 634 677
Teething powder
syrup
435 655 420313
Antibiotic 142
Sedatives 46
Traditional
Concoction herbs
15 481
Teething soap etc 750
Other Folk RemediesSource httpswwwlifelovelizcom20150108traditional-
teething-remedies-around-world
Caribbean Hang raw egg over where baby sleeps
India Ayurvedic Remedy with cloves
Chinese Traditional Chinese Medicine (TCM) Acupuncture Acupressure
Japanese Wooden Teething Ring
France Sophie the giraffe - teething toy
Baltic Amber Teething Necklace Dangers strangulation aspiration beads
German Zwieback Toast
bull Acupressure
bull Massaging two important acupoints called the ldquotwo gatesrdquo or Large Intestine 4 (Li 4) and Liver 3 (Liv 3) can ease babyrsquos teething pain
bull It is simple effective and easy to do anywhere
bull Shonishin ndashJapanese needleless therapybull Source www bonnchirocomshonishin-needle-less-acupuncture-for-infants-and-
toddlers
Health education to the nurses and Community health officers at Ibadan Nigeria
Photoposter
Educational tool (In collaboration with WHO) In English and 3 major Nigerian languages
bull Effectiveness tested (Bankole et al 2005)
bull More effective as instructional tool in interactive atmosphere than just pasted on walls
TIMING OF ERUPTION Natalneonatal teeth
Associated with erroneous cultural beliefs among community nurses and
traditional birth attendants (TBA)
Britain ndashHeroes
China ndashBearers of misfortune
Natal tooth
Perceptions regarding natalneonatal teeth in infants
Traditional birth
attendaants
Bankole et al
(2013
Igbo Ora
Community
Unpublished
PERCEIVED CAUSES
Evil spirits evil child Abiku 319 487
Mothers contravened taboos 92 35
Prolonged maternal gestation 49
EFFECT ON THE FAMILY
Curse 74 106
Abomination 245 360
Embarrassment 11 360
Practices regarding natalneonatal teeth
Traditional birth
attendants
Bankole et al 2003)
Practices
Immediate extraction
Spiritual cleansing
356 Pain infection HIV
hepatitis B tetanus
Get rid of child 49 Infanticide
EFFECT ON CHILD
Strange odd behavior 313 Stigmatization
Evil spiritual powers 411 Stigmatization
Mental retardation
dull
31
With Traditional Birth Attendants at Ibadan South East Local government area
REVERSAL OF ERUPTION SEQUENCE
bull African ethnographies - infants whose upper teeth erupt before their lower teeth have been killed because of such ldquodevelopmental anomaliesrdquo
bull Considered a bad omen and sign of misfortune among Hamar Ethiopia Benin Rebublic
bull Reversal of eruption sequence of primary incisors in infants in Yoruba community has led to unpleasant circumstances
Reversal of eruption sequence
Reversal of eruption sequence
TraditionalBirth Attendants
Bankole and Lawal (2018)
PERCEIVED CAUSES
Evil spirits 218 476
Contravening taboos 80 26
EFFECT ON THE FAMILY
Curse 135 214Abomination 276 218
Embarrassment 233 114
Practices regarding reversal of eruption sequence of the anterior primary teeth
Practices Bankole and
Lawal(2018 )Effect
Immediate extraction 337 Pain infection HJV
hepatitis B infection
tetanus
HideGet rid of child 613 Infanticide
EFFECT ON CHILD
Strange behavior 227 Stigmatization
Evil powers 417 Stigmatization
Mental retardation 25
Dr Bankole and Dr Lawal with the Traditional Birth Attendants at the Ibadan South West LGA
DIETDental caries has escalated in developing countries
bull Misconception Food and drinks refined processed or modern is best and associated with affluence (Aderinokun et al 2011)
bull Parents donrsquot want their children to be deprived of what they lacked when young
bull This has led to a cultural shift in diet
bull Some African American believe motherrsquos diet during pregnancy cause dental caries in the child
bull Somali refugees Hutterites and Latino immigrant caregivers believed genetics plays a role in development early childhood caries (Prowse 2014)
Practices
bull YorubaHausa community common snacks have assumed local flavours several shapes coloursof sweets sold
bull Natural foods fruits are being sweetened Oke Bankole et al 2011 )
bull Nomadic Fulani sugary diet in between their meals sweetened drinks in bottles Sippy cups (827) and (716) give pacifiers dipped in sweet liquids Reduce temper tantrums with sweets Bankole et al 2015
Infant feeding practices
bull Babies with sweetened drinks in bottles pacifiers dipped in sweet liquidsputting infant to bed with a bottle of sweetened liquid Reported among Mexican Americans and Puerto Ricans Hong Kong Saudi mothers Al-Zahrani et al 2014
bull High risk factors contributing development of early childhood caries in infants
Diet
bull Perception
Animals such as pig are unclean
bull Practices
bull Hindus donrsquot eat beef Muslims donrsquot eat pork
bull Protective prevent taeniasis cystecercosis -edematous oral ulcers gingival bleeding lesions mimicking mucocles in children
(Alves et al 2011)
Dental Fluorosis bull In East and central African countries (tribal
areas of Tanzania Magadi a fluoride rich tronaused in cooking
bull Used as a tenderizer and preservative
bull High Fluoride Concentration 7900 ppm
bull Magadi use may suggest high prevalence of fluorosis in northern Tanzania (Kaseva 2006)
Oral Hygiene
Perceptions among mothers
bull Hausa Fulani- 142 - babyrsquos mouth should be cleaned before teeth erupt
bull Yoruba- Babyrsquos mouthtongue cleaned before teeth erupt to prevent thrush
bull Hausa Fulani- 635 - commencement tooth cleaning between 6 and 12 months of age (Bankole et al 2017)
bull Yoruba- chewing sticks should not be used at night Causes premature death of mother (Oke et al 2011)
Practices
Hausa Fulani- 594 cleaned infants teeth once daily
- 614 children start cleaning their teeth unsupervised before the age of six years
- 751 of supervision was carried out by the grandparents
- Sudan -343 mothers donrsquot clean childrenrsquos teeth below the age of 2 years (Abduljalil et al 2016)
-Hausa - mothers start cleaning childrenrsquos teeth when enough teeth to justify effort (Oke et al 2011)
Oral hygiene practices
Cleaning materials used in infancyearly childhood
CommunityTribe
GlycerinFresh tomato Hydrogen peroxideAluminum sulphateVerona Amygdalina (bitter leaf)Iyere (African black pepper)Alligator pepperCitrus lime Combinations
Yoruba - Nigeria (Aderinokun 2000)
Alum (Aluminum sulphate) Bitter leaf (Verona Amygdalina)
Iyere (African black pepper)
Citrus lime Alligator pepper
Oral hygiene practices
Tooth Cleaning materials
CommunityTribe Side effect
Salt and cotton wool
Hausa (Oke et al 2011)
Finger Nomadic Fulani
Wooden twigSalvadora persiccatwig (miswak) Neem tree Chewing stick
Nomadic Fulani ( Bankole et al 2017)
Somali
India (Kochar et al 2014)
Yoruba Senegal (Diouf 2013)
Improper use ndashgingival trauma
round ceramics omadic ulani
brasion sensiti it
and omadic ulani
shes ood charcoal
Somali (Beveridge
India Senegal
Tooth Cleaning materials
CommunityTribe Side effect
Ground ceramics Nomadic Fulani Tooth abrasion
Sand Nomadic Fulani
AshesWood
Charcoal
Somali India Senegal
Tooth abrasion
IMPORTANCE OF THE PRIMARY DENTITION IN CHILDREN
bull Primary teeth in children are sometimes not regarded as important
bull Mothers of preschool children in Mumbai -436 believed 192 were uncertain that there is no need to visit a dentist for treating milk teeth as they will soon fall off (Jain et al 2014)
COMMON DENTAL DISEASES
Dental Caries
bull Early childhood caries is a significant public health problem caries affecting children globally
bull In recent years in developing countries like Sub-Saharan Africa the prevalence is predicted to increase
bull Early childhood caries is largely untreated in a study in South Africa reported a caries prevalence of 716 and these 675 were untreated (Mohammed and Barnes 2018 )
Dental caries Perceived cause of dental
caries
Community tribe
Worms (resembling
maggots)
Borom bop (master of the
head)
Lagatas
Smaller version of pubu
Worms -removed from
ears
Yoruba Nomadic Fulani
Chinese (Dong et al 2007)
Senegalese ( Diouf et al 2003)
Brazil
Papua New Guinea
Indian (Nagaraj et al2014)
Dental caries -Care remedies Dental care remedies Community tribe Effect
Hydrochloric acid (Wet cell
battery liquid)
Aluminum Phosphate
(Alum)
Tobacco snuff
Charcoal and salt
Gentian violet
Atare (Alligator Pepper)
Yoruba Brazil
Kenya (Mulu Maryanne)
Yoruba (Oke et al 2011)
Chemical burns
mucosal ulceration
Erosion
Tetracycline capsule (topical)
Paracetamol (topical)
Hausa Nomadic Fulani
Hausa
Greyish brown tooth
discolouration
Mucosal ulceration
Traditional concoction
Dental are remedies Dental care remedies Community
tribe
Effect
White wineVinegar Powdered alum musk and frankincense
Chinese (Dong et al 2007)
Herbs traditional medicine
Aborigines (Wong 2005)
Nettles
Hot sweet potato
Wads hot leaves ginger
Residue smoking pipe
White sap of shrub used
to kill maggots
Insecticide ointment
Papua New
Guinea
Predisposition to
oral cancer
Toxic
Dental care remedies Dental care remedies Community Effect
Cooked meat
salt alcohol grease
deodorant
Iran
fingernail polish remover
black tar
Garlic Warm coconut milk
Brazil Toxic
Kawakawa Māori(Pepper Tree
Leaves) chewed
Harakeke -Korari Flax
the gum used for toothache
Maori
GingivitisPeriodontal disease
Perceptions
bull Bleeding gums caused by
bull Child stores food in pouch of mouth and does not clean teeth
Remedies for gingival periodontal disease
Remedies Community tribe
Effect
Aluminium phosphate (Alum ) + Lapalapa sap (Jatropha curcas)Warm water and salt Tomato and alum+polystrene foam or cotton woolHydrogen peroxide
Yoruba
Antibiotics NomadiFulani
Resistant strains Hyper sensitivityreactions
Herbs
ORAL HABITS Kola nut chewing
Common West Central Africa Symbol of hospitality Contains caffeine tannin
bull Helps students keep awakewithstand fatigue
Practices
bull One-year prevalence student use was 291 Erinfolami et al (2011)
bull Majority started at age 14 years or below
bull Dangers -insomnia nausea tooth discolourationcarcinogenic potential for development of oral cancer
Areca Nut Chewing Habitbull Areca nut is the seed of areca palm
bull Widely grown- Asia India Bangladesh Japan
bull Believed to help fatigue
bull Highest period of risk for first use is between 5 and 12 Farrand et al 2001
74 4-16 age group in Karachi indulged in the habit (Shah et al 2002)
Dangers Oral sub mucous fibrosis
bull Risk of oral cancer 99 times( Wollina et al 2004 ) Foreign body aspiration Severe tooth wear -- sensitivity root fractures
Mandibular arch with generalized staining in the deciduous dentition
Prajapati D Nayak R Nayak UA Shah PJ Areca nut chewing habit in preschoolers Two rare case reports and literature review Int J Dent Health Concern 201511-5 (Permission given)
Mandibular arch with generalized staining in the deciduous dentition
Prajapati D Nayak R Nayak UA Shah PJ Areca nut chewing habit in preschoolers Two rare case reports and literature review Int J Dent Health Concern 201511-5 (Permission given)
Oral tobacco use and cigar smoking
bull High prevalence tobacco use in any form is reported among school going adolescents aged 13ndash15 years in India (Arora and Reddy 2005) Smoking Chutta is relatively popular may begin in childhood in India
bull Acts as a stimulant euphoric
bull May sleep with tobacco mixture in mouth
Harmful effects halitosis brown black staining gingival recession if wad is held against gingivaleucoplakia oral squamous cell carcinoma
Tobacco use in children
PRACTICES RELATED TO PUBERTY AND GROOMING
Tooth filing tooth sharpening
Practiced -Nigeria Niger-Delta area (Ukeghesonand Akadiri ) Democratic Republic of Congo Thailand Indonesia
bull Perception Historically -spiritual reasons Contemporary times - aesthetic reasons
bull In Nigeria maxillary midline diastema is regarded as a symbol of beauty (Arigbede and Adesuwa 2012
bull Teeth filed- because represent negative emotions eg anger jealousy (Balinese Indonesia)
30 respondents would not mind having artificially created diastema (Omotosho and Kadri (2010)
Practices
bull Done in adolescence - fashionable
bull Manually done Usually incisors
Harmful effects
bull pain during process
bull Tooth discolouration (teeth -non vital)
bull Infection -pus discharge lip swelling
Tooth filing
Peri-apical x-ray of lower central incisor
Lacquering and staining of teethPerformed in Vietnam Laos Thailand Indonesia and Philippines
Perception For cosmetic reasons
bull Main ingredient dye dark-brown solution of ferric acetate called kanemizu (iron filings in vinegar)
bull Coating the teeth with this liquid helped to prevent tooth decay and enamel decay
bull Practice has slowly declined
Traditional gingival tattooinglips bull Practiced in Africarsquos Sahel region Woddebe
Fulani tribe Senegal Ethiopia middle eastern countries
Perception Reason aesthetic appeal superstition
bull Practices Done when females reach puberty
bull Kanuri females Borno State Nigeria tattooing lip gingiva usually performed thorns of Balanites aegyptiaca (Bukar et al 2004 )
bull Pigments -Mixture charcoal and seeds of Acacia nilotica vartomentosa
Lip plug lip plate
bull The lip plate (lip plug or lip disc) form of body modification
bull Amazonian tribes young males traditionally -rite of passage indicate status and prestige
bull Mursi of Ethiopia girls age 13 to 18
bull At puberty mother cuts her lower lip
bull Held open by a wooden plug - inserted into thereby stretching the lip
bull At times -combined with removal of two or four lower anterior incisal teeth
Lip plug lip plate
TRADITIONAL DENTAL SERVICES
bull Perceptions
Cause of illness determines treatment taken Practices
bull Yoruba community patronize traditional dentists (Oke Bankole et al 2011) Edo state
bull Services rendered include worm extraction tooth extraction drug prescription and offering sacrifices to deities
bull Charges based on the worm count
Northern Nigeria called Serdia Toothache associated with dandruff
Cameroon traditional healers perform atraumatic tooth extraction Agbor et al (2011)
bull Leaves stems of Dichrocephala integrifolia
bull Tooth pulled out fingerssharp instrument
bull No pain Plant has anaesthetic properties
bull Dangers infection sepsis infection with hepatitis B Human Immunodeficiency Virus
bull Jewish Unlikely keep Friday appointment with the dentist for their children
bull Routine appointments on Fridays avoided (Scambler et al )
The traditional healer harvesting the medicinal plant in Cameroon
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J Ethnobiol Ethnomed 2011 715
Tooth extraction by a traditional dentist
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J EthnobiolEthnomed 2011 715
bull Health is a consequence of an individualrsquos lifestyle
bull Essential to Identify cultural factors that are harmful and those that are beneficial
bull As paediatric dentists we should discourage the unhealthy practices through rigorous health education and promote the adoption of healthy practices
bull Need for multicentric research on the cultural influence of the family and peers regarding oral health of children
bull Bankole OO Lawal FB Ibiyemi O (2017) Dispelling myths associated with natalneonatal teeth ldquoAdunnirdquo a health education video in a native Nigerian language Annals of Ibadan Postgraduate Medicine15(2)137-141
Thank you for listening
Other Folk RemediesSource httpswwwlifelovelizcom20150108traditional-
teething-remedies-around-world
Caribbean Hang raw egg over where baby sleeps
India Ayurvedic Remedy with cloves
Chinese Traditional Chinese Medicine (TCM) Acupuncture Acupressure
Japanese Wooden Teething Ring
France Sophie the giraffe - teething toy
Baltic Amber Teething Necklace Dangers strangulation aspiration beads
German Zwieback Toast
bull Acupressure
bull Massaging two important acupoints called the ldquotwo gatesrdquo or Large Intestine 4 (Li 4) and Liver 3 (Liv 3) can ease babyrsquos teething pain
bull It is simple effective and easy to do anywhere
bull Shonishin ndashJapanese needleless therapybull Source www bonnchirocomshonishin-needle-less-acupuncture-for-infants-and-
toddlers
Health education to the nurses and Community health officers at Ibadan Nigeria
Photoposter
Educational tool (In collaboration with WHO) In English and 3 major Nigerian languages
bull Effectiveness tested (Bankole et al 2005)
bull More effective as instructional tool in interactive atmosphere than just pasted on walls
TIMING OF ERUPTION Natalneonatal teeth
Associated with erroneous cultural beliefs among community nurses and
traditional birth attendants (TBA)
Britain ndashHeroes
China ndashBearers of misfortune
Natal tooth
Perceptions regarding natalneonatal teeth in infants
Traditional birth
attendaants
Bankole et al
(2013
Igbo Ora
Community
Unpublished
PERCEIVED CAUSES
Evil spirits evil child Abiku 319 487
Mothers contravened taboos 92 35
Prolonged maternal gestation 49
EFFECT ON THE FAMILY
Curse 74 106
Abomination 245 360
Embarrassment 11 360
Practices regarding natalneonatal teeth
Traditional birth
attendants
Bankole et al 2003)
Practices
Immediate extraction
Spiritual cleansing
356 Pain infection HIV
hepatitis B tetanus
Get rid of child 49 Infanticide
EFFECT ON CHILD
Strange odd behavior 313 Stigmatization
Evil spiritual powers 411 Stigmatization
Mental retardation
dull
31
With Traditional Birth Attendants at Ibadan South East Local government area
REVERSAL OF ERUPTION SEQUENCE
bull African ethnographies - infants whose upper teeth erupt before their lower teeth have been killed because of such ldquodevelopmental anomaliesrdquo
bull Considered a bad omen and sign of misfortune among Hamar Ethiopia Benin Rebublic
bull Reversal of eruption sequence of primary incisors in infants in Yoruba community has led to unpleasant circumstances
Reversal of eruption sequence
Reversal of eruption sequence
TraditionalBirth Attendants
Bankole and Lawal (2018)
PERCEIVED CAUSES
Evil spirits 218 476
Contravening taboos 80 26
EFFECT ON THE FAMILY
Curse 135 214Abomination 276 218
Embarrassment 233 114
Practices regarding reversal of eruption sequence of the anterior primary teeth
Practices Bankole and
Lawal(2018 )Effect
Immediate extraction 337 Pain infection HJV
hepatitis B infection
tetanus
HideGet rid of child 613 Infanticide
EFFECT ON CHILD
Strange behavior 227 Stigmatization
Evil powers 417 Stigmatization
Mental retardation 25
Dr Bankole and Dr Lawal with the Traditional Birth Attendants at the Ibadan South West LGA
DIETDental caries has escalated in developing countries
bull Misconception Food and drinks refined processed or modern is best and associated with affluence (Aderinokun et al 2011)
bull Parents donrsquot want their children to be deprived of what they lacked when young
bull This has led to a cultural shift in diet
bull Some African American believe motherrsquos diet during pregnancy cause dental caries in the child
bull Somali refugees Hutterites and Latino immigrant caregivers believed genetics plays a role in development early childhood caries (Prowse 2014)
Practices
bull YorubaHausa community common snacks have assumed local flavours several shapes coloursof sweets sold
bull Natural foods fruits are being sweetened Oke Bankole et al 2011 )
bull Nomadic Fulani sugary diet in between their meals sweetened drinks in bottles Sippy cups (827) and (716) give pacifiers dipped in sweet liquids Reduce temper tantrums with sweets Bankole et al 2015
Infant feeding practices
bull Babies with sweetened drinks in bottles pacifiers dipped in sweet liquidsputting infant to bed with a bottle of sweetened liquid Reported among Mexican Americans and Puerto Ricans Hong Kong Saudi mothers Al-Zahrani et al 2014
bull High risk factors contributing development of early childhood caries in infants
Diet
bull Perception
Animals such as pig are unclean
bull Practices
bull Hindus donrsquot eat beef Muslims donrsquot eat pork
bull Protective prevent taeniasis cystecercosis -edematous oral ulcers gingival bleeding lesions mimicking mucocles in children
(Alves et al 2011)
Dental Fluorosis bull In East and central African countries (tribal
areas of Tanzania Magadi a fluoride rich tronaused in cooking
bull Used as a tenderizer and preservative
bull High Fluoride Concentration 7900 ppm
bull Magadi use may suggest high prevalence of fluorosis in northern Tanzania (Kaseva 2006)
Oral Hygiene
Perceptions among mothers
bull Hausa Fulani- 142 - babyrsquos mouth should be cleaned before teeth erupt
bull Yoruba- Babyrsquos mouthtongue cleaned before teeth erupt to prevent thrush
bull Hausa Fulani- 635 - commencement tooth cleaning between 6 and 12 months of age (Bankole et al 2017)
bull Yoruba- chewing sticks should not be used at night Causes premature death of mother (Oke et al 2011)
Practices
Hausa Fulani- 594 cleaned infants teeth once daily
- 614 children start cleaning their teeth unsupervised before the age of six years
- 751 of supervision was carried out by the grandparents
- Sudan -343 mothers donrsquot clean childrenrsquos teeth below the age of 2 years (Abduljalil et al 2016)
-Hausa - mothers start cleaning childrenrsquos teeth when enough teeth to justify effort (Oke et al 2011)
Oral hygiene practices
Cleaning materials used in infancyearly childhood
CommunityTribe
GlycerinFresh tomato Hydrogen peroxideAluminum sulphateVerona Amygdalina (bitter leaf)Iyere (African black pepper)Alligator pepperCitrus lime Combinations
Yoruba - Nigeria (Aderinokun 2000)
Alum (Aluminum sulphate) Bitter leaf (Verona Amygdalina)
Iyere (African black pepper)
Citrus lime Alligator pepper
Oral hygiene practices
Tooth Cleaning materials
CommunityTribe Side effect
Salt and cotton wool
Hausa (Oke et al 2011)
Finger Nomadic Fulani
Wooden twigSalvadora persiccatwig (miswak) Neem tree Chewing stick
Nomadic Fulani ( Bankole et al 2017)
Somali
India (Kochar et al 2014)
Yoruba Senegal (Diouf 2013)
Improper use ndashgingival trauma
round ceramics omadic ulani
brasion sensiti it
and omadic ulani
shes ood charcoal
Somali (Beveridge
India Senegal
Tooth Cleaning materials
CommunityTribe Side effect
Ground ceramics Nomadic Fulani Tooth abrasion
Sand Nomadic Fulani
AshesWood
Charcoal
Somali India Senegal
Tooth abrasion
IMPORTANCE OF THE PRIMARY DENTITION IN CHILDREN
bull Primary teeth in children are sometimes not regarded as important
bull Mothers of preschool children in Mumbai -436 believed 192 were uncertain that there is no need to visit a dentist for treating milk teeth as they will soon fall off (Jain et al 2014)
COMMON DENTAL DISEASES
Dental Caries
bull Early childhood caries is a significant public health problem caries affecting children globally
bull In recent years in developing countries like Sub-Saharan Africa the prevalence is predicted to increase
bull Early childhood caries is largely untreated in a study in South Africa reported a caries prevalence of 716 and these 675 were untreated (Mohammed and Barnes 2018 )
Dental caries Perceived cause of dental
caries
Community tribe
Worms (resembling
maggots)
Borom bop (master of the
head)
Lagatas
Smaller version of pubu
Worms -removed from
ears
Yoruba Nomadic Fulani
Chinese (Dong et al 2007)
Senegalese ( Diouf et al 2003)
Brazil
Papua New Guinea
Indian (Nagaraj et al2014)
Dental caries -Care remedies Dental care remedies Community tribe Effect
Hydrochloric acid (Wet cell
battery liquid)
Aluminum Phosphate
(Alum)
Tobacco snuff
Charcoal and salt
Gentian violet
Atare (Alligator Pepper)
Yoruba Brazil
Kenya (Mulu Maryanne)
Yoruba (Oke et al 2011)
Chemical burns
mucosal ulceration
Erosion
Tetracycline capsule (topical)
Paracetamol (topical)
Hausa Nomadic Fulani
Hausa
Greyish brown tooth
discolouration
Mucosal ulceration
Traditional concoction
Dental are remedies Dental care remedies Community
tribe
Effect
White wineVinegar Powdered alum musk and frankincense
Chinese (Dong et al 2007)
Herbs traditional medicine
Aborigines (Wong 2005)
Nettles
Hot sweet potato
Wads hot leaves ginger
Residue smoking pipe
White sap of shrub used
to kill maggots
Insecticide ointment
Papua New
Guinea
Predisposition to
oral cancer
Toxic
Dental care remedies Dental care remedies Community Effect
Cooked meat
salt alcohol grease
deodorant
Iran
fingernail polish remover
black tar
Garlic Warm coconut milk
Brazil Toxic
Kawakawa Māori(Pepper Tree
Leaves) chewed
Harakeke -Korari Flax
the gum used for toothache
Maori
GingivitisPeriodontal disease
Perceptions
bull Bleeding gums caused by
bull Child stores food in pouch of mouth and does not clean teeth
Remedies for gingival periodontal disease
Remedies Community tribe
Effect
Aluminium phosphate (Alum ) + Lapalapa sap (Jatropha curcas)Warm water and salt Tomato and alum+polystrene foam or cotton woolHydrogen peroxide
Yoruba
Antibiotics NomadiFulani
Resistant strains Hyper sensitivityreactions
Herbs
ORAL HABITS Kola nut chewing
Common West Central Africa Symbol of hospitality Contains caffeine tannin
bull Helps students keep awakewithstand fatigue
Practices
bull One-year prevalence student use was 291 Erinfolami et al (2011)
bull Majority started at age 14 years or below
bull Dangers -insomnia nausea tooth discolourationcarcinogenic potential for development of oral cancer
Areca Nut Chewing Habitbull Areca nut is the seed of areca palm
bull Widely grown- Asia India Bangladesh Japan
bull Believed to help fatigue
bull Highest period of risk for first use is between 5 and 12 Farrand et al 2001
74 4-16 age group in Karachi indulged in the habit (Shah et al 2002)
Dangers Oral sub mucous fibrosis
bull Risk of oral cancer 99 times( Wollina et al 2004 ) Foreign body aspiration Severe tooth wear -- sensitivity root fractures
Mandibular arch with generalized staining in the deciduous dentition
Prajapati D Nayak R Nayak UA Shah PJ Areca nut chewing habit in preschoolers Two rare case reports and literature review Int J Dent Health Concern 201511-5 (Permission given)
Mandibular arch with generalized staining in the deciduous dentition
Prajapati D Nayak R Nayak UA Shah PJ Areca nut chewing habit in preschoolers Two rare case reports and literature review Int J Dent Health Concern 201511-5 (Permission given)
Oral tobacco use and cigar smoking
bull High prevalence tobacco use in any form is reported among school going adolescents aged 13ndash15 years in India (Arora and Reddy 2005) Smoking Chutta is relatively popular may begin in childhood in India
bull Acts as a stimulant euphoric
bull May sleep with tobacco mixture in mouth
Harmful effects halitosis brown black staining gingival recession if wad is held against gingivaleucoplakia oral squamous cell carcinoma
Tobacco use in children
PRACTICES RELATED TO PUBERTY AND GROOMING
Tooth filing tooth sharpening
Practiced -Nigeria Niger-Delta area (Ukeghesonand Akadiri ) Democratic Republic of Congo Thailand Indonesia
bull Perception Historically -spiritual reasons Contemporary times - aesthetic reasons
bull In Nigeria maxillary midline diastema is regarded as a symbol of beauty (Arigbede and Adesuwa 2012
bull Teeth filed- because represent negative emotions eg anger jealousy (Balinese Indonesia)
30 respondents would not mind having artificially created diastema (Omotosho and Kadri (2010)
Practices
bull Done in adolescence - fashionable
bull Manually done Usually incisors
Harmful effects
bull pain during process
bull Tooth discolouration (teeth -non vital)
bull Infection -pus discharge lip swelling
Tooth filing
Peri-apical x-ray of lower central incisor
Lacquering and staining of teethPerformed in Vietnam Laos Thailand Indonesia and Philippines
Perception For cosmetic reasons
bull Main ingredient dye dark-brown solution of ferric acetate called kanemizu (iron filings in vinegar)
bull Coating the teeth with this liquid helped to prevent tooth decay and enamel decay
bull Practice has slowly declined
Traditional gingival tattooinglips bull Practiced in Africarsquos Sahel region Woddebe
Fulani tribe Senegal Ethiopia middle eastern countries
Perception Reason aesthetic appeal superstition
bull Practices Done when females reach puberty
bull Kanuri females Borno State Nigeria tattooing lip gingiva usually performed thorns of Balanites aegyptiaca (Bukar et al 2004 )
bull Pigments -Mixture charcoal and seeds of Acacia nilotica vartomentosa
Lip plug lip plate
bull The lip plate (lip plug or lip disc) form of body modification
bull Amazonian tribes young males traditionally -rite of passage indicate status and prestige
bull Mursi of Ethiopia girls age 13 to 18
bull At puberty mother cuts her lower lip
bull Held open by a wooden plug - inserted into thereby stretching the lip
bull At times -combined with removal of two or four lower anterior incisal teeth
Lip plug lip plate
TRADITIONAL DENTAL SERVICES
bull Perceptions
Cause of illness determines treatment taken Practices
bull Yoruba community patronize traditional dentists (Oke Bankole et al 2011) Edo state
bull Services rendered include worm extraction tooth extraction drug prescription and offering sacrifices to deities
bull Charges based on the worm count
Northern Nigeria called Serdia Toothache associated with dandruff
Cameroon traditional healers perform atraumatic tooth extraction Agbor et al (2011)
bull Leaves stems of Dichrocephala integrifolia
bull Tooth pulled out fingerssharp instrument
bull No pain Plant has anaesthetic properties
bull Dangers infection sepsis infection with hepatitis B Human Immunodeficiency Virus
bull Jewish Unlikely keep Friday appointment with the dentist for their children
bull Routine appointments on Fridays avoided (Scambler et al )
The traditional healer harvesting the medicinal plant in Cameroon
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J Ethnobiol Ethnomed 2011 715
Tooth extraction by a traditional dentist
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J EthnobiolEthnomed 2011 715
bull Health is a consequence of an individualrsquos lifestyle
bull Essential to Identify cultural factors that are harmful and those that are beneficial
bull As paediatric dentists we should discourage the unhealthy practices through rigorous health education and promote the adoption of healthy practices
bull Need for multicentric research on the cultural influence of the family and peers regarding oral health of children
bull Bankole OO Lawal FB Ibiyemi O (2017) Dispelling myths associated with natalneonatal teeth ldquoAdunnirdquo a health education video in a native Nigerian language Annals of Ibadan Postgraduate Medicine15(2)137-141
Thank you for listening
bull Acupressure
bull Massaging two important acupoints called the ldquotwo gatesrdquo or Large Intestine 4 (Li 4) and Liver 3 (Liv 3) can ease babyrsquos teething pain
bull It is simple effective and easy to do anywhere
bull Shonishin ndashJapanese needleless therapybull Source www bonnchirocomshonishin-needle-less-acupuncture-for-infants-and-
toddlers
Health education to the nurses and Community health officers at Ibadan Nigeria
Photoposter
Educational tool (In collaboration with WHO) In English and 3 major Nigerian languages
bull Effectiveness tested (Bankole et al 2005)
bull More effective as instructional tool in interactive atmosphere than just pasted on walls
TIMING OF ERUPTION Natalneonatal teeth
Associated with erroneous cultural beliefs among community nurses and
traditional birth attendants (TBA)
Britain ndashHeroes
China ndashBearers of misfortune
Natal tooth
Perceptions regarding natalneonatal teeth in infants
Traditional birth
attendaants
Bankole et al
(2013
Igbo Ora
Community
Unpublished
PERCEIVED CAUSES
Evil spirits evil child Abiku 319 487
Mothers contravened taboos 92 35
Prolonged maternal gestation 49
EFFECT ON THE FAMILY
Curse 74 106
Abomination 245 360
Embarrassment 11 360
Practices regarding natalneonatal teeth
Traditional birth
attendants
Bankole et al 2003)
Practices
Immediate extraction
Spiritual cleansing
356 Pain infection HIV
hepatitis B tetanus
Get rid of child 49 Infanticide
EFFECT ON CHILD
Strange odd behavior 313 Stigmatization
Evil spiritual powers 411 Stigmatization
Mental retardation
dull
31
With Traditional Birth Attendants at Ibadan South East Local government area
REVERSAL OF ERUPTION SEQUENCE
bull African ethnographies - infants whose upper teeth erupt before their lower teeth have been killed because of such ldquodevelopmental anomaliesrdquo
bull Considered a bad omen and sign of misfortune among Hamar Ethiopia Benin Rebublic
bull Reversal of eruption sequence of primary incisors in infants in Yoruba community has led to unpleasant circumstances
Reversal of eruption sequence
Reversal of eruption sequence
TraditionalBirth Attendants
Bankole and Lawal (2018)
PERCEIVED CAUSES
Evil spirits 218 476
Contravening taboos 80 26
EFFECT ON THE FAMILY
Curse 135 214Abomination 276 218
Embarrassment 233 114
Practices regarding reversal of eruption sequence of the anterior primary teeth
Practices Bankole and
Lawal(2018 )Effect
Immediate extraction 337 Pain infection HJV
hepatitis B infection
tetanus
HideGet rid of child 613 Infanticide
EFFECT ON CHILD
Strange behavior 227 Stigmatization
Evil powers 417 Stigmatization
Mental retardation 25
Dr Bankole and Dr Lawal with the Traditional Birth Attendants at the Ibadan South West LGA
DIETDental caries has escalated in developing countries
bull Misconception Food and drinks refined processed or modern is best and associated with affluence (Aderinokun et al 2011)
bull Parents donrsquot want their children to be deprived of what they lacked when young
bull This has led to a cultural shift in diet
bull Some African American believe motherrsquos diet during pregnancy cause dental caries in the child
bull Somali refugees Hutterites and Latino immigrant caregivers believed genetics plays a role in development early childhood caries (Prowse 2014)
Practices
bull YorubaHausa community common snacks have assumed local flavours several shapes coloursof sweets sold
bull Natural foods fruits are being sweetened Oke Bankole et al 2011 )
bull Nomadic Fulani sugary diet in between their meals sweetened drinks in bottles Sippy cups (827) and (716) give pacifiers dipped in sweet liquids Reduce temper tantrums with sweets Bankole et al 2015
Infant feeding practices
bull Babies with sweetened drinks in bottles pacifiers dipped in sweet liquidsputting infant to bed with a bottle of sweetened liquid Reported among Mexican Americans and Puerto Ricans Hong Kong Saudi mothers Al-Zahrani et al 2014
bull High risk factors contributing development of early childhood caries in infants
Diet
bull Perception
Animals such as pig are unclean
bull Practices
bull Hindus donrsquot eat beef Muslims donrsquot eat pork
bull Protective prevent taeniasis cystecercosis -edematous oral ulcers gingival bleeding lesions mimicking mucocles in children
(Alves et al 2011)
Dental Fluorosis bull In East and central African countries (tribal
areas of Tanzania Magadi a fluoride rich tronaused in cooking
bull Used as a tenderizer and preservative
bull High Fluoride Concentration 7900 ppm
bull Magadi use may suggest high prevalence of fluorosis in northern Tanzania (Kaseva 2006)
Oral Hygiene
Perceptions among mothers
bull Hausa Fulani- 142 - babyrsquos mouth should be cleaned before teeth erupt
bull Yoruba- Babyrsquos mouthtongue cleaned before teeth erupt to prevent thrush
bull Hausa Fulani- 635 - commencement tooth cleaning between 6 and 12 months of age (Bankole et al 2017)
bull Yoruba- chewing sticks should not be used at night Causes premature death of mother (Oke et al 2011)
Practices
Hausa Fulani- 594 cleaned infants teeth once daily
- 614 children start cleaning their teeth unsupervised before the age of six years
- 751 of supervision was carried out by the grandparents
- Sudan -343 mothers donrsquot clean childrenrsquos teeth below the age of 2 years (Abduljalil et al 2016)
-Hausa - mothers start cleaning childrenrsquos teeth when enough teeth to justify effort (Oke et al 2011)
Oral hygiene practices
Cleaning materials used in infancyearly childhood
CommunityTribe
GlycerinFresh tomato Hydrogen peroxideAluminum sulphateVerona Amygdalina (bitter leaf)Iyere (African black pepper)Alligator pepperCitrus lime Combinations
Yoruba - Nigeria (Aderinokun 2000)
Alum (Aluminum sulphate) Bitter leaf (Verona Amygdalina)
Iyere (African black pepper)
Citrus lime Alligator pepper
Oral hygiene practices
Tooth Cleaning materials
CommunityTribe Side effect
Salt and cotton wool
Hausa (Oke et al 2011)
Finger Nomadic Fulani
Wooden twigSalvadora persiccatwig (miswak) Neem tree Chewing stick
Nomadic Fulani ( Bankole et al 2017)
Somali
India (Kochar et al 2014)
Yoruba Senegal (Diouf 2013)
Improper use ndashgingival trauma
round ceramics omadic ulani
brasion sensiti it
and omadic ulani
shes ood charcoal
Somali (Beveridge
India Senegal
Tooth Cleaning materials
CommunityTribe Side effect
Ground ceramics Nomadic Fulani Tooth abrasion
Sand Nomadic Fulani
AshesWood
Charcoal
Somali India Senegal
Tooth abrasion
IMPORTANCE OF THE PRIMARY DENTITION IN CHILDREN
bull Primary teeth in children are sometimes not regarded as important
bull Mothers of preschool children in Mumbai -436 believed 192 were uncertain that there is no need to visit a dentist for treating milk teeth as they will soon fall off (Jain et al 2014)
COMMON DENTAL DISEASES
Dental Caries
bull Early childhood caries is a significant public health problem caries affecting children globally
bull In recent years in developing countries like Sub-Saharan Africa the prevalence is predicted to increase
bull Early childhood caries is largely untreated in a study in South Africa reported a caries prevalence of 716 and these 675 were untreated (Mohammed and Barnes 2018 )
Dental caries Perceived cause of dental
caries
Community tribe
Worms (resembling
maggots)
Borom bop (master of the
head)
Lagatas
Smaller version of pubu
Worms -removed from
ears
Yoruba Nomadic Fulani
Chinese (Dong et al 2007)
Senegalese ( Diouf et al 2003)
Brazil
Papua New Guinea
Indian (Nagaraj et al2014)
Dental caries -Care remedies Dental care remedies Community tribe Effect
Hydrochloric acid (Wet cell
battery liquid)
Aluminum Phosphate
(Alum)
Tobacco snuff
Charcoal and salt
Gentian violet
Atare (Alligator Pepper)
Yoruba Brazil
Kenya (Mulu Maryanne)
Yoruba (Oke et al 2011)
Chemical burns
mucosal ulceration
Erosion
Tetracycline capsule (topical)
Paracetamol (topical)
Hausa Nomadic Fulani
Hausa
Greyish brown tooth
discolouration
Mucosal ulceration
Traditional concoction
Dental are remedies Dental care remedies Community
tribe
Effect
White wineVinegar Powdered alum musk and frankincense
Chinese (Dong et al 2007)
Herbs traditional medicine
Aborigines (Wong 2005)
Nettles
Hot sweet potato
Wads hot leaves ginger
Residue smoking pipe
White sap of shrub used
to kill maggots
Insecticide ointment
Papua New
Guinea
Predisposition to
oral cancer
Toxic
Dental care remedies Dental care remedies Community Effect
Cooked meat
salt alcohol grease
deodorant
Iran
fingernail polish remover
black tar
Garlic Warm coconut milk
Brazil Toxic
Kawakawa Māori(Pepper Tree
Leaves) chewed
Harakeke -Korari Flax
the gum used for toothache
Maori
GingivitisPeriodontal disease
Perceptions
bull Bleeding gums caused by
bull Child stores food in pouch of mouth and does not clean teeth
Remedies for gingival periodontal disease
Remedies Community tribe
Effect
Aluminium phosphate (Alum ) + Lapalapa sap (Jatropha curcas)Warm water and salt Tomato and alum+polystrene foam or cotton woolHydrogen peroxide
Yoruba
Antibiotics NomadiFulani
Resistant strains Hyper sensitivityreactions
Herbs
ORAL HABITS Kola nut chewing
Common West Central Africa Symbol of hospitality Contains caffeine tannin
bull Helps students keep awakewithstand fatigue
Practices
bull One-year prevalence student use was 291 Erinfolami et al (2011)
bull Majority started at age 14 years or below
bull Dangers -insomnia nausea tooth discolourationcarcinogenic potential for development of oral cancer
Areca Nut Chewing Habitbull Areca nut is the seed of areca palm
bull Widely grown- Asia India Bangladesh Japan
bull Believed to help fatigue
bull Highest period of risk for first use is between 5 and 12 Farrand et al 2001
74 4-16 age group in Karachi indulged in the habit (Shah et al 2002)
Dangers Oral sub mucous fibrosis
bull Risk of oral cancer 99 times( Wollina et al 2004 ) Foreign body aspiration Severe tooth wear -- sensitivity root fractures
Mandibular arch with generalized staining in the deciduous dentition
Prajapati D Nayak R Nayak UA Shah PJ Areca nut chewing habit in preschoolers Two rare case reports and literature review Int J Dent Health Concern 201511-5 (Permission given)
Mandibular arch with generalized staining in the deciduous dentition
Prajapati D Nayak R Nayak UA Shah PJ Areca nut chewing habit in preschoolers Two rare case reports and literature review Int J Dent Health Concern 201511-5 (Permission given)
Oral tobacco use and cigar smoking
bull High prevalence tobacco use in any form is reported among school going adolescents aged 13ndash15 years in India (Arora and Reddy 2005) Smoking Chutta is relatively popular may begin in childhood in India
bull Acts as a stimulant euphoric
bull May sleep with tobacco mixture in mouth
Harmful effects halitosis brown black staining gingival recession if wad is held against gingivaleucoplakia oral squamous cell carcinoma
Tobacco use in children
PRACTICES RELATED TO PUBERTY AND GROOMING
Tooth filing tooth sharpening
Practiced -Nigeria Niger-Delta area (Ukeghesonand Akadiri ) Democratic Republic of Congo Thailand Indonesia
bull Perception Historically -spiritual reasons Contemporary times - aesthetic reasons
bull In Nigeria maxillary midline diastema is regarded as a symbol of beauty (Arigbede and Adesuwa 2012
bull Teeth filed- because represent negative emotions eg anger jealousy (Balinese Indonesia)
30 respondents would not mind having artificially created diastema (Omotosho and Kadri (2010)
Practices
bull Done in adolescence - fashionable
bull Manually done Usually incisors
Harmful effects
bull pain during process
bull Tooth discolouration (teeth -non vital)
bull Infection -pus discharge lip swelling
Tooth filing
Peri-apical x-ray of lower central incisor
Lacquering and staining of teethPerformed in Vietnam Laos Thailand Indonesia and Philippines
Perception For cosmetic reasons
bull Main ingredient dye dark-brown solution of ferric acetate called kanemizu (iron filings in vinegar)
bull Coating the teeth with this liquid helped to prevent tooth decay and enamel decay
bull Practice has slowly declined
Traditional gingival tattooinglips bull Practiced in Africarsquos Sahel region Woddebe
Fulani tribe Senegal Ethiopia middle eastern countries
Perception Reason aesthetic appeal superstition
bull Practices Done when females reach puberty
bull Kanuri females Borno State Nigeria tattooing lip gingiva usually performed thorns of Balanites aegyptiaca (Bukar et al 2004 )
bull Pigments -Mixture charcoal and seeds of Acacia nilotica vartomentosa
Lip plug lip plate
bull The lip plate (lip plug or lip disc) form of body modification
bull Amazonian tribes young males traditionally -rite of passage indicate status and prestige
bull Mursi of Ethiopia girls age 13 to 18
bull At puberty mother cuts her lower lip
bull Held open by a wooden plug - inserted into thereby stretching the lip
bull At times -combined with removal of two or four lower anterior incisal teeth
Lip plug lip plate
TRADITIONAL DENTAL SERVICES
bull Perceptions
Cause of illness determines treatment taken Practices
bull Yoruba community patronize traditional dentists (Oke Bankole et al 2011) Edo state
bull Services rendered include worm extraction tooth extraction drug prescription and offering sacrifices to deities
bull Charges based on the worm count
Northern Nigeria called Serdia Toothache associated with dandruff
Cameroon traditional healers perform atraumatic tooth extraction Agbor et al (2011)
bull Leaves stems of Dichrocephala integrifolia
bull Tooth pulled out fingerssharp instrument
bull No pain Plant has anaesthetic properties
bull Dangers infection sepsis infection with hepatitis B Human Immunodeficiency Virus
bull Jewish Unlikely keep Friday appointment with the dentist for their children
bull Routine appointments on Fridays avoided (Scambler et al )
The traditional healer harvesting the medicinal plant in Cameroon
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J Ethnobiol Ethnomed 2011 715
Tooth extraction by a traditional dentist
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J EthnobiolEthnomed 2011 715
bull Health is a consequence of an individualrsquos lifestyle
bull Essential to Identify cultural factors that are harmful and those that are beneficial
bull As paediatric dentists we should discourage the unhealthy practices through rigorous health education and promote the adoption of healthy practices
bull Need for multicentric research on the cultural influence of the family and peers regarding oral health of children
bull Bankole OO Lawal FB Ibiyemi O (2017) Dispelling myths associated with natalneonatal teeth ldquoAdunnirdquo a health education video in a native Nigerian language Annals of Ibadan Postgraduate Medicine15(2)137-141
Thank you for listening
Health education to the nurses and Community health officers at Ibadan Nigeria
Photoposter
Educational tool (In collaboration with WHO) In English and 3 major Nigerian languages
bull Effectiveness tested (Bankole et al 2005)
bull More effective as instructional tool in interactive atmosphere than just pasted on walls
TIMING OF ERUPTION Natalneonatal teeth
Associated with erroneous cultural beliefs among community nurses and
traditional birth attendants (TBA)
Britain ndashHeroes
China ndashBearers of misfortune
Natal tooth
Perceptions regarding natalneonatal teeth in infants
Traditional birth
attendaants
Bankole et al
(2013
Igbo Ora
Community
Unpublished
PERCEIVED CAUSES
Evil spirits evil child Abiku 319 487
Mothers contravened taboos 92 35
Prolonged maternal gestation 49
EFFECT ON THE FAMILY
Curse 74 106
Abomination 245 360
Embarrassment 11 360
Practices regarding natalneonatal teeth
Traditional birth
attendants
Bankole et al 2003)
Practices
Immediate extraction
Spiritual cleansing
356 Pain infection HIV
hepatitis B tetanus
Get rid of child 49 Infanticide
EFFECT ON CHILD
Strange odd behavior 313 Stigmatization
Evil spiritual powers 411 Stigmatization
Mental retardation
dull
31
With Traditional Birth Attendants at Ibadan South East Local government area
REVERSAL OF ERUPTION SEQUENCE
bull African ethnographies - infants whose upper teeth erupt before their lower teeth have been killed because of such ldquodevelopmental anomaliesrdquo
bull Considered a bad omen and sign of misfortune among Hamar Ethiopia Benin Rebublic
bull Reversal of eruption sequence of primary incisors in infants in Yoruba community has led to unpleasant circumstances
Reversal of eruption sequence
Reversal of eruption sequence
TraditionalBirth Attendants
Bankole and Lawal (2018)
PERCEIVED CAUSES
Evil spirits 218 476
Contravening taboos 80 26
EFFECT ON THE FAMILY
Curse 135 214Abomination 276 218
Embarrassment 233 114
Practices regarding reversal of eruption sequence of the anterior primary teeth
Practices Bankole and
Lawal(2018 )Effect
Immediate extraction 337 Pain infection HJV
hepatitis B infection
tetanus
HideGet rid of child 613 Infanticide
EFFECT ON CHILD
Strange behavior 227 Stigmatization
Evil powers 417 Stigmatization
Mental retardation 25
Dr Bankole and Dr Lawal with the Traditional Birth Attendants at the Ibadan South West LGA
DIETDental caries has escalated in developing countries
bull Misconception Food and drinks refined processed or modern is best and associated with affluence (Aderinokun et al 2011)
bull Parents donrsquot want their children to be deprived of what they lacked when young
bull This has led to a cultural shift in diet
bull Some African American believe motherrsquos diet during pregnancy cause dental caries in the child
bull Somali refugees Hutterites and Latino immigrant caregivers believed genetics plays a role in development early childhood caries (Prowse 2014)
Practices
bull YorubaHausa community common snacks have assumed local flavours several shapes coloursof sweets sold
bull Natural foods fruits are being sweetened Oke Bankole et al 2011 )
bull Nomadic Fulani sugary diet in between their meals sweetened drinks in bottles Sippy cups (827) and (716) give pacifiers dipped in sweet liquids Reduce temper tantrums with sweets Bankole et al 2015
Infant feeding practices
bull Babies with sweetened drinks in bottles pacifiers dipped in sweet liquidsputting infant to bed with a bottle of sweetened liquid Reported among Mexican Americans and Puerto Ricans Hong Kong Saudi mothers Al-Zahrani et al 2014
bull High risk factors contributing development of early childhood caries in infants
Diet
bull Perception
Animals such as pig are unclean
bull Practices
bull Hindus donrsquot eat beef Muslims donrsquot eat pork
bull Protective prevent taeniasis cystecercosis -edematous oral ulcers gingival bleeding lesions mimicking mucocles in children
(Alves et al 2011)
Dental Fluorosis bull In East and central African countries (tribal
areas of Tanzania Magadi a fluoride rich tronaused in cooking
bull Used as a tenderizer and preservative
bull High Fluoride Concentration 7900 ppm
bull Magadi use may suggest high prevalence of fluorosis in northern Tanzania (Kaseva 2006)
Oral Hygiene
Perceptions among mothers
bull Hausa Fulani- 142 - babyrsquos mouth should be cleaned before teeth erupt
bull Yoruba- Babyrsquos mouthtongue cleaned before teeth erupt to prevent thrush
bull Hausa Fulani- 635 - commencement tooth cleaning between 6 and 12 months of age (Bankole et al 2017)
bull Yoruba- chewing sticks should not be used at night Causes premature death of mother (Oke et al 2011)
Practices
Hausa Fulani- 594 cleaned infants teeth once daily
- 614 children start cleaning their teeth unsupervised before the age of six years
- 751 of supervision was carried out by the grandparents
- Sudan -343 mothers donrsquot clean childrenrsquos teeth below the age of 2 years (Abduljalil et al 2016)
-Hausa - mothers start cleaning childrenrsquos teeth when enough teeth to justify effort (Oke et al 2011)
Oral hygiene practices
Cleaning materials used in infancyearly childhood
CommunityTribe
GlycerinFresh tomato Hydrogen peroxideAluminum sulphateVerona Amygdalina (bitter leaf)Iyere (African black pepper)Alligator pepperCitrus lime Combinations
Yoruba - Nigeria (Aderinokun 2000)
Alum (Aluminum sulphate) Bitter leaf (Verona Amygdalina)
Iyere (African black pepper)
Citrus lime Alligator pepper
Oral hygiene practices
Tooth Cleaning materials
CommunityTribe Side effect
Salt and cotton wool
Hausa (Oke et al 2011)
Finger Nomadic Fulani
Wooden twigSalvadora persiccatwig (miswak) Neem tree Chewing stick
Nomadic Fulani ( Bankole et al 2017)
Somali
India (Kochar et al 2014)
Yoruba Senegal (Diouf 2013)
Improper use ndashgingival trauma
round ceramics omadic ulani
brasion sensiti it
and omadic ulani
shes ood charcoal
Somali (Beveridge
India Senegal
Tooth Cleaning materials
CommunityTribe Side effect
Ground ceramics Nomadic Fulani Tooth abrasion
Sand Nomadic Fulani
AshesWood
Charcoal
Somali India Senegal
Tooth abrasion
IMPORTANCE OF THE PRIMARY DENTITION IN CHILDREN
bull Primary teeth in children are sometimes not regarded as important
bull Mothers of preschool children in Mumbai -436 believed 192 were uncertain that there is no need to visit a dentist for treating milk teeth as they will soon fall off (Jain et al 2014)
COMMON DENTAL DISEASES
Dental Caries
bull Early childhood caries is a significant public health problem caries affecting children globally
bull In recent years in developing countries like Sub-Saharan Africa the prevalence is predicted to increase
bull Early childhood caries is largely untreated in a study in South Africa reported a caries prevalence of 716 and these 675 were untreated (Mohammed and Barnes 2018 )
Dental caries Perceived cause of dental
caries
Community tribe
Worms (resembling
maggots)
Borom bop (master of the
head)
Lagatas
Smaller version of pubu
Worms -removed from
ears
Yoruba Nomadic Fulani
Chinese (Dong et al 2007)
Senegalese ( Diouf et al 2003)
Brazil
Papua New Guinea
Indian (Nagaraj et al2014)
Dental caries -Care remedies Dental care remedies Community tribe Effect
Hydrochloric acid (Wet cell
battery liquid)
Aluminum Phosphate
(Alum)
Tobacco snuff
Charcoal and salt
Gentian violet
Atare (Alligator Pepper)
Yoruba Brazil
Kenya (Mulu Maryanne)
Yoruba (Oke et al 2011)
Chemical burns
mucosal ulceration
Erosion
Tetracycline capsule (topical)
Paracetamol (topical)
Hausa Nomadic Fulani
Hausa
Greyish brown tooth
discolouration
Mucosal ulceration
Traditional concoction
Dental are remedies Dental care remedies Community
tribe
Effect
White wineVinegar Powdered alum musk and frankincense
Chinese (Dong et al 2007)
Herbs traditional medicine
Aborigines (Wong 2005)
Nettles
Hot sweet potato
Wads hot leaves ginger
Residue smoking pipe
White sap of shrub used
to kill maggots
Insecticide ointment
Papua New
Guinea
Predisposition to
oral cancer
Toxic
Dental care remedies Dental care remedies Community Effect
Cooked meat
salt alcohol grease
deodorant
Iran
fingernail polish remover
black tar
Garlic Warm coconut milk
Brazil Toxic
Kawakawa Māori(Pepper Tree
Leaves) chewed
Harakeke -Korari Flax
the gum used for toothache
Maori
GingivitisPeriodontal disease
Perceptions
bull Bleeding gums caused by
bull Child stores food in pouch of mouth and does not clean teeth
Remedies for gingival periodontal disease
Remedies Community tribe
Effect
Aluminium phosphate (Alum ) + Lapalapa sap (Jatropha curcas)Warm water and salt Tomato and alum+polystrene foam or cotton woolHydrogen peroxide
Yoruba
Antibiotics NomadiFulani
Resistant strains Hyper sensitivityreactions
Herbs
ORAL HABITS Kola nut chewing
Common West Central Africa Symbol of hospitality Contains caffeine tannin
bull Helps students keep awakewithstand fatigue
Practices
bull One-year prevalence student use was 291 Erinfolami et al (2011)
bull Majority started at age 14 years or below
bull Dangers -insomnia nausea tooth discolourationcarcinogenic potential for development of oral cancer
Areca Nut Chewing Habitbull Areca nut is the seed of areca palm
bull Widely grown- Asia India Bangladesh Japan
bull Believed to help fatigue
bull Highest period of risk for first use is between 5 and 12 Farrand et al 2001
74 4-16 age group in Karachi indulged in the habit (Shah et al 2002)
Dangers Oral sub mucous fibrosis
bull Risk of oral cancer 99 times( Wollina et al 2004 ) Foreign body aspiration Severe tooth wear -- sensitivity root fractures
Mandibular arch with generalized staining in the deciduous dentition
Prajapati D Nayak R Nayak UA Shah PJ Areca nut chewing habit in preschoolers Two rare case reports and literature review Int J Dent Health Concern 201511-5 (Permission given)
Mandibular arch with generalized staining in the deciduous dentition
Prajapati D Nayak R Nayak UA Shah PJ Areca nut chewing habit in preschoolers Two rare case reports and literature review Int J Dent Health Concern 201511-5 (Permission given)
Oral tobacco use and cigar smoking
bull High prevalence tobacco use in any form is reported among school going adolescents aged 13ndash15 years in India (Arora and Reddy 2005) Smoking Chutta is relatively popular may begin in childhood in India
bull Acts as a stimulant euphoric
bull May sleep with tobacco mixture in mouth
Harmful effects halitosis brown black staining gingival recession if wad is held against gingivaleucoplakia oral squamous cell carcinoma
Tobacco use in children
PRACTICES RELATED TO PUBERTY AND GROOMING
Tooth filing tooth sharpening
Practiced -Nigeria Niger-Delta area (Ukeghesonand Akadiri ) Democratic Republic of Congo Thailand Indonesia
bull Perception Historically -spiritual reasons Contemporary times - aesthetic reasons
bull In Nigeria maxillary midline diastema is regarded as a symbol of beauty (Arigbede and Adesuwa 2012
bull Teeth filed- because represent negative emotions eg anger jealousy (Balinese Indonesia)
30 respondents would not mind having artificially created diastema (Omotosho and Kadri (2010)
Practices
bull Done in adolescence - fashionable
bull Manually done Usually incisors
Harmful effects
bull pain during process
bull Tooth discolouration (teeth -non vital)
bull Infection -pus discharge lip swelling
Tooth filing
Peri-apical x-ray of lower central incisor
Lacquering and staining of teethPerformed in Vietnam Laos Thailand Indonesia and Philippines
Perception For cosmetic reasons
bull Main ingredient dye dark-brown solution of ferric acetate called kanemizu (iron filings in vinegar)
bull Coating the teeth with this liquid helped to prevent tooth decay and enamel decay
bull Practice has slowly declined
Traditional gingival tattooinglips bull Practiced in Africarsquos Sahel region Woddebe
Fulani tribe Senegal Ethiopia middle eastern countries
Perception Reason aesthetic appeal superstition
bull Practices Done when females reach puberty
bull Kanuri females Borno State Nigeria tattooing lip gingiva usually performed thorns of Balanites aegyptiaca (Bukar et al 2004 )
bull Pigments -Mixture charcoal and seeds of Acacia nilotica vartomentosa
Lip plug lip plate
bull The lip plate (lip plug or lip disc) form of body modification
bull Amazonian tribes young males traditionally -rite of passage indicate status and prestige
bull Mursi of Ethiopia girls age 13 to 18
bull At puberty mother cuts her lower lip
bull Held open by a wooden plug - inserted into thereby stretching the lip
bull At times -combined with removal of two or four lower anterior incisal teeth
Lip plug lip plate
TRADITIONAL DENTAL SERVICES
bull Perceptions
Cause of illness determines treatment taken Practices
bull Yoruba community patronize traditional dentists (Oke Bankole et al 2011) Edo state
bull Services rendered include worm extraction tooth extraction drug prescription and offering sacrifices to deities
bull Charges based on the worm count
Northern Nigeria called Serdia Toothache associated with dandruff
Cameroon traditional healers perform atraumatic tooth extraction Agbor et al (2011)
bull Leaves stems of Dichrocephala integrifolia
bull Tooth pulled out fingerssharp instrument
bull No pain Plant has anaesthetic properties
bull Dangers infection sepsis infection with hepatitis B Human Immunodeficiency Virus
bull Jewish Unlikely keep Friday appointment with the dentist for their children
bull Routine appointments on Fridays avoided (Scambler et al )
The traditional healer harvesting the medicinal plant in Cameroon
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J Ethnobiol Ethnomed 2011 715
Tooth extraction by a traditional dentist
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J EthnobiolEthnomed 2011 715
bull Health is a consequence of an individualrsquos lifestyle
bull Essential to Identify cultural factors that are harmful and those that are beneficial
bull As paediatric dentists we should discourage the unhealthy practices through rigorous health education and promote the adoption of healthy practices
bull Need for multicentric research on the cultural influence of the family and peers regarding oral health of children
bull Bankole OO Lawal FB Ibiyemi O (2017) Dispelling myths associated with natalneonatal teeth ldquoAdunnirdquo a health education video in a native Nigerian language Annals of Ibadan Postgraduate Medicine15(2)137-141
Thank you for listening
Photoposter
Educational tool (In collaboration with WHO) In English and 3 major Nigerian languages
bull Effectiveness tested (Bankole et al 2005)
bull More effective as instructional tool in interactive atmosphere than just pasted on walls
TIMING OF ERUPTION Natalneonatal teeth
Associated with erroneous cultural beliefs among community nurses and
traditional birth attendants (TBA)
Britain ndashHeroes
China ndashBearers of misfortune
Natal tooth
Perceptions regarding natalneonatal teeth in infants
Traditional birth
attendaants
Bankole et al
(2013
Igbo Ora
Community
Unpublished
PERCEIVED CAUSES
Evil spirits evil child Abiku 319 487
Mothers contravened taboos 92 35
Prolonged maternal gestation 49
EFFECT ON THE FAMILY
Curse 74 106
Abomination 245 360
Embarrassment 11 360
Practices regarding natalneonatal teeth
Traditional birth
attendants
Bankole et al 2003)
Practices
Immediate extraction
Spiritual cleansing
356 Pain infection HIV
hepatitis B tetanus
Get rid of child 49 Infanticide
EFFECT ON CHILD
Strange odd behavior 313 Stigmatization
Evil spiritual powers 411 Stigmatization
Mental retardation
dull
31
With Traditional Birth Attendants at Ibadan South East Local government area
REVERSAL OF ERUPTION SEQUENCE
bull African ethnographies - infants whose upper teeth erupt before their lower teeth have been killed because of such ldquodevelopmental anomaliesrdquo
bull Considered a bad omen and sign of misfortune among Hamar Ethiopia Benin Rebublic
bull Reversal of eruption sequence of primary incisors in infants in Yoruba community has led to unpleasant circumstances
Reversal of eruption sequence
Reversal of eruption sequence
TraditionalBirth Attendants
Bankole and Lawal (2018)
PERCEIVED CAUSES
Evil spirits 218 476
Contravening taboos 80 26
EFFECT ON THE FAMILY
Curse 135 214Abomination 276 218
Embarrassment 233 114
Practices regarding reversal of eruption sequence of the anterior primary teeth
Practices Bankole and
Lawal(2018 )Effect
Immediate extraction 337 Pain infection HJV
hepatitis B infection
tetanus
HideGet rid of child 613 Infanticide
EFFECT ON CHILD
Strange behavior 227 Stigmatization
Evil powers 417 Stigmatization
Mental retardation 25
Dr Bankole and Dr Lawal with the Traditional Birth Attendants at the Ibadan South West LGA
DIETDental caries has escalated in developing countries
bull Misconception Food and drinks refined processed or modern is best and associated with affluence (Aderinokun et al 2011)
bull Parents donrsquot want their children to be deprived of what they lacked when young
bull This has led to a cultural shift in diet
bull Some African American believe motherrsquos diet during pregnancy cause dental caries in the child
bull Somali refugees Hutterites and Latino immigrant caregivers believed genetics plays a role in development early childhood caries (Prowse 2014)
Practices
bull YorubaHausa community common snacks have assumed local flavours several shapes coloursof sweets sold
bull Natural foods fruits are being sweetened Oke Bankole et al 2011 )
bull Nomadic Fulani sugary diet in between their meals sweetened drinks in bottles Sippy cups (827) and (716) give pacifiers dipped in sweet liquids Reduce temper tantrums with sweets Bankole et al 2015
Infant feeding practices
bull Babies with sweetened drinks in bottles pacifiers dipped in sweet liquidsputting infant to bed with a bottle of sweetened liquid Reported among Mexican Americans and Puerto Ricans Hong Kong Saudi mothers Al-Zahrani et al 2014
bull High risk factors contributing development of early childhood caries in infants
Diet
bull Perception
Animals such as pig are unclean
bull Practices
bull Hindus donrsquot eat beef Muslims donrsquot eat pork
bull Protective prevent taeniasis cystecercosis -edematous oral ulcers gingival bleeding lesions mimicking mucocles in children
(Alves et al 2011)
Dental Fluorosis bull In East and central African countries (tribal
areas of Tanzania Magadi a fluoride rich tronaused in cooking
bull Used as a tenderizer and preservative
bull High Fluoride Concentration 7900 ppm
bull Magadi use may suggest high prevalence of fluorosis in northern Tanzania (Kaseva 2006)
Oral Hygiene
Perceptions among mothers
bull Hausa Fulani- 142 - babyrsquos mouth should be cleaned before teeth erupt
bull Yoruba- Babyrsquos mouthtongue cleaned before teeth erupt to prevent thrush
bull Hausa Fulani- 635 - commencement tooth cleaning between 6 and 12 months of age (Bankole et al 2017)
bull Yoruba- chewing sticks should not be used at night Causes premature death of mother (Oke et al 2011)
Practices
Hausa Fulani- 594 cleaned infants teeth once daily
- 614 children start cleaning their teeth unsupervised before the age of six years
- 751 of supervision was carried out by the grandparents
- Sudan -343 mothers donrsquot clean childrenrsquos teeth below the age of 2 years (Abduljalil et al 2016)
-Hausa - mothers start cleaning childrenrsquos teeth when enough teeth to justify effort (Oke et al 2011)
Oral hygiene practices
Cleaning materials used in infancyearly childhood
CommunityTribe
GlycerinFresh tomato Hydrogen peroxideAluminum sulphateVerona Amygdalina (bitter leaf)Iyere (African black pepper)Alligator pepperCitrus lime Combinations
Yoruba - Nigeria (Aderinokun 2000)
Alum (Aluminum sulphate) Bitter leaf (Verona Amygdalina)
Iyere (African black pepper)
Citrus lime Alligator pepper
Oral hygiene practices
Tooth Cleaning materials
CommunityTribe Side effect
Salt and cotton wool
Hausa (Oke et al 2011)
Finger Nomadic Fulani
Wooden twigSalvadora persiccatwig (miswak) Neem tree Chewing stick
Nomadic Fulani ( Bankole et al 2017)
Somali
India (Kochar et al 2014)
Yoruba Senegal (Diouf 2013)
Improper use ndashgingival trauma
round ceramics omadic ulani
brasion sensiti it
and omadic ulani
shes ood charcoal
Somali (Beveridge
India Senegal
Tooth Cleaning materials
CommunityTribe Side effect
Ground ceramics Nomadic Fulani Tooth abrasion
Sand Nomadic Fulani
AshesWood
Charcoal
Somali India Senegal
Tooth abrasion
IMPORTANCE OF THE PRIMARY DENTITION IN CHILDREN
bull Primary teeth in children are sometimes not regarded as important
bull Mothers of preschool children in Mumbai -436 believed 192 were uncertain that there is no need to visit a dentist for treating milk teeth as they will soon fall off (Jain et al 2014)
COMMON DENTAL DISEASES
Dental Caries
bull Early childhood caries is a significant public health problem caries affecting children globally
bull In recent years in developing countries like Sub-Saharan Africa the prevalence is predicted to increase
bull Early childhood caries is largely untreated in a study in South Africa reported a caries prevalence of 716 and these 675 were untreated (Mohammed and Barnes 2018 )
Dental caries Perceived cause of dental
caries
Community tribe
Worms (resembling
maggots)
Borom bop (master of the
head)
Lagatas
Smaller version of pubu
Worms -removed from
ears
Yoruba Nomadic Fulani
Chinese (Dong et al 2007)
Senegalese ( Diouf et al 2003)
Brazil
Papua New Guinea
Indian (Nagaraj et al2014)
Dental caries -Care remedies Dental care remedies Community tribe Effect
Hydrochloric acid (Wet cell
battery liquid)
Aluminum Phosphate
(Alum)
Tobacco snuff
Charcoal and salt
Gentian violet
Atare (Alligator Pepper)
Yoruba Brazil
Kenya (Mulu Maryanne)
Yoruba (Oke et al 2011)
Chemical burns
mucosal ulceration
Erosion
Tetracycline capsule (topical)
Paracetamol (topical)
Hausa Nomadic Fulani
Hausa
Greyish brown tooth
discolouration
Mucosal ulceration
Traditional concoction
Dental are remedies Dental care remedies Community
tribe
Effect
White wineVinegar Powdered alum musk and frankincense
Chinese (Dong et al 2007)
Herbs traditional medicine
Aborigines (Wong 2005)
Nettles
Hot sweet potato
Wads hot leaves ginger
Residue smoking pipe
White sap of shrub used
to kill maggots
Insecticide ointment
Papua New
Guinea
Predisposition to
oral cancer
Toxic
Dental care remedies Dental care remedies Community Effect
Cooked meat
salt alcohol grease
deodorant
Iran
fingernail polish remover
black tar
Garlic Warm coconut milk
Brazil Toxic
Kawakawa Māori(Pepper Tree
Leaves) chewed
Harakeke -Korari Flax
the gum used for toothache
Maori
GingivitisPeriodontal disease
Perceptions
bull Bleeding gums caused by
bull Child stores food in pouch of mouth and does not clean teeth
Remedies for gingival periodontal disease
Remedies Community tribe
Effect
Aluminium phosphate (Alum ) + Lapalapa sap (Jatropha curcas)Warm water and salt Tomato and alum+polystrene foam or cotton woolHydrogen peroxide
Yoruba
Antibiotics NomadiFulani
Resistant strains Hyper sensitivityreactions
Herbs
ORAL HABITS Kola nut chewing
Common West Central Africa Symbol of hospitality Contains caffeine tannin
bull Helps students keep awakewithstand fatigue
Practices
bull One-year prevalence student use was 291 Erinfolami et al (2011)
bull Majority started at age 14 years or below
bull Dangers -insomnia nausea tooth discolourationcarcinogenic potential for development of oral cancer
Areca Nut Chewing Habitbull Areca nut is the seed of areca palm
bull Widely grown- Asia India Bangladesh Japan
bull Believed to help fatigue
bull Highest period of risk for first use is between 5 and 12 Farrand et al 2001
74 4-16 age group in Karachi indulged in the habit (Shah et al 2002)
Dangers Oral sub mucous fibrosis
bull Risk of oral cancer 99 times( Wollina et al 2004 ) Foreign body aspiration Severe tooth wear -- sensitivity root fractures
Mandibular arch with generalized staining in the deciduous dentition
Prajapati D Nayak R Nayak UA Shah PJ Areca nut chewing habit in preschoolers Two rare case reports and literature review Int J Dent Health Concern 201511-5 (Permission given)
Mandibular arch with generalized staining in the deciduous dentition
Prajapati D Nayak R Nayak UA Shah PJ Areca nut chewing habit in preschoolers Two rare case reports and literature review Int J Dent Health Concern 201511-5 (Permission given)
Oral tobacco use and cigar smoking
bull High prevalence tobacco use in any form is reported among school going adolescents aged 13ndash15 years in India (Arora and Reddy 2005) Smoking Chutta is relatively popular may begin in childhood in India
bull Acts as a stimulant euphoric
bull May sleep with tobacco mixture in mouth
Harmful effects halitosis brown black staining gingival recession if wad is held against gingivaleucoplakia oral squamous cell carcinoma
Tobacco use in children
PRACTICES RELATED TO PUBERTY AND GROOMING
Tooth filing tooth sharpening
Practiced -Nigeria Niger-Delta area (Ukeghesonand Akadiri ) Democratic Republic of Congo Thailand Indonesia
bull Perception Historically -spiritual reasons Contemporary times - aesthetic reasons
bull In Nigeria maxillary midline diastema is regarded as a symbol of beauty (Arigbede and Adesuwa 2012
bull Teeth filed- because represent negative emotions eg anger jealousy (Balinese Indonesia)
30 respondents would not mind having artificially created diastema (Omotosho and Kadri (2010)
Practices
bull Done in adolescence - fashionable
bull Manually done Usually incisors
Harmful effects
bull pain during process
bull Tooth discolouration (teeth -non vital)
bull Infection -pus discharge lip swelling
Tooth filing
Peri-apical x-ray of lower central incisor
Lacquering and staining of teethPerformed in Vietnam Laos Thailand Indonesia and Philippines
Perception For cosmetic reasons
bull Main ingredient dye dark-brown solution of ferric acetate called kanemizu (iron filings in vinegar)
bull Coating the teeth with this liquid helped to prevent tooth decay and enamel decay
bull Practice has slowly declined
Traditional gingival tattooinglips bull Practiced in Africarsquos Sahel region Woddebe
Fulani tribe Senegal Ethiopia middle eastern countries
Perception Reason aesthetic appeal superstition
bull Practices Done when females reach puberty
bull Kanuri females Borno State Nigeria tattooing lip gingiva usually performed thorns of Balanites aegyptiaca (Bukar et al 2004 )
bull Pigments -Mixture charcoal and seeds of Acacia nilotica vartomentosa
Lip plug lip plate
bull The lip plate (lip plug or lip disc) form of body modification
bull Amazonian tribes young males traditionally -rite of passage indicate status and prestige
bull Mursi of Ethiopia girls age 13 to 18
bull At puberty mother cuts her lower lip
bull Held open by a wooden plug - inserted into thereby stretching the lip
bull At times -combined with removal of two or four lower anterior incisal teeth
Lip plug lip plate
TRADITIONAL DENTAL SERVICES
bull Perceptions
Cause of illness determines treatment taken Practices
bull Yoruba community patronize traditional dentists (Oke Bankole et al 2011) Edo state
bull Services rendered include worm extraction tooth extraction drug prescription and offering sacrifices to deities
bull Charges based on the worm count
Northern Nigeria called Serdia Toothache associated with dandruff
Cameroon traditional healers perform atraumatic tooth extraction Agbor et al (2011)
bull Leaves stems of Dichrocephala integrifolia
bull Tooth pulled out fingerssharp instrument
bull No pain Plant has anaesthetic properties
bull Dangers infection sepsis infection with hepatitis B Human Immunodeficiency Virus
bull Jewish Unlikely keep Friday appointment with the dentist for their children
bull Routine appointments on Fridays avoided (Scambler et al )
The traditional healer harvesting the medicinal plant in Cameroon
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J Ethnobiol Ethnomed 2011 715
Tooth extraction by a traditional dentist
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J EthnobiolEthnomed 2011 715
bull Health is a consequence of an individualrsquos lifestyle
bull Essential to Identify cultural factors that are harmful and those that are beneficial
bull As paediatric dentists we should discourage the unhealthy practices through rigorous health education and promote the adoption of healthy practices
bull Need for multicentric research on the cultural influence of the family and peers regarding oral health of children
bull Bankole OO Lawal FB Ibiyemi O (2017) Dispelling myths associated with natalneonatal teeth ldquoAdunnirdquo a health education video in a native Nigerian language Annals of Ibadan Postgraduate Medicine15(2)137-141
Thank you for listening
TIMING OF ERUPTION Natalneonatal teeth
Associated with erroneous cultural beliefs among community nurses and
traditional birth attendants (TBA)
Britain ndashHeroes
China ndashBearers of misfortune
Natal tooth
Perceptions regarding natalneonatal teeth in infants
Traditional birth
attendaants
Bankole et al
(2013
Igbo Ora
Community
Unpublished
PERCEIVED CAUSES
Evil spirits evil child Abiku 319 487
Mothers contravened taboos 92 35
Prolonged maternal gestation 49
EFFECT ON THE FAMILY
Curse 74 106
Abomination 245 360
Embarrassment 11 360
Practices regarding natalneonatal teeth
Traditional birth
attendants
Bankole et al 2003)
Practices
Immediate extraction
Spiritual cleansing
356 Pain infection HIV
hepatitis B tetanus
Get rid of child 49 Infanticide
EFFECT ON CHILD
Strange odd behavior 313 Stigmatization
Evil spiritual powers 411 Stigmatization
Mental retardation
dull
31
With Traditional Birth Attendants at Ibadan South East Local government area
REVERSAL OF ERUPTION SEQUENCE
bull African ethnographies - infants whose upper teeth erupt before their lower teeth have been killed because of such ldquodevelopmental anomaliesrdquo
bull Considered a bad omen and sign of misfortune among Hamar Ethiopia Benin Rebublic
bull Reversal of eruption sequence of primary incisors in infants in Yoruba community has led to unpleasant circumstances
Reversal of eruption sequence
Reversal of eruption sequence
TraditionalBirth Attendants
Bankole and Lawal (2018)
PERCEIVED CAUSES
Evil spirits 218 476
Contravening taboos 80 26
EFFECT ON THE FAMILY
Curse 135 214Abomination 276 218
Embarrassment 233 114
Practices regarding reversal of eruption sequence of the anterior primary teeth
Practices Bankole and
Lawal(2018 )Effect
Immediate extraction 337 Pain infection HJV
hepatitis B infection
tetanus
HideGet rid of child 613 Infanticide
EFFECT ON CHILD
Strange behavior 227 Stigmatization
Evil powers 417 Stigmatization
Mental retardation 25
Dr Bankole and Dr Lawal with the Traditional Birth Attendants at the Ibadan South West LGA
DIETDental caries has escalated in developing countries
bull Misconception Food and drinks refined processed or modern is best and associated with affluence (Aderinokun et al 2011)
bull Parents donrsquot want their children to be deprived of what they lacked when young
bull This has led to a cultural shift in diet
bull Some African American believe motherrsquos diet during pregnancy cause dental caries in the child
bull Somali refugees Hutterites and Latino immigrant caregivers believed genetics plays a role in development early childhood caries (Prowse 2014)
Practices
bull YorubaHausa community common snacks have assumed local flavours several shapes coloursof sweets sold
bull Natural foods fruits are being sweetened Oke Bankole et al 2011 )
bull Nomadic Fulani sugary diet in between their meals sweetened drinks in bottles Sippy cups (827) and (716) give pacifiers dipped in sweet liquids Reduce temper tantrums with sweets Bankole et al 2015
Infant feeding practices
bull Babies with sweetened drinks in bottles pacifiers dipped in sweet liquidsputting infant to bed with a bottle of sweetened liquid Reported among Mexican Americans and Puerto Ricans Hong Kong Saudi mothers Al-Zahrani et al 2014
bull High risk factors contributing development of early childhood caries in infants
Diet
bull Perception
Animals such as pig are unclean
bull Practices
bull Hindus donrsquot eat beef Muslims donrsquot eat pork
bull Protective prevent taeniasis cystecercosis -edematous oral ulcers gingival bleeding lesions mimicking mucocles in children
(Alves et al 2011)
Dental Fluorosis bull In East and central African countries (tribal
areas of Tanzania Magadi a fluoride rich tronaused in cooking
bull Used as a tenderizer and preservative
bull High Fluoride Concentration 7900 ppm
bull Magadi use may suggest high prevalence of fluorosis in northern Tanzania (Kaseva 2006)
Oral Hygiene
Perceptions among mothers
bull Hausa Fulani- 142 - babyrsquos mouth should be cleaned before teeth erupt
bull Yoruba- Babyrsquos mouthtongue cleaned before teeth erupt to prevent thrush
bull Hausa Fulani- 635 - commencement tooth cleaning between 6 and 12 months of age (Bankole et al 2017)
bull Yoruba- chewing sticks should not be used at night Causes premature death of mother (Oke et al 2011)
Practices
Hausa Fulani- 594 cleaned infants teeth once daily
- 614 children start cleaning their teeth unsupervised before the age of six years
- 751 of supervision was carried out by the grandparents
- Sudan -343 mothers donrsquot clean childrenrsquos teeth below the age of 2 years (Abduljalil et al 2016)
-Hausa - mothers start cleaning childrenrsquos teeth when enough teeth to justify effort (Oke et al 2011)
Oral hygiene practices
Cleaning materials used in infancyearly childhood
CommunityTribe
GlycerinFresh tomato Hydrogen peroxideAluminum sulphateVerona Amygdalina (bitter leaf)Iyere (African black pepper)Alligator pepperCitrus lime Combinations
Yoruba - Nigeria (Aderinokun 2000)
Alum (Aluminum sulphate) Bitter leaf (Verona Amygdalina)
Iyere (African black pepper)
Citrus lime Alligator pepper
Oral hygiene practices
Tooth Cleaning materials
CommunityTribe Side effect
Salt and cotton wool
Hausa (Oke et al 2011)
Finger Nomadic Fulani
Wooden twigSalvadora persiccatwig (miswak) Neem tree Chewing stick
Nomadic Fulani ( Bankole et al 2017)
Somali
India (Kochar et al 2014)
Yoruba Senegal (Diouf 2013)
Improper use ndashgingival trauma
round ceramics omadic ulani
brasion sensiti it
and omadic ulani
shes ood charcoal
Somali (Beveridge
India Senegal
Tooth Cleaning materials
CommunityTribe Side effect
Ground ceramics Nomadic Fulani Tooth abrasion
Sand Nomadic Fulani
AshesWood
Charcoal
Somali India Senegal
Tooth abrasion
IMPORTANCE OF THE PRIMARY DENTITION IN CHILDREN
bull Primary teeth in children are sometimes not regarded as important
bull Mothers of preschool children in Mumbai -436 believed 192 were uncertain that there is no need to visit a dentist for treating milk teeth as they will soon fall off (Jain et al 2014)
COMMON DENTAL DISEASES
Dental Caries
bull Early childhood caries is a significant public health problem caries affecting children globally
bull In recent years in developing countries like Sub-Saharan Africa the prevalence is predicted to increase
bull Early childhood caries is largely untreated in a study in South Africa reported a caries prevalence of 716 and these 675 were untreated (Mohammed and Barnes 2018 )
Dental caries Perceived cause of dental
caries
Community tribe
Worms (resembling
maggots)
Borom bop (master of the
head)
Lagatas
Smaller version of pubu
Worms -removed from
ears
Yoruba Nomadic Fulani
Chinese (Dong et al 2007)
Senegalese ( Diouf et al 2003)
Brazil
Papua New Guinea
Indian (Nagaraj et al2014)
Dental caries -Care remedies Dental care remedies Community tribe Effect
Hydrochloric acid (Wet cell
battery liquid)
Aluminum Phosphate
(Alum)
Tobacco snuff
Charcoal and salt
Gentian violet
Atare (Alligator Pepper)
Yoruba Brazil
Kenya (Mulu Maryanne)
Yoruba (Oke et al 2011)
Chemical burns
mucosal ulceration
Erosion
Tetracycline capsule (topical)
Paracetamol (topical)
Hausa Nomadic Fulani
Hausa
Greyish brown tooth
discolouration
Mucosal ulceration
Traditional concoction
Dental are remedies Dental care remedies Community
tribe
Effect
White wineVinegar Powdered alum musk and frankincense
Chinese (Dong et al 2007)
Herbs traditional medicine
Aborigines (Wong 2005)
Nettles
Hot sweet potato
Wads hot leaves ginger
Residue smoking pipe
White sap of shrub used
to kill maggots
Insecticide ointment
Papua New
Guinea
Predisposition to
oral cancer
Toxic
Dental care remedies Dental care remedies Community Effect
Cooked meat
salt alcohol grease
deodorant
Iran
fingernail polish remover
black tar
Garlic Warm coconut milk
Brazil Toxic
Kawakawa Māori(Pepper Tree
Leaves) chewed
Harakeke -Korari Flax
the gum used for toothache
Maori
GingivitisPeriodontal disease
Perceptions
bull Bleeding gums caused by
bull Child stores food in pouch of mouth and does not clean teeth
Remedies for gingival periodontal disease
Remedies Community tribe
Effect
Aluminium phosphate (Alum ) + Lapalapa sap (Jatropha curcas)Warm water and salt Tomato and alum+polystrene foam or cotton woolHydrogen peroxide
Yoruba
Antibiotics NomadiFulani
Resistant strains Hyper sensitivityreactions
Herbs
ORAL HABITS Kola nut chewing
Common West Central Africa Symbol of hospitality Contains caffeine tannin
bull Helps students keep awakewithstand fatigue
Practices
bull One-year prevalence student use was 291 Erinfolami et al (2011)
bull Majority started at age 14 years or below
bull Dangers -insomnia nausea tooth discolourationcarcinogenic potential for development of oral cancer
Areca Nut Chewing Habitbull Areca nut is the seed of areca palm
bull Widely grown- Asia India Bangladesh Japan
bull Believed to help fatigue
bull Highest period of risk for first use is between 5 and 12 Farrand et al 2001
74 4-16 age group in Karachi indulged in the habit (Shah et al 2002)
Dangers Oral sub mucous fibrosis
bull Risk of oral cancer 99 times( Wollina et al 2004 ) Foreign body aspiration Severe tooth wear -- sensitivity root fractures
Mandibular arch with generalized staining in the deciduous dentition
Prajapati D Nayak R Nayak UA Shah PJ Areca nut chewing habit in preschoolers Two rare case reports and literature review Int J Dent Health Concern 201511-5 (Permission given)
Mandibular arch with generalized staining in the deciduous dentition
Prajapati D Nayak R Nayak UA Shah PJ Areca nut chewing habit in preschoolers Two rare case reports and literature review Int J Dent Health Concern 201511-5 (Permission given)
Oral tobacco use and cigar smoking
bull High prevalence tobacco use in any form is reported among school going adolescents aged 13ndash15 years in India (Arora and Reddy 2005) Smoking Chutta is relatively popular may begin in childhood in India
bull Acts as a stimulant euphoric
bull May sleep with tobacco mixture in mouth
Harmful effects halitosis brown black staining gingival recession if wad is held against gingivaleucoplakia oral squamous cell carcinoma
Tobacco use in children
PRACTICES RELATED TO PUBERTY AND GROOMING
Tooth filing tooth sharpening
Practiced -Nigeria Niger-Delta area (Ukeghesonand Akadiri ) Democratic Republic of Congo Thailand Indonesia
bull Perception Historically -spiritual reasons Contemporary times - aesthetic reasons
bull In Nigeria maxillary midline diastema is regarded as a symbol of beauty (Arigbede and Adesuwa 2012
bull Teeth filed- because represent negative emotions eg anger jealousy (Balinese Indonesia)
30 respondents would not mind having artificially created diastema (Omotosho and Kadri (2010)
Practices
bull Done in adolescence - fashionable
bull Manually done Usually incisors
Harmful effects
bull pain during process
bull Tooth discolouration (teeth -non vital)
bull Infection -pus discharge lip swelling
Tooth filing
Peri-apical x-ray of lower central incisor
Lacquering and staining of teethPerformed in Vietnam Laos Thailand Indonesia and Philippines
Perception For cosmetic reasons
bull Main ingredient dye dark-brown solution of ferric acetate called kanemizu (iron filings in vinegar)
bull Coating the teeth with this liquid helped to prevent tooth decay and enamel decay
bull Practice has slowly declined
Traditional gingival tattooinglips bull Practiced in Africarsquos Sahel region Woddebe
Fulani tribe Senegal Ethiopia middle eastern countries
Perception Reason aesthetic appeal superstition
bull Practices Done when females reach puberty
bull Kanuri females Borno State Nigeria tattooing lip gingiva usually performed thorns of Balanites aegyptiaca (Bukar et al 2004 )
bull Pigments -Mixture charcoal and seeds of Acacia nilotica vartomentosa
Lip plug lip plate
bull The lip plate (lip plug or lip disc) form of body modification
bull Amazonian tribes young males traditionally -rite of passage indicate status and prestige
bull Mursi of Ethiopia girls age 13 to 18
bull At puberty mother cuts her lower lip
bull Held open by a wooden plug - inserted into thereby stretching the lip
bull At times -combined with removal of two or four lower anterior incisal teeth
Lip plug lip plate
TRADITIONAL DENTAL SERVICES
bull Perceptions
Cause of illness determines treatment taken Practices
bull Yoruba community patronize traditional dentists (Oke Bankole et al 2011) Edo state
bull Services rendered include worm extraction tooth extraction drug prescription and offering sacrifices to deities
bull Charges based on the worm count
Northern Nigeria called Serdia Toothache associated with dandruff
Cameroon traditional healers perform atraumatic tooth extraction Agbor et al (2011)
bull Leaves stems of Dichrocephala integrifolia
bull Tooth pulled out fingerssharp instrument
bull No pain Plant has anaesthetic properties
bull Dangers infection sepsis infection with hepatitis B Human Immunodeficiency Virus
bull Jewish Unlikely keep Friday appointment with the dentist for their children
bull Routine appointments on Fridays avoided (Scambler et al )
The traditional healer harvesting the medicinal plant in Cameroon
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J Ethnobiol Ethnomed 2011 715
Tooth extraction by a traditional dentist
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J EthnobiolEthnomed 2011 715
bull Health is a consequence of an individualrsquos lifestyle
bull Essential to Identify cultural factors that are harmful and those that are beneficial
bull As paediatric dentists we should discourage the unhealthy practices through rigorous health education and promote the adoption of healthy practices
bull Need for multicentric research on the cultural influence of the family and peers regarding oral health of children
bull Bankole OO Lawal FB Ibiyemi O (2017) Dispelling myths associated with natalneonatal teeth ldquoAdunnirdquo a health education video in a native Nigerian language Annals of Ibadan Postgraduate Medicine15(2)137-141
Thank you for listening
Natal tooth
Perceptions regarding natalneonatal teeth in infants
Traditional birth
attendaants
Bankole et al
(2013
Igbo Ora
Community
Unpublished
PERCEIVED CAUSES
Evil spirits evil child Abiku 319 487
Mothers contravened taboos 92 35
Prolonged maternal gestation 49
EFFECT ON THE FAMILY
Curse 74 106
Abomination 245 360
Embarrassment 11 360
Practices regarding natalneonatal teeth
Traditional birth
attendants
Bankole et al 2003)
Practices
Immediate extraction
Spiritual cleansing
356 Pain infection HIV
hepatitis B tetanus
Get rid of child 49 Infanticide
EFFECT ON CHILD
Strange odd behavior 313 Stigmatization
Evil spiritual powers 411 Stigmatization
Mental retardation
dull
31
With Traditional Birth Attendants at Ibadan South East Local government area
REVERSAL OF ERUPTION SEQUENCE
bull African ethnographies - infants whose upper teeth erupt before their lower teeth have been killed because of such ldquodevelopmental anomaliesrdquo
bull Considered a bad omen and sign of misfortune among Hamar Ethiopia Benin Rebublic
bull Reversal of eruption sequence of primary incisors in infants in Yoruba community has led to unpleasant circumstances
Reversal of eruption sequence
Reversal of eruption sequence
TraditionalBirth Attendants
Bankole and Lawal (2018)
PERCEIVED CAUSES
Evil spirits 218 476
Contravening taboos 80 26
EFFECT ON THE FAMILY
Curse 135 214Abomination 276 218
Embarrassment 233 114
Practices regarding reversal of eruption sequence of the anterior primary teeth
Practices Bankole and
Lawal(2018 )Effect
Immediate extraction 337 Pain infection HJV
hepatitis B infection
tetanus
HideGet rid of child 613 Infanticide
EFFECT ON CHILD
Strange behavior 227 Stigmatization
Evil powers 417 Stigmatization
Mental retardation 25
Dr Bankole and Dr Lawal with the Traditional Birth Attendants at the Ibadan South West LGA
DIETDental caries has escalated in developing countries
bull Misconception Food and drinks refined processed or modern is best and associated with affluence (Aderinokun et al 2011)
bull Parents donrsquot want their children to be deprived of what they lacked when young
bull This has led to a cultural shift in diet
bull Some African American believe motherrsquos diet during pregnancy cause dental caries in the child
bull Somali refugees Hutterites and Latino immigrant caregivers believed genetics plays a role in development early childhood caries (Prowse 2014)
Practices
bull YorubaHausa community common snacks have assumed local flavours several shapes coloursof sweets sold
bull Natural foods fruits are being sweetened Oke Bankole et al 2011 )
bull Nomadic Fulani sugary diet in between their meals sweetened drinks in bottles Sippy cups (827) and (716) give pacifiers dipped in sweet liquids Reduce temper tantrums with sweets Bankole et al 2015
Infant feeding practices
bull Babies with sweetened drinks in bottles pacifiers dipped in sweet liquidsputting infant to bed with a bottle of sweetened liquid Reported among Mexican Americans and Puerto Ricans Hong Kong Saudi mothers Al-Zahrani et al 2014
bull High risk factors contributing development of early childhood caries in infants
Diet
bull Perception
Animals such as pig are unclean
bull Practices
bull Hindus donrsquot eat beef Muslims donrsquot eat pork
bull Protective prevent taeniasis cystecercosis -edematous oral ulcers gingival bleeding lesions mimicking mucocles in children
(Alves et al 2011)
Dental Fluorosis bull In East and central African countries (tribal
areas of Tanzania Magadi a fluoride rich tronaused in cooking
bull Used as a tenderizer and preservative
bull High Fluoride Concentration 7900 ppm
bull Magadi use may suggest high prevalence of fluorosis in northern Tanzania (Kaseva 2006)
Oral Hygiene
Perceptions among mothers
bull Hausa Fulani- 142 - babyrsquos mouth should be cleaned before teeth erupt
bull Yoruba- Babyrsquos mouthtongue cleaned before teeth erupt to prevent thrush
bull Hausa Fulani- 635 - commencement tooth cleaning between 6 and 12 months of age (Bankole et al 2017)
bull Yoruba- chewing sticks should not be used at night Causes premature death of mother (Oke et al 2011)
Practices
Hausa Fulani- 594 cleaned infants teeth once daily
- 614 children start cleaning their teeth unsupervised before the age of six years
- 751 of supervision was carried out by the grandparents
- Sudan -343 mothers donrsquot clean childrenrsquos teeth below the age of 2 years (Abduljalil et al 2016)
-Hausa - mothers start cleaning childrenrsquos teeth when enough teeth to justify effort (Oke et al 2011)
Oral hygiene practices
Cleaning materials used in infancyearly childhood
CommunityTribe
GlycerinFresh tomato Hydrogen peroxideAluminum sulphateVerona Amygdalina (bitter leaf)Iyere (African black pepper)Alligator pepperCitrus lime Combinations
Yoruba - Nigeria (Aderinokun 2000)
Alum (Aluminum sulphate) Bitter leaf (Verona Amygdalina)
Iyere (African black pepper)
Citrus lime Alligator pepper
Oral hygiene practices
Tooth Cleaning materials
CommunityTribe Side effect
Salt and cotton wool
Hausa (Oke et al 2011)
Finger Nomadic Fulani
Wooden twigSalvadora persiccatwig (miswak) Neem tree Chewing stick
Nomadic Fulani ( Bankole et al 2017)
Somali
India (Kochar et al 2014)
Yoruba Senegal (Diouf 2013)
Improper use ndashgingival trauma
round ceramics omadic ulani
brasion sensiti it
and omadic ulani
shes ood charcoal
Somali (Beveridge
India Senegal
Tooth Cleaning materials
CommunityTribe Side effect
Ground ceramics Nomadic Fulani Tooth abrasion
Sand Nomadic Fulani
AshesWood
Charcoal
Somali India Senegal
Tooth abrasion
IMPORTANCE OF THE PRIMARY DENTITION IN CHILDREN
bull Primary teeth in children are sometimes not regarded as important
bull Mothers of preschool children in Mumbai -436 believed 192 were uncertain that there is no need to visit a dentist for treating milk teeth as they will soon fall off (Jain et al 2014)
COMMON DENTAL DISEASES
Dental Caries
bull Early childhood caries is a significant public health problem caries affecting children globally
bull In recent years in developing countries like Sub-Saharan Africa the prevalence is predicted to increase
bull Early childhood caries is largely untreated in a study in South Africa reported a caries prevalence of 716 and these 675 were untreated (Mohammed and Barnes 2018 )
Dental caries Perceived cause of dental
caries
Community tribe
Worms (resembling
maggots)
Borom bop (master of the
head)
Lagatas
Smaller version of pubu
Worms -removed from
ears
Yoruba Nomadic Fulani
Chinese (Dong et al 2007)
Senegalese ( Diouf et al 2003)
Brazil
Papua New Guinea
Indian (Nagaraj et al2014)
Dental caries -Care remedies Dental care remedies Community tribe Effect
Hydrochloric acid (Wet cell
battery liquid)
Aluminum Phosphate
(Alum)
Tobacco snuff
Charcoal and salt
Gentian violet
Atare (Alligator Pepper)
Yoruba Brazil
Kenya (Mulu Maryanne)
Yoruba (Oke et al 2011)
Chemical burns
mucosal ulceration
Erosion
Tetracycline capsule (topical)
Paracetamol (topical)
Hausa Nomadic Fulani
Hausa
Greyish brown tooth
discolouration
Mucosal ulceration
Traditional concoction
Dental are remedies Dental care remedies Community
tribe
Effect
White wineVinegar Powdered alum musk and frankincense
Chinese (Dong et al 2007)
Herbs traditional medicine
Aborigines (Wong 2005)
Nettles
Hot sweet potato
Wads hot leaves ginger
Residue smoking pipe
White sap of shrub used
to kill maggots
Insecticide ointment
Papua New
Guinea
Predisposition to
oral cancer
Toxic
Dental care remedies Dental care remedies Community Effect
Cooked meat
salt alcohol grease
deodorant
Iran
fingernail polish remover
black tar
Garlic Warm coconut milk
Brazil Toxic
Kawakawa Māori(Pepper Tree
Leaves) chewed
Harakeke -Korari Flax
the gum used for toothache
Maori
GingivitisPeriodontal disease
Perceptions
bull Bleeding gums caused by
bull Child stores food in pouch of mouth and does not clean teeth
Remedies for gingival periodontal disease
Remedies Community tribe
Effect
Aluminium phosphate (Alum ) + Lapalapa sap (Jatropha curcas)Warm water and salt Tomato and alum+polystrene foam or cotton woolHydrogen peroxide
Yoruba
Antibiotics NomadiFulani
Resistant strains Hyper sensitivityreactions
Herbs
ORAL HABITS Kola nut chewing
Common West Central Africa Symbol of hospitality Contains caffeine tannin
bull Helps students keep awakewithstand fatigue
Practices
bull One-year prevalence student use was 291 Erinfolami et al (2011)
bull Majority started at age 14 years or below
bull Dangers -insomnia nausea tooth discolourationcarcinogenic potential for development of oral cancer
Areca Nut Chewing Habitbull Areca nut is the seed of areca palm
bull Widely grown- Asia India Bangladesh Japan
bull Believed to help fatigue
bull Highest period of risk for first use is between 5 and 12 Farrand et al 2001
74 4-16 age group in Karachi indulged in the habit (Shah et al 2002)
Dangers Oral sub mucous fibrosis
bull Risk of oral cancer 99 times( Wollina et al 2004 ) Foreign body aspiration Severe tooth wear -- sensitivity root fractures
Mandibular arch with generalized staining in the deciduous dentition
Prajapati D Nayak R Nayak UA Shah PJ Areca nut chewing habit in preschoolers Two rare case reports and literature review Int J Dent Health Concern 201511-5 (Permission given)
Mandibular arch with generalized staining in the deciduous dentition
Prajapati D Nayak R Nayak UA Shah PJ Areca nut chewing habit in preschoolers Two rare case reports and literature review Int J Dent Health Concern 201511-5 (Permission given)
Oral tobacco use and cigar smoking
bull High prevalence tobacco use in any form is reported among school going adolescents aged 13ndash15 years in India (Arora and Reddy 2005) Smoking Chutta is relatively popular may begin in childhood in India
bull Acts as a stimulant euphoric
bull May sleep with tobacco mixture in mouth
Harmful effects halitosis brown black staining gingival recession if wad is held against gingivaleucoplakia oral squamous cell carcinoma
Tobacco use in children
PRACTICES RELATED TO PUBERTY AND GROOMING
Tooth filing tooth sharpening
Practiced -Nigeria Niger-Delta area (Ukeghesonand Akadiri ) Democratic Republic of Congo Thailand Indonesia
bull Perception Historically -spiritual reasons Contemporary times - aesthetic reasons
bull In Nigeria maxillary midline diastema is regarded as a symbol of beauty (Arigbede and Adesuwa 2012
bull Teeth filed- because represent negative emotions eg anger jealousy (Balinese Indonesia)
30 respondents would not mind having artificially created diastema (Omotosho and Kadri (2010)
Practices
bull Done in adolescence - fashionable
bull Manually done Usually incisors
Harmful effects
bull pain during process
bull Tooth discolouration (teeth -non vital)
bull Infection -pus discharge lip swelling
Tooth filing
Peri-apical x-ray of lower central incisor
Lacquering and staining of teethPerformed in Vietnam Laos Thailand Indonesia and Philippines
Perception For cosmetic reasons
bull Main ingredient dye dark-brown solution of ferric acetate called kanemizu (iron filings in vinegar)
bull Coating the teeth with this liquid helped to prevent tooth decay and enamel decay
bull Practice has slowly declined
Traditional gingival tattooinglips bull Practiced in Africarsquos Sahel region Woddebe
Fulani tribe Senegal Ethiopia middle eastern countries
Perception Reason aesthetic appeal superstition
bull Practices Done when females reach puberty
bull Kanuri females Borno State Nigeria tattooing lip gingiva usually performed thorns of Balanites aegyptiaca (Bukar et al 2004 )
bull Pigments -Mixture charcoal and seeds of Acacia nilotica vartomentosa
Lip plug lip plate
bull The lip plate (lip plug or lip disc) form of body modification
bull Amazonian tribes young males traditionally -rite of passage indicate status and prestige
bull Mursi of Ethiopia girls age 13 to 18
bull At puberty mother cuts her lower lip
bull Held open by a wooden plug - inserted into thereby stretching the lip
bull At times -combined with removal of two or four lower anterior incisal teeth
Lip plug lip plate
TRADITIONAL DENTAL SERVICES
bull Perceptions
Cause of illness determines treatment taken Practices
bull Yoruba community patronize traditional dentists (Oke Bankole et al 2011) Edo state
bull Services rendered include worm extraction tooth extraction drug prescription and offering sacrifices to deities
bull Charges based on the worm count
Northern Nigeria called Serdia Toothache associated with dandruff
Cameroon traditional healers perform atraumatic tooth extraction Agbor et al (2011)
bull Leaves stems of Dichrocephala integrifolia
bull Tooth pulled out fingerssharp instrument
bull No pain Plant has anaesthetic properties
bull Dangers infection sepsis infection with hepatitis B Human Immunodeficiency Virus
bull Jewish Unlikely keep Friday appointment with the dentist for their children
bull Routine appointments on Fridays avoided (Scambler et al )
The traditional healer harvesting the medicinal plant in Cameroon
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J Ethnobiol Ethnomed 2011 715
Tooth extraction by a traditional dentist
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J EthnobiolEthnomed 2011 715
bull Health is a consequence of an individualrsquos lifestyle
bull Essential to Identify cultural factors that are harmful and those that are beneficial
bull As paediatric dentists we should discourage the unhealthy practices through rigorous health education and promote the adoption of healthy practices
bull Need for multicentric research on the cultural influence of the family and peers regarding oral health of children
bull Bankole OO Lawal FB Ibiyemi O (2017) Dispelling myths associated with natalneonatal teeth ldquoAdunnirdquo a health education video in a native Nigerian language Annals of Ibadan Postgraduate Medicine15(2)137-141
Thank you for listening
Perceptions regarding natalneonatal teeth in infants
Traditional birth
attendaants
Bankole et al
(2013
Igbo Ora
Community
Unpublished
PERCEIVED CAUSES
Evil spirits evil child Abiku 319 487
Mothers contravened taboos 92 35
Prolonged maternal gestation 49
EFFECT ON THE FAMILY
Curse 74 106
Abomination 245 360
Embarrassment 11 360
Practices regarding natalneonatal teeth
Traditional birth
attendants
Bankole et al 2003)
Practices
Immediate extraction
Spiritual cleansing
356 Pain infection HIV
hepatitis B tetanus
Get rid of child 49 Infanticide
EFFECT ON CHILD
Strange odd behavior 313 Stigmatization
Evil spiritual powers 411 Stigmatization
Mental retardation
dull
31
With Traditional Birth Attendants at Ibadan South East Local government area
REVERSAL OF ERUPTION SEQUENCE
bull African ethnographies - infants whose upper teeth erupt before their lower teeth have been killed because of such ldquodevelopmental anomaliesrdquo
bull Considered a bad omen and sign of misfortune among Hamar Ethiopia Benin Rebublic
bull Reversal of eruption sequence of primary incisors in infants in Yoruba community has led to unpleasant circumstances
Reversal of eruption sequence
Reversal of eruption sequence
TraditionalBirth Attendants
Bankole and Lawal (2018)
PERCEIVED CAUSES
Evil spirits 218 476
Contravening taboos 80 26
EFFECT ON THE FAMILY
Curse 135 214Abomination 276 218
Embarrassment 233 114
Practices regarding reversal of eruption sequence of the anterior primary teeth
Practices Bankole and
Lawal(2018 )Effect
Immediate extraction 337 Pain infection HJV
hepatitis B infection
tetanus
HideGet rid of child 613 Infanticide
EFFECT ON CHILD
Strange behavior 227 Stigmatization
Evil powers 417 Stigmatization
Mental retardation 25
Dr Bankole and Dr Lawal with the Traditional Birth Attendants at the Ibadan South West LGA
DIETDental caries has escalated in developing countries
bull Misconception Food and drinks refined processed or modern is best and associated with affluence (Aderinokun et al 2011)
bull Parents donrsquot want their children to be deprived of what they lacked when young
bull This has led to a cultural shift in diet
bull Some African American believe motherrsquos diet during pregnancy cause dental caries in the child
bull Somali refugees Hutterites and Latino immigrant caregivers believed genetics plays a role in development early childhood caries (Prowse 2014)
Practices
bull YorubaHausa community common snacks have assumed local flavours several shapes coloursof sweets sold
bull Natural foods fruits are being sweetened Oke Bankole et al 2011 )
bull Nomadic Fulani sugary diet in between their meals sweetened drinks in bottles Sippy cups (827) and (716) give pacifiers dipped in sweet liquids Reduce temper tantrums with sweets Bankole et al 2015
Infant feeding practices
bull Babies with sweetened drinks in bottles pacifiers dipped in sweet liquidsputting infant to bed with a bottle of sweetened liquid Reported among Mexican Americans and Puerto Ricans Hong Kong Saudi mothers Al-Zahrani et al 2014
bull High risk factors contributing development of early childhood caries in infants
Diet
bull Perception
Animals such as pig are unclean
bull Practices
bull Hindus donrsquot eat beef Muslims donrsquot eat pork
bull Protective prevent taeniasis cystecercosis -edematous oral ulcers gingival bleeding lesions mimicking mucocles in children
(Alves et al 2011)
Dental Fluorosis bull In East and central African countries (tribal
areas of Tanzania Magadi a fluoride rich tronaused in cooking
bull Used as a tenderizer and preservative
bull High Fluoride Concentration 7900 ppm
bull Magadi use may suggest high prevalence of fluorosis in northern Tanzania (Kaseva 2006)
Oral Hygiene
Perceptions among mothers
bull Hausa Fulani- 142 - babyrsquos mouth should be cleaned before teeth erupt
bull Yoruba- Babyrsquos mouthtongue cleaned before teeth erupt to prevent thrush
bull Hausa Fulani- 635 - commencement tooth cleaning between 6 and 12 months of age (Bankole et al 2017)
bull Yoruba- chewing sticks should not be used at night Causes premature death of mother (Oke et al 2011)
Practices
Hausa Fulani- 594 cleaned infants teeth once daily
- 614 children start cleaning their teeth unsupervised before the age of six years
- 751 of supervision was carried out by the grandparents
- Sudan -343 mothers donrsquot clean childrenrsquos teeth below the age of 2 years (Abduljalil et al 2016)
-Hausa - mothers start cleaning childrenrsquos teeth when enough teeth to justify effort (Oke et al 2011)
Oral hygiene practices
Cleaning materials used in infancyearly childhood
CommunityTribe
GlycerinFresh tomato Hydrogen peroxideAluminum sulphateVerona Amygdalina (bitter leaf)Iyere (African black pepper)Alligator pepperCitrus lime Combinations
Yoruba - Nigeria (Aderinokun 2000)
Alum (Aluminum sulphate) Bitter leaf (Verona Amygdalina)
Iyere (African black pepper)
Citrus lime Alligator pepper
Oral hygiene practices
Tooth Cleaning materials
CommunityTribe Side effect
Salt and cotton wool
Hausa (Oke et al 2011)
Finger Nomadic Fulani
Wooden twigSalvadora persiccatwig (miswak) Neem tree Chewing stick
Nomadic Fulani ( Bankole et al 2017)
Somali
India (Kochar et al 2014)
Yoruba Senegal (Diouf 2013)
Improper use ndashgingival trauma
round ceramics omadic ulani
brasion sensiti it
and omadic ulani
shes ood charcoal
Somali (Beveridge
India Senegal
Tooth Cleaning materials
CommunityTribe Side effect
Ground ceramics Nomadic Fulani Tooth abrasion
Sand Nomadic Fulani
AshesWood
Charcoal
Somali India Senegal
Tooth abrasion
IMPORTANCE OF THE PRIMARY DENTITION IN CHILDREN
bull Primary teeth in children are sometimes not regarded as important
bull Mothers of preschool children in Mumbai -436 believed 192 were uncertain that there is no need to visit a dentist for treating milk teeth as they will soon fall off (Jain et al 2014)
COMMON DENTAL DISEASES
Dental Caries
bull Early childhood caries is a significant public health problem caries affecting children globally
bull In recent years in developing countries like Sub-Saharan Africa the prevalence is predicted to increase
bull Early childhood caries is largely untreated in a study in South Africa reported a caries prevalence of 716 and these 675 were untreated (Mohammed and Barnes 2018 )
Dental caries Perceived cause of dental
caries
Community tribe
Worms (resembling
maggots)
Borom bop (master of the
head)
Lagatas
Smaller version of pubu
Worms -removed from
ears
Yoruba Nomadic Fulani
Chinese (Dong et al 2007)
Senegalese ( Diouf et al 2003)
Brazil
Papua New Guinea
Indian (Nagaraj et al2014)
Dental caries -Care remedies Dental care remedies Community tribe Effect
Hydrochloric acid (Wet cell
battery liquid)
Aluminum Phosphate
(Alum)
Tobacco snuff
Charcoal and salt
Gentian violet
Atare (Alligator Pepper)
Yoruba Brazil
Kenya (Mulu Maryanne)
Yoruba (Oke et al 2011)
Chemical burns
mucosal ulceration
Erosion
Tetracycline capsule (topical)
Paracetamol (topical)
Hausa Nomadic Fulani
Hausa
Greyish brown tooth
discolouration
Mucosal ulceration
Traditional concoction
Dental are remedies Dental care remedies Community
tribe
Effect
White wineVinegar Powdered alum musk and frankincense
Chinese (Dong et al 2007)
Herbs traditional medicine
Aborigines (Wong 2005)
Nettles
Hot sweet potato
Wads hot leaves ginger
Residue smoking pipe
White sap of shrub used
to kill maggots
Insecticide ointment
Papua New
Guinea
Predisposition to
oral cancer
Toxic
Dental care remedies Dental care remedies Community Effect
Cooked meat
salt alcohol grease
deodorant
Iran
fingernail polish remover
black tar
Garlic Warm coconut milk
Brazil Toxic
Kawakawa Māori(Pepper Tree
Leaves) chewed
Harakeke -Korari Flax
the gum used for toothache
Maori
GingivitisPeriodontal disease
Perceptions
bull Bleeding gums caused by
bull Child stores food in pouch of mouth and does not clean teeth
Remedies for gingival periodontal disease
Remedies Community tribe
Effect
Aluminium phosphate (Alum ) + Lapalapa sap (Jatropha curcas)Warm water and salt Tomato and alum+polystrene foam or cotton woolHydrogen peroxide
Yoruba
Antibiotics NomadiFulani
Resistant strains Hyper sensitivityreactions
Herbs
ORAL HABITS Kola nut chewing
Common West Central Africa Symbol of hospitality Contains caffeine tannin
bull Helps students keep awakewithstand fatigue
Practices
bull One-year prevalence student use was 291 Erinfolami et al (2011)
bull Majority started at age 14 years or below
bull Dangers -insomnia nausea tooth discolourationcarcinogenic potential for development of oral cancer
Areca Nut Chewing Habitbull Areca nut is the seed of areca palm
bull Widely grown- Asia India Bangladesh Japan
bull Believed to help fatigue
bull Highest period of risk for first use is between 5 and 12 Farrand et al 2001
74 4-16 age group in Karachi indulged in the habit (Shah et al 2002)
Dangers Oral sub mucous fibrosis
bull Risk of oral cancer 99 times( Wollina et al 2004 ) Foreign body aspiration Severe tooth wear -- sensitivity root fractures
Mandibular arch with generalized staining in the deciduous dentition
Prajapati D Nayak R Nayak UA Shah PJ Areca nut chewing habit in preschoolers Two rare case reports and literature review Int J Dent Health Concern 201511-5 (Permission given)
Mandibular arch with generalized staining in the deciduous dentition
Prajapati D Nayak R Nayak UA Shah PJ Areca nut chewing habit in preschoolers Two rare case reports and literature review Int J Dent Health Concern 201511-5 (Permission given)
Oral tobacco use and cigar smoking
bull High prevalence tobacco use in any form is reported among school going adolescents aged 13ndash15 years in India (Arora and Reddy 2005) Smoking Chutta is relatively popular may begin in childhood in India
bull Acts as a stimulant euphoric
bull May sleep with tobacco mixture in mouth
Harmful effects halitosis brown black staining gingival recession if wad is held against gingivaleucoplakia oral squamous cell carcinoma
Tobacco use in children
PRACTICES RELATED TO PUBERTY AND GROOMING
Tooth filing tooth sharpening
Practiced -Nigeria Niger-Delta area (Ukeghesonand Akadiri ) Democratic Republic of Congo Thailand Indonesia
bull Perception Historically -spiritual reasons Contemporary times - aesthetic reasons
bull In Nigeria maxillary midline diastema is regarded as a symbol of beauty (Arigbede and Adesuwa 2012
bull Teeth filed- because represent negative emotions eg anger jealousy (Balinese Indonesia)
30 respondents would not mind having artificially created diastema (Omotosho and Kadri (2010)
Practices
bull Done in adolescence - fashionable
bull Manually done Usually incisors
Harmful effects
bull pain during process
bull Tooth discolouration (teeth -non vital)
bull Infection -pus discharge lip swelling
Tooth filing
Peri-apical x-ray of lower central incisor
Lacquering and staining of teethPerformed in Vietnam Laos Thailand Indonesia and Philippines
Perception For cosmetic reasons
bull Main ingredient dye dark-brown solution of ferric acetate called kanemizu (iron filings in vinegar)
bull Coating the teeth with this liquid helped to prevent tooth decay and enamel decay
bull Practice has slowly declined
Traditional gingival tattooinglips bull Practiced in Africarsquos Sahel region Woddebe
Fulani tribe Senegal Ethiopia middle eastern countries
Perception Reason aesthetic appeal superstition
bull Practices Done when females reach puberty
bull Kanuri females Borno State Nigeria tattooing lip gingiva usually performed thorns of Balanites aegyptiaca (Bukar et al 2004 )
bull Pigments -Mixture charcoal and seeds of Acacia nilotica vartomentosa
Lip plug lip plate
bull The lip plate (lip plug or lip disc) form of body modification
bull Amazonian tribes young males traditionally -rite of passage indicate status and prestige
bull Mursi of Ethiopia girls age 13 to 18
bull At puberty mother cuts her lower lip
bull Held open by a wooden plug - inserted into thereby stretching the lip
bull At times -combined with removal of two or four lower anterior incisal teeth
Lip plug lip plate
TRADITIONAL DENTAL SERVICES
bull Perceptions
Cause of illness determines treatment taken Practices
bull Yoruba community patronize traditional dentists (Oke Bankole et al 2011) Edo state
bull Services rendered include worm extraction tooth extraction drug prescription and offering sacrifices to deities
bull Charges based on the worm count
Northern Nigeria called Serdia Toothache associated with dandruff
Cameroon traditional healers perform atraumatic tooth extraction Agbor et al (2011)
bull Leaves stems of Dichrocephala integrifolia
bull Tooth pulled out fingerssharp instrument
bull No pain Plant has anaesthetic properties
bull Dangers infection sepsis infection with hepatitis B Human Immunodeficiency Virus
bull Jewish Unlikely keep Friday appointment with the dentist for their children
bull Routine appointments on Fridays avoided (Scambler et al )
The traditional healer harvesting the medicinal plant in Cameroon
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J Ethnobiol Ethnomed 2011 715
Tooth extraction by a traditional dentist
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J EthnobiolEthnomed 2011 715
bull Health is a consequence of an individualrsquos lifestyle
bull Essential to Identify cultural factors that are harmful and those that are beneficial
bull As paediatric dentists we should discourage the unhealthy practices through rigorous health education and promote the adoption of healthy practices
bull Need for multicentric research on the cultural influence of the family and peers regarding oral health of children
bull Bankole OO Lawal FB Ibiyemi O (2017) Dispelling myths associated with natalneonatal teeth ldquoAdunnirdquo a health education video in a native Nigerian language Annals of Ibadan Postgraduate Medicine15(2)137-141
Thank you for listening
Practices regarding natalneonatal teeth
Traditional birth
attendants
Bankole et al 2003)
Practices
Immediate extraction
Spiritual cleansing
356 Pain infection HIV
hepatitis B tetanus
Get rid of child 49 Infanticide
EFFECT ON CHILD
Strange odd behavior 313 Stigmatization
Evil spiritual powers 411 Stigmatization
Mental retardation
dull
31
With Traditional Birth Attendants at Ibadan South East Local government area
REVERSAL OF ERUPTION SEQUENCE
bull African ethnographies - infants whose upper teeth erupt before their lower teeth have been killed because of such ldquodevelopmental anomaliesrdquo
bull Considered a bad omen and sign of misfortune among Hamar Ethiopia Benin Rebublic
bull Reversal of eruption sequence of primary incisors in infants in Yoruba community has led to unpleasant circumstances
Reversal of eruption sequence
Reversal of eruption sequence
TraditionalBirth Attendants
Bankole and Lawal (2018)
PERCEIVED CAUSES
Evil spirits 218 476
Contravening taboos 80 26
EFFECT ON THE FAMILY
Curse 135 214Abomination 276 218
Embarrassment 233 114
Practices regarding reversal of eruption sequence of the anterior primary teeth
Practices Bankole and
Lawal(2018 )Effect
Immediate extraction 337 Pain infection HJV
hepatitis B infection
tetanus
HideGet rid of child 613 Infanticide
EFFECT ON CHILD
Strange behavior 227 Stigmatization
Evil powers 417 Stigmatization
Mental retardation 25
Dr Bankole and Dr Lawal with the Traditional Birth Attendants at the Ibadan South West LGA
DIETDental caries has escalated in developing countries
bull Misconception Food and drinks refined processed or modern is best and associated with affluence (Aderinokun et al 2011)
bull Parents donrsquot want their children to be deprived of what they lacked when young
bull This has led to a cultural shift in diet
bull Some African American believe motherrsquos diet during pregnancy cause dental caries in the child
bull Somali refugees Hutterites and Latino immigrant caregivers believed genetics plays a role in development early childhood caries (Prowse 2014)
Practices
bull YorubaHausa community common snacks have assumed local flavours several shapes coloursof sweets sold
bull Natural foods fruits are being sweetened Oke Bankole et al 2011 )
bull Nomadic Fulani sugary diet in between their meals sweetened drinks in bottles Sippy cups (827) and (716) give pacifiers dipped in sweet liquids Reduce temper tantrums with sweets Bankole et al 2015
Infant feeding practices
bull Babies with sweetened drinks in bottles pacifiers dipped in sweet liquidsputting infant to bed with a bottle of sweetened liquid Reported among Mexican Americans and Puerto Ricans Hong Kong Saudi mothers Al-Zahrani et al 2014
bull High risk factors contributing development of early childhood caries in infants
Diet
bull Perception
Animals such as pig are unclean
bull Practices
bull Hindus donrsquot eat beef Muslims donrsquot eat pork
bull Protective prevent taeniasis cystecercosis -edematous oral ulcers gingival bleeding lesions mimicking mucocles in children
(Alves et al 2011)
Dental Fluorosis bull In East and central African countries (tribal
areas of Tanzania Magadi a fluoride rich tronaused in cooking
bull Used as a tenderizer and preservative
bull High Fluoride Concentration 7900 ppm
bull Magadi use may suggest high prevalence of fluorosis in northern Tanzania (Kaseva 2006)
Oral Hygiene
Perceptions among mothers
bull Hausa Fulani- 142 - babyrsquos mouth should be cleaned before teeth erupt
bull Yoruba- Babyrsquos mouthtongue cleaned before teeth erupt to prevent thrush
bull Hausa Fulani- 635 - commencement tooth cleaning between 6 and 12 months of age (Bankole et al 2017)
bull Yoruba- chewing sticks should not be used at night Causes premature death of mother (Oke et al 2011)
Practices
Hausa Fulani- 594 cleaned infants teeth once daily
- 614 children start cleaning their teeth unsupervised before the age of six years
- 751 of supervision was carried out by the grandparents
- Sudan -343 mothers donrsquot clean childrenrsquos teeth below the age of 2 years (Abduljalil et al 2016)
-Hausa - mothers start cleaning childrenrsquos teeth when enough teeth to justify effort (Oke et al 2011)
Oral hygiene practices
Cleaning materials used in infancyearly childhood
CommunityTribe
GlycerinFresh tomato Hydrogen peroxideAluminum sulphateVerona Amygdalina (bitter leaf)Iyere (African black pepper)Alligator pepperCitrus lime Combinations
Yoruba - Nigeria (Aderinokun 2000)
Alum (Aluminum sulphate) Bitter leaf (Verona Amygdalina)
Iyere (African black pepper)
Citrus lime Alligator pepper
Oral hygiene practices
Tooth Cleaning materials
CommunityTribe Side effect
Salt and cotton wool
Hausa (Oke et al 2011)
Finger Nomadic Fulani
Wooden twigSalvadora persiccatwig (miswak) Neem tree Chewing stick
Nomadic Fulani ( Bankole et al 2017)
Somali
India (Kochar et al 2014)
Yoruba Senegal (Diouf 2013)
Improper use ndashgingival trauma
round ceramics omadic ulani
brasion sensiti it
and omadic ulani
shes ood charcoal
Somali (Beveridge
India Senegal
Tooth Cleaning materials
CommunityTribe Side effect
Ground ceramics Nomadic Fulani Tooth abrasion
Sand Nomadic Fulani
AshesWood
Charcoal
Somali India Senegal
Tooth abrasion
IMPORTANCE OF THE PRIMARY DENTITION IN CHILDREN
bull Primary teeth in children are sometimes not regarded as important
bull Mothers of preschool children in Mumbai -436 believed 192 were uncertain that there is no need to visit a dentist for treating milk teeth as they will soon fall off (Jain et al 2014)
COMMON DENTAL DISEASES
Dental Caries
bull Early childhood caries is a significant public health problem caries affecting children globally
bull In recent years in developing countries like Sub-Saharan Africa the prevalence is predicted to increase
bull Early childhood caries is largely untreated in a study in South Africa reported a caries prevalence of 716 and these 675 were untreated (Mohammed and Barnes 2018 )
Dental caries Perceived cause of dental
caries
Community tribe
Worms (resembling
maggots)
Borom bop (master of the
head)
Lagatas
Smaller version of pubu
Worms -removed from
ears
Yoruba Nomadic Fulani
Chinese (Dong et al 2007)
Senegalese ( Diouf et al 2003)
Brazil
Papua New Guinea
Indian (Nagaraj et al2014)
Dental caries -Care remedies Dental care remedies Community tribe Effect
Hydrochloric acid (Wet cell
battery liquid)
Aluminum Phosphate
(Alum)
Tobacco snuff
Charcoal and salt
Gentian violet
Atare (Alligator Pepper)
Yoruba Brazil
Kenya (Mulu Maryanne)
Yoruba (Oke et al 2011)
Chemical burns
mucosal ulceration
Erosion
Tetracycline capsule (topical)
Paracetamol (topical)
Hausa Nomadic Fulani
Hausa
Greyish brown tooth
discolouration
Mucosal ulceration
Traditional concoction
Dental are remedies Dental care remedies Community
tribe
Effect
White wineVinegar Powdered alum musk and frankincense
Chinese (Dong et al 2007)
Herbs traditional medicine
Aborigines (Wong 2005)
Nettles
Hot sweet potato
Wads hot leaves ginger
Residue smoking pipe
White sap of shrub used
to kill maggots
Insecticide ointment
Papua New
Guinea
Predisposition to
oral cancer
Toxic
Dental care remedies Dental care remedies Community Effect
Cooked meat
salt alcohol grease
deodorant
Iran
fingernail polish remover
black tar
Garlic Warm coconut milk
Brazil Toxic
Kawakawa Māori(Pepper Tree
Leaves) chewed
Harakeke -Korari Flax
the gum used for toothache
Maori
GingivitisPeriodontal disease
Perceptions
bull Bleeding gums caused by
bull Child stores food in pouch of mouth and does not clean teeth
Remedies for gingival periodontal disease
Remedies Community tribe
Effect
Aluminium phosphate (Alum ) + Lapalapa sap (Jatropha curcas)Warm water and salt Tomato and alum+polystrene foam or cotton woolHydrogen peroxide
Yoruba
Antibiotics NomadiFulani
Resistant strains Hyper sensitivityreactions
Herbs
ORAL HABITS Kola nut chewing
Common West Central Africa Symbol of hospitality Contains caffeine tannin
bull Helps students keep awakewithstand fatigue
Practices
bull One-year prevalence student use was 291 Erinfolami et al (2011)
bull Majority started at age 14 years or below
bull Dangers -insomnia nausea tooth discolourationcarcinogenic potential for development of oral cancer
Areca Nut Chewing Habitbull Areca nut is the seed of areca palm
bull Widely grown- Asia India Bangladesh Japan
bull Believed to help fatigue
bull Highest period of risk for first use is between 5 and 12 Farrand et al 2001
74 4-16 age group in Karachi indulged in the habit (Shah et al 2002)
Dangers Oral sub mucous fibrosis
bull Risk of oral cancer 99 times( Wollina et al 2004 ) Foreign body aspiration Severe tooth wear -- sensitivity root fractures
Mandibular arch with generalized staining in the deciduous dentition
Prajapati D Nayak R Nayak UA Shah PJ Areca nut chewing habit in preschoolers Two rare case reports and literature review Int J Dent Health Concern 201511-5 (Permission given)
Mandibular arch with generalized staining in the deciduous dentition
Prajapati D Nayak R Nayak UA Shah PJ Areca nut chewing habit in preschoolers Two rare case reports and literature review Int J Dent Health Concern 201511-5 (Permission given)
Oral tobacco use and cigar smoking
bull High prevalence tobacco use in any form is reported among school going adolescents aged 13ndash15 years in India (Arora and Reddy 2005) Smoking Chutta is relatively popular may begin in childhood in India
bull Acts as a stimulant euphoric
bull May sleep with tobacco mixture in mouth
Harmful effects halitosis brown black staining gingival recession if wad is held against gingivaleucoplakia oral squamous cell carcinoma
Tobacco use in children
PRACTICES RELATED TO PUBERTY AND GROOMING
Tooth filing tooth sharpening
Practiced -Nigeria Niger-Delta area (Ukeghesonand Akadiri ) Democratic Republic of Congo Thailand Indonesia
bull Perception Historically -spiritual reasons Contemporary times - aesthetic reasons
bull In Nigeria maxillary midline diastema is regarded as a symbol of beauty (Arigbede and Adesuwa 2012
bull Teeth filed- because represent negative emotions eg anger jealousy (Balinese Indonesia)
30 respondents would not mind having artificially created diastema (Omotosho and Kadri (2010)
Practices
bull Done in adolescence - fashionable
bull Manually done Usually incisors
Harmful effects
bull pain during process
bull Tooth discolouration (teeth -non vital)
bull Infection -pus discharge lip swelling
Tooth filing
Peri-apical x-ray of lower central incisor
Lacquering and staining of teethPerformed in Vietnam Laos Thailand Indonesia and Philippines
Perception For cosmetic reasons
bull Main ingredient dye dark-brown solution of ferric acetate called kanemizu (iron filings in vinegar)
bull Coating the teeth with this liquid helped to prevent tooth decay and enamel decay
bull Practice has slowly declined
Traditional gingival tattooinglips bull Practiced in Africarsquos Sahel region Woddebe
Fulani tribe Senegal Ethiopia middle eastern countries
Perception Reason aesthetic appeal superstition
bull Practices Done when females reach puberty
bull Kanuri females Borno State Nigeria tattooing lip gingiva usually performed thorns of Balanites aegyptiaca (Bukar et al 2004 )
bull Pigments -Mixture charcoal and seeds of Acacia nilotica vartomentosa
Lip plug lip plate
bull The lip plate (lip plug or lip disc) form of body modification
bull Amazonian tribes young males traditionally -rite of passage indicate status and prestige
bull Mursi of Ethiopia girls age 13 to 18
bull At puberty mother cuts her lower lip
bull Held open by a wooden plug - inserted into thereby stretching the lip
bull At times -combined with removal of two or four lower anterior incisal teeth
Lip plug lip plate
TRADITIONAL DENTAL SERVICES
bull Perceptions
Cause of illness determines treatment taken Practices
bull Yoruba community patronize traditional dentists (Oke Bankole et al 2011) Edo state
bull Services rendered include worm extraction tooth extraction drug prescription and offering sacrifices to deities
bull Charges based on the worm count
Northern Nigeria called Serdia Toothache associated with dandruff
Cameroon traditional healers perform atraumatic tooth extraction Agbor et al (2011)
bull Leaves stems of Dichrocephala integrifolia
bull Tooth pulled out fingerssharp instrument
bull No pain Plant has anaesthetic properties
bull Dangers infection sepsis infection with hepatitis B Human Immunodeficiency Virus
bull Jewish Unlikely keep Friday appointment with the dentist for their children
bull Routine appointments on Fridays avoided (Scambler et al )
The traditional healer harvesting the medicinal plant in Cameroon
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J Ethnobiol Ethnomed 2011 715
Tooth extraction by a traditional dentist
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J EthnobiolEthnomed 2011 715
bull Health is a consequence of an individualrsquos lifestyle
bull Essential to Identify cultural factors that are harmful and those that are beneficial
bull As paediatric dentists we should discourage the unhealthy practices through rigorous health education and promote the adoption of healthy practices
bull Need for multicentric research on the cultural influence of the family and peers regarding oral health of children
bull Bankole OO Lawal FB Ibiyemi O (2017) Dispelling myths associated with natalneonatal teeth ldquoAdunnirdquo a health education video in a native Nigerian language Annals of Ibadan Postgraduate Medicine15(2)137-141
Thank you for listening
With Traditional Birth Attendants at Ibadan South East Local government area
REVERSAL OF ERUPTION SEQUENCE
bull African ethnographies - infants whose upper teeth erupt before their lower teeth have been killed because of such ldquodevelopmental anomaliesrdquo
bull Considered a bad omen and sign of misfortune among Hamar Ethiopia Benin Rebublic
bull Reversal of eruption sequence of primary incisors in infants in Yoruba community has led to unpleasant circumstances
Reversal of eruption sequence
Reversal of eruption sequence
TraditionalBirth Attendants
Bankole and Lawal (2018)
PERCEIVED CAUSES
Evil spirits 218 476
Contravening taboos 80 26
EFFECT ON THE FAMILY
Curse 135 214Abomination 276 218
Embarrassment 233 114
Practices regarding reversal of eruption sequence of the anterior primary teeth
Practices Bankole and
Lawal(2018 )Effect
Immediate extraction 337 Pain infection HJV
hepatitis B infection
tetanus
HideGet rid of child 613 Infanticide
EFFECT ON CHILD
Strange behavior 227 Stigmatization
Evil powers 417 Stigmatization
Mental retardation 25
Dr Bankole and Dr Lawal with the Traditional Birth Attendants at the Ibadan South West LGA
DIETDental caries has escalated in developing countries
bull Misconception Food and drinks refined processed or modern is best and associated with affluence (Aderinokun et al 2011)
bull Parents donrsquot want their children to be deprived of what they lacked when young
bull This has led to a cultural shift in diet
bull Some African American believe motherrsquos diet during pregnancy cause dental caries in the child
bull Somali refugees Hutterites and Latino immigrant caregivers believed genetics plays a role in development early childhood caries (Prowse 2014)
Practices
bull YorubaHausa community common snacks have assumed local flavours several shapes coloursof sweets sold
bull Natural foods fruits are being sweetened Oke Bankole et al 2011 )
bull Nomadic Fulani sugary diet in between their meals sweetened drinks in bottles Sippy cups (827) and (716) give pacifiers dipped in sweet liquids Reduce temper tantrums with sweets Bankole et al 2015
Infant feeding practices
bull Babies with sweetened drinks in bottles pacifiers dipped in sweet liquidsputting infant to bed with a bottle of sweetened liquid Reported among Mexican Americans and Puerto Ricans Hong Kong Saudi mothers Al-Zahrani et al 2014
bull High risk factors contributing development of early childhood caries in infants
Diet
bull Perception
Animals such as pig are unclean
bull Practices
bull Hindus donrsquot eat beef Muslims donrsquot eat pork
bull Protective prevent taeniasis cystecercosis -edematous oral ulcers gingival bleeding lesions mimicking mucocles in children
(Alves et al 2011)
Dental Fluorosis bull In East and central African countries (tribal
areas of Tanzania Magadi a fluoride rich tronaused in cooking
bull Used as a tenderizer and preservative
bull High Fluoride Concentration 7900 ppm
bull Magadi use may suggest high prevalence of fluorosis in northern Tanzania (Kaseva 2006)
Oral Hygiene
Perceptions among mothers
bull Hausa Fulani- 142 - babyrsquos mouth should be cleaned before teeth erupt
bull Yoruba- Babyrsquos mouthtongue cleaned before teeth erupt to prevent thrush
bull Hausa Fulani- 635 - commencement tooth cleaning between 6 and 12 months of age (Bankole et al 2017)
bull Yoruba- chewing sticks should not be used at night Causes premature death of mother (Oke et al 2011)
Practices
Hausa Fulani- 594 cleaned infants teeth once daily
- 614 children start cleaning their teeth unsupervised before the age of six years
- 751 of supervision was carried out by the grandparents
- Sudan -343 mothers donrsquot clean childrenrsquos teeth below the age of 2 years (Abduljalil et al 2016)
-Hausa - mothers start cleaning childrenrsquos teeth when enough teeth to justify effort (Oke et al 2011)
Oral hygiene practices
Cleaning materials used in infancyearly childhood
CommunityTribe
GlycerinFresh tomato Hydrogen peroxideAluminum sulphateVerona Amygdalina (bitter leaf)Iyere (African black pepper)Alligator pepperCitrus lime Combinations
Yoruba - Nigeria (Aderinokun 2000)
Alum (Aluminum sulphate) Bitter leaf (Verona Amygdalina)
Iyere (African black pepper)
Citrus lime Alligator pepper
Oral hygiene practices
Tooth Cleaning materials
CommunityTribe Side effect
Salt and cotton wool
Hausa (Oke et al 2011)
Finger Nomadic Fulani
Wooden twigSalvadora persiccatwig (miswak) Neem tree Chewing stick
Nomadic Fulani ( Bankole et al 2017)
Somali
India (Kochar et al 2014)
Yoruba Senegal (Diouf 2013)
Improper use ndashgingival trauma
round ceramics omadic ulani
brasion sensiti it
and omadic ulani
shes ood charcoal
Somali (Beveridge
India Senegal
Tooth Cleaning materials
CommunityTribe Side effect
Ground ceramics Nomadic Fulani Tooth abrasion
Sand Nomadic Fulani
AshesWood
Charcoal
Somali India Senegal
Tooth abrasion
IMPORTANCE OF THE PRIMARY DENTITION IN CHILDREN
bull Primary teeth in children are sometimes not regarded as important
bull Mothers of preschool children in Mumbai -436 believed 192 were uncertain that there is no need to visit a dentist for treating milk teeth as they will soon fall off (Jain et al 2014)
COMMON DENTAL DISEASES
Dental Caries
bull Early childhood caries is a significant public health problem caries affecting children globally
bull In recent years in developing countries like Sub-Saharan Africa the prevalence is predicted to increase
bull Early childhood caries is largely untreated in a study in South Africa reported a caries prevalence of 716 and these 675 were untreated (Mohammed and Barnes 2018 )
Dental caries Perceived cause of dental
caries
Community tribe
Worms (resembling
maggots)
Borom bop (master of the
head)
Lagatas
Smaller version of pubu
Worms -removed from
ears
Yoruba Nomadic Fulani
Chinese (Dong et al 2007)
Senegalese ( Diouf et al 2003)
Brazil
Papua New Guinea
Indian (Nagaraj et al2014)
Dental caries -Care remedies Dental care remedies Community tribe Effect
Hydrochloric acid (Wet cell
battery liquid)
Aluminum Phosphate
(Alum)
Tobacco snuff
Charcoal and salt
Gentian violet
Atare (Alligator Pepper)
Yoruba Brazil
Kenya (Mulu Maryanne)
Yoruba (Oke et al 2011)
Chemical burns
mucosal ulceration
Erosion
Tetracycline capsule (topical)
Paracetamol (topical)
Hausa Nomadic Fulani
Hausa
Greyish brown tooth
discolouration
Mucosal ulceration
Traditional concoction
Dental are remedies Dental care remedies Community
tribe
Effect
White wineVinegar Powdered alum musk and frankincense
Chinese (Dong et al 2007)
Herbs traditional medicine
Aborigines (Wong 2005)
Nettles
Hot sweet potato
Wads hot leaves ginger
Residue smoking pipe
White sap of shrub used
to kill maggots
Insecticide ointment
Papua New
Guinea
Predisposition to
oral cancer
Toxic
Dental care remedies Dental care remedies Community Effect
Cooked meat
salt alcohol grease
deodorant
Iran
fingernail polish remover
black tar
Garlic Warm coconut milk
Brazil Toxic
Kawakawa Māori(Pepper Tree
Leaves) chewed
Harakeke -Korari Flax
the gum used for toothache
Maori
GingivitisPeriodontal disease
Perceptions
bull Bleeding gums caused by
bull Child stores food in pouch of mouth and does not clean teeth
Remedies for gingival periodontal disease
Remedies Community tribe
Effect
Aluminium phosphate (Alum ) + Lapalapa sap (Jatropha curcas)Warm water and salt Tomato and alum+polystrene foam or cotton woolHydrogen peroxide
Yoruba
Antibiotics NomadiFulani
Resistant strains Hyper sensitivityreactions
Herbs
ORAL HABITS Kola nut chewing
Common West Central Africa Symbol of hospitality Contains caffeine tannin
bull Helps students keep awakewithstand fatigue
Practices
bull One-year prevalence student use was 291 Erinfolami et al (2011)
bull Majority started at age 14 years or below
bull Dangers -insomnia nausea tooth discolourationcarcinogenic potential for development of oral cancer
Areca Nut Chewing Habitbull Areca nut is the seed of areca palm
bull Widely grown- Asia India Bangladesh Japan
bull Believed to help fatigue
bull Highest period of risk for first use is between 5 and 12 Farrand et al 2001
74 4-16 age group in Karachi indulged in the habit (Shah et al 2002)
Dangers Oral sub mucous fibrosis
bull Risk of oral cancer 99 times( Wollina et al 2004 ) Foreign body aspiration Severe tooth wear -- sensitivity root fractures
Mandibular arch with generalized staining in the deciduous dentition
Prajapati D Nayak R Nayak UA Shah PJ Areca nut chewing habit in preschoolers Two rare case reports and literature review Int J Dent Health Concern 201511-5 (Permission given)
Mandibular arch with generalized staining in the deciduous dentition
Prajapati D Nayak R Nayak UA Shah PJ Areca nut chewing habit in preschoolers Two rare case reports and literature review Int J Dent Health Concern 201511-5 (Permission given)
Oral tobacco use and cigar smoking
bull High prevalence tobacco use in any form is reported among school going adolescents aged 13ndash15 years in India (Arora and Reddy 2005) Smoking Chutta is relatively popular may begin in childhood in India
bull Acts as a stimulant euphoric
bull May sleep with tobacco mixture in mouth
Harmful effects halitosis brown black staining gingival recession if wad is held against gingivaleucoplakia oral squamous cell carcinoma
Tobacco use in children
PRACTICES RELATED TO PUBERTY AND GROOMING
Tooth filing tooth sharpening
Practiced -Nigeria Niger-Delta area (Ukeghesonand Akadiri ) Democratic Republic of Congo Thailand Indonesia
bull Perception Historically -spiritual reasons Contemporary times - aesthetic reasons
bull In Nigeria maxillary midline diastema is regarded as a symbol of beauty (Arigbede and Adesuwa 2012
bull Teeth filed- because represent negative emotions eg anger jealousy (Balinese Indonesia)
30 respondents would not mind having artificially created diastema (Omotosho and Kadri (2010)
Practices
bull Done in adolescence - fashionable
bull Manually done Usually incisors
Harmful effects
bull pain during process
bull Tooth discolouration (teeth -non vital)
bull Infection -pus discharge lip swelling
Tooth filing
Peri-apical x-ray of lower central incisor
Lacquering and staining of teethPerformed in Vietnam Laos Thailand Indonesia and Philippines
Perception For cosmetic reasons
bull Main ingredient dye dark-brown solution of ferric acetate called kanemizu (iron filings in vinegar)
bull Coating the teeth with this liquid helped to prevent tooth decay and enamel decay
bull Practice has slowly declined
Traditional gingival tattooinglips bull Practiced in Africarsquos Sahel region Woddebe
Fulani tribe Senegal Ethiopia middle eastern countries
Perception Reason aesthetic appeal superstition
bull Practices Done when females reach puberty
bull Kanuri females Borno State Nigeria tattooing lip gingiva usually performed thorns of Balanites aegyptiaca (Bukar et al 2004 )
bull Pigments -Mixture charcoal and seeds of Acacia nilotica vartomentosa
Lip plug lip plate
bull The lip plate (lip plug or lip disc) form of body modification
bull Amazonian tribes young males traditionally -rite of passage indicate status and prestige
bull Mursi of Ethiopia girls age 13 to 18
bull At puberty mother cuts her lower lip
bull Held open by a wooden plug - inserted into thereby stretching the lip
bull At times -combined with removal of two or four lower anterior incisal teeth
Lip plug lip plate
TRADITIONAL DENTAL SERVICES
bull Perceptions
Cause of illness determines treatment taken Practices
bull Yoruba community patronize traditional dentists (Oke Bankole et al 2011) Edo state
bull Services rendered include worm extraction tooth extraction drug prescription and offering sacrifices to deities
bull Charges based on the worm count
Northern Nigeria called Serdia Toothache associated with dandruff
Cameroon traditional healers perform atraumatic tooth extraction Agbor et al (2011)
bull Leaves stems of Dichrocephala integrifolia
bull Tooth pulled out fingerssharp instrument
bull No pain Plant has anaesthetic properties
bull Dangers infection sepsis infection with hepatitis B Human Immunodeficiency Virus
bull Jewish Unlikely keep Friday appointment with the dentist for their children
bull Routine appointments on Fridays avoided (Scambler et al )
The traditional healer harvesting the medicinal plant in Cameroon
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J Ethnobiol Ethnomed 2011 715
Tooth extraction by a traditional dentist
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J EthnobiolEthnomed 2011 715
bull Health is a consequence of an individualrsquos lifestyle
bull Essential to Identify cultural factors that are harmful and those that are beneficial
bull As paediatric dentists we should discourage the unhealthy practices through rigorous health education and promote the adoption of healthy practices
bull Need for multicentric research on the cultural influence of the family and peers regarding oral health of children
bull Bankole OO Lawal FB Ibiyemi O (2017) Dispelling myths associated with natalneonatal teeth ldquoAdunnirdquo a health education video in a native Nigerian language Annals of Ibadan Postgraduate Medicine15(2)137-141
Thank you for listening
REVERSAL OF ERUPTION SEQUENCE
bull African ethnographies - infants whose upper teeth erupt before their lower teeth have been killed because of such ldquodevelopmental anomaliesrdquo
bull Considered a bad omen and sign of misfortune among Hamar Ethiopia Benin Rebublic
bull Reversal of eruption sequence of primary incisors in infants in Yoruba community has led to unpleasant circumstances
Reversal of eruption sequence
Reversal of eruption sequence
TraditionalBirth Attendants
Bankole and Lawal (2018)
PERCEIVED CAUSES
Evil spirits 218 476
Contravening taboos 80 26
EFFECT ON THE FAMILY
Curse 135 214Abomination 276 218
Embarrassment 233 114
Practices regarding reversal of eruption sequence of the anterior primary teeth
Practices Bankole and
Lawal(2018 )Effect
Immediate extraction 337 Pain infection HJV
hepatitis B infection
tetanus
HideGet rid of child 613 Infanticide
EFFECT ON CHILD
Strange behavior 227 Stigmatization
Evil powers 417 Stigmatization
Mental retardation 25
Dr Bankole and Dr Lawal with the Traditional Birth Attendants at the Ibadan South West LGA
DIETDental caries has escalated in developing countries
bull Misconception Food and drinks refined processed or modern is best and associated with affluence (Aderinokun et al 2011)
bull Parents donrsquot want their children to be deprived of what they lacked when young
bull This has led to a cultural shift in diet
bull Some African American believe motherrsquos diet during pregnancy cause dental caries in the child
bull Somali refugees Hutterites and Latino immigrant caregivers believed genetics plays a role in development early childhood caries (Prowse 2014)
Practices
bull YorubaHausa community common snacks have assumed local flavours several shapes coloursof sweets sold
bull Natural foods fruits are being sweetened Oke Bankole et al 2011 )
bull Nomadic Fulani sugary diet in between their meals sweetened drinks in bottles Sippy cups (827) and (716) give pacifiers dipped in sweet liquids Reduce temper tantrums with sweets Bankole et al 2015
Infant feeding practices
bull Babies with sweetened drinks in bottles pacifiers dipped in sweet liquidsputting infant to bed with a bottle of sweetened liquid Reported among Mexican Americans and Puerto Ricans Hong Kong Saudi mothers Al-Zahrani et al 2014
bull High risk factors contributing development of early childhood caries in infants
Diet
bull Perception
Animals such as pig are unclean
bull Practices
bull Hindus donrsquot eat beef Muslims donrsquot eat pork
bull Protective prevent taeniasis cystecercosis -edematous oral ulcers gingival bleeding lesions mimicking mucocles in children
(Alves et al 2011)
Dental Fluorosis bull In East and central African countries (tribal
areas of Tanzania Magadi a fluoride rich tronaused in cooking
bull Used as a tenderizer and preservative
bull High Fluoride Concentration 7900 ppm
bull Magadi use may suggest high prevalence of fluorosis in northern Tanzania (Kaseva 2006)
Oral Hygiene
Perceptions among mothers
bull Hausa Fulani- 142 - babyrsquos mouth should be cleaned before teeth erupt
bull Yoruba- Babyrsquos mouthtongue cleaned before teeth erupt to prevent thrush
bull Hausa Fulani- 635 - commencement tooth cleaning between 6 and 12 months of age (Bankole et al 2017)
bull Yoruba- chewing sticks should not be used at night Causes premature death of mother (Oke et al 2011)
Practices
Hausa Fulani- 594 cleaned infants teeth once daily
- 614 children start cleaning their teeth unsupervised before the age of six years
- 751 of supervision was carried out by the grandparents
- Sudan -343 mothers donrsquot clean childrenrsquos teeth below the age of 2 years (Abduljalil et al 2016)
-Hausa - mothers start cleaning childrenrsquos teeth when enough teeth to justify effort (Oke et al 2011)
Oral hygiene practices
Cleaning materials used in infancyearly childhood
CommunityTribe
GlycerinFresh tomato Hydrogen peroxideAluminum sulphateVerona Amygdalina (bitter leaf)Iyere (African black pepper)Alligator pepperCitrus lime Combinations
Yoruba - Nigeria (Aderinokun 2000)
Alum (Aluminum sulphate) Bitter leaf (Verona Amygdalina)
Iyere (African black pepper)
Citrus lime Alligator pepper
Oral hygiene practices
Tooth Cleaning materials
CommunityTribe Side effect
Salt and cotton wool
Hausa (Oke et al 2011)
Finger Nomadic Fulani
Wooden twigSalvadora persiccatwig (miswak) Neem tree Chewing stick
Nomadic Fulani ( Bankole et al 2017)
Somali
India (Kochar et al 2014)
Yoruba Senegal (Diouf 2013)
Improper use ndashgingival trauma
round ceramics omadic ulani
brasion sensiti it
and omadic ulani
shes ood charcoal
Somali (Beveridge
India Senegal
Tooth Cleaning materials
CommunityTribe Side effect
Ground ceramics Nomadic Fulani Tooth abrasion
Sand Nomadic Fulani
AshesWood
Charcoal
Somali India Senegal
Tooth abrasion
IMPORTANCE OF THE PRIMARY DENTITION IN CHILDREN
bull Primary teeth in children are sometimes not regarded as important
bull Mothers of preschool children in Mumbai -436 believed 192 were uncertain that there is no need to visit a dentist for treating milk teeth as they will soon fall off (Jain et al 2014)
COMMON DENTAL DISEASES
Dental Caries
bull Early childhood caries is a significant public health problem caries affecting children globally
bull In recent years in developing countries like Sub-Saharan Africa the prevalence is predicted to increase
bull Early childhood caries is largely untreated in a study in South Africa reported a caries prevalence of 716 and these 675 were untreated (Mohammed and Barnes 2018 )
Dental caries Perceived cause of dental
caries
Community tribe
Worms (resembling
maggots)
Borom bop (master of the
head)
Lagatas
Smaller version of pubu
Worms -removed from
ears
Yoruba Nomadic Fulani
Chinese (Dong et al 2007)
Senegalese ( Diouf et al 2003)
Brazil
Papua New Guinea
Indian (Nagaraj et al2014)
Dental caries -Care remedies Dental care remedies Community tribe Effect
Hydrochloric acid (Wet cell
battery liquid)
Aluminum Phosphate
(Alum)
Tobacco snuff
Charcoal and salt
Gentian violet
Atare (Alligator Pepper)
Yoruba Brazil
Kenya (Mulu Maryanne)
Yoruba (Oke et al 2011)
Chemical burns
mucosal ulceration
Erosion
Tetracycline capsule (topical)
Paracetamol (topical)
Hausa Nomadic Fulani
Hausa
Greyish brown tooth
discolouration
Mucosal ulceration
Traditional concoction
Dental are remedies Dental care remedies Community
tribe
Effect
White wineVinegar Powdered alum musk and frankincense
Chinese (Dong et al 2007)
Herbs traditional medicine
Aborigines (Wong 2005)
Nettles
Hot sweet potato
Wads hot leaves ginger
Residue smoking pipe
White sap of shrub used
to kill maggots
Insecticide ointment
Papua New
Guinea
Predisposition to
oral cancer
Toxic
Dental care remedies Dental care remedies Community Effect
Cooked meat
salt alcohol grease
deodorant
Iran
fingernail polish remover
black tar
Garlic Warm coconut milk
Brazil Toxic
Kawakawa Māori(Pepper Tree
Leaves) chewed
Harakeke -Korari Flax
the gum used for toothache
Maori
GingivitisPeriodontal disease
Perceptions
bull Bleeding gums caused by
bull Child stores food in pouch of mouth and does not clean teeth
Remedies for gingival periodontal disease
Remedies Community tribe
Effect
Aluminium phosphate (Alum ) + Lapalapa sap (Jatropha curcas)Warm water and salt Tomato and alum+polystrene foam or cotton woolHydrogen peroxide
Yoruba
Antibiotics NomadiFulani
Resistant strains Hyper sensitivityreactions
Herbs
ORAL HABITS Kola nut chewing
Common West Central Africa Symbol of hospitality Contains caffeine tannin
bull Helps students keep awakewithstand fatigue
Practices
bull One-year prevalence student use was 291 Erinfolami et al (2011)
bull Majority started at age 14 years or below
bull Dangers -insomnia nausea tooth discolourationcarcinogenic potential for development of oral cancer
Areca Nut Chewing Habitbull Areca nut is the seed of areca palm
bull Widely grown- Asia India Bangladesh Japan
bull Believed to help fatigue
bull Highest period of risk for first use is between 5 and 12 Farrand et al 2001
74 4-16 age group in Karachi indulged in the habit (Shah et al 2002)
Dangers Oral sub mucous fibrosis
bull Risk of oral cancer 99 times( Wollina et al 2004 ) Foreign body aspiration Severe tooth wear -- sensitivity root fractures
Mandibular arch with generalized staining in the deciduous dentition
Prajapati D Nayak R Nayak UA Shah PJ Areca nut chewing habit in preschoolers Two rare case reports and literature review Int J Dent Health Concern 201511-5 (Permission given)
Mandibular arch with generalized staining in the deciduous dentition
Prajapati D Nayak R Nayak UA Shah PJ Areca nut chewing habit in preschoolers Two rare case reports and literature review Int J Dent Health Concern 201511-5 (Permission given)
Oral tobacco use and cigar smoking
bull High prevalence tobacco use in any form is reported among school going adolescents aged 13ndash15 years in India (Arora and Reddy 2005) Smoking Chutta is relatively popular may begin in childhood in India
bull Acts as a stimulant euphoric
bull May sleep with tobacco mixture in mouth
Harmful effects halitosis brown black staining gingival recession if wad is held against gingivaleucoplakia oral squamous cell carcinoma
Tobacco use in children
PRACTICES RELATED TO PUBERTY AND GROOMING
Tooth filing tooth sharpening
Practiced -Nigeria Niger-Delta area (Ukeghesonand Akadiri ) Democratic Republic of Congo Thailand Indonesia
bull Perception Historically -spiritual reasons Contemporary times - aesthetic reasons
bull In Nigeria maxillary midline diastema is regarded as a symbol of beauty (Arigbede and Adesuwa 2012
bull Teeth filed- because represent negative emotions eg anger jealousy (Balinese Indonesia)
30 respondents would not mind having artificially created diastema (Omotosho and Kadri (2010)
Practices
bull Done in adolescence - fashionable
bull Manually done Usually incisors
Harmful effects
bull pain during process
bull Tooth discolouration (teeth -non vital)
bull Infection -pus discharge lip swelling
Tooth filing
Peri-apical x-ray of lower central incisor
Lacquering and staining of teethPerformed in Vietnam Laos Thailand Indonesia and Philippines
Perception For cosmetic reasons
bull Main ingredient dye dark-brown solution of ferric acetate called kanemizu (iron filings in vinegar)
bull Coating the teeth with this liquid helped to prevent tooth decay and enamel decay
bull Practice has slowly declined
Traditional gingival tattooinglips bull Practiced in Africarsquos Sahel region Woddebe
Fulani tribe Senegal Ethiopia middle eastern countries
Perception Reason aesthetic appeal superstition
bull Practices Done when females reach puberty
bull Kanuri females Borno State Nigeria tattooing lip gingiva usually performed thorns of Balanites aegyptiaca (Bukar et al 2004 )
bull Pigments -Mixture charcoal and seeds of Acacia nilotica vartomentosa
Lip plug lip plate
bull The lip plate (lip plug or lip disc) form of body modification
bull Amazonian tribes young males traditionally -rite of passage indicate status and prestige
bull Mursi of Ethiopia girls age 13 to 18
bull At puberty mother cuts her lower lip
bull Held open by a wooden plug - inserted into thereby stretching the lip
bull At times -combined with removal of two or four lower anterior incisal teeth
Lip plug lip plate
TRADITIONAL DENTAL SERVICES
bull Perceptions
Cause of illness determines treatment taken Practices
bull Yoruba community patronize traditional dentists (Oke Bankole et al 2011) Edo state
bull Services rendered include worm extraction tooth extraction drug prescription and offering sacrifices to deities
bull Charges based on the worm count
Northern Nigeria called Serdia Toothache associated with dandruff
Cameroon traditional healers perform atraumatic tooth extraction Agbor et al (2011)
bull Leaves stems of Dichrocephala integrifolia
bull Tooth pulled out fingerssharp instrument
bull No pain Plant has anaesthetic properties
bull Dangers infection sepsis infection with hepatitis B Human Immunodeficiency Virus
bull Jewish Unlikely keep Friday appointment with the dentist for their children
bull Routine appointments on Fridays avoided (Scambler et al )
The traditional healer harvesting the medicinal plant in Cameroon
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J Ethnobiol Ethnomed 2011 715
Tooth extraction by a traditional dentist
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J EthnobiolEthnomed 2011 715
bull Health is a consequence of an individualrsquos lifestyle
bull Essential to Identify cultural factors that are harmful and those that are beneficial
bull As paediatric dentists we should discourage the unhealthy practices through rigorous health education and promote the adoption of healthy practices
bull Need for multicentric research on the cultural influence of the family and peers regarding oral health of children
bull Bankole OO Lawal FB Ibiyemi O (2017) Dispelling myths associated with natalneonatal teeth ldquoAdunnirdquo a health education video in a native Nigerian language Annals of Ibadan Postgraduate Medicine15(2)137-141
Thank you for listening
Reversal of eruption sequence
Reversal of eruption sequence
TraditionalBirth Attendants
Bankole and Lawal (2018)
PERCEIVED CAUSES
Evil spirits 218 476
Contravening taboos 80 26
EFFECT ON THE FAMILY
Curse 135 214Abomination 276 218
Embarrassment 233 114
Practices regarding reversal of eruption sequence of the anterior primary teeth
Practices Bankole and
Lawal(2018 )Effect
Immediate extraction 337 Pain infection HJV
hepatitis B infection
tetanus
HideGet rid of child 613 Infanticide
EFFECT ON CHILD
Strange behavior 227 Stigmatization
Evil powers 417 Stigmatization
Mental retardation 25
Dr Bankole and Dr Lawal with the Traditional Birth Attendants at the Ibadan South West LGA
DIETDental caries has escalated in developing countries
bull Misconception Food and drinks refined processed or modern is best and associated with affluence (Aderinokun et al 2011)
bull Parents donrsquot want their children to be deprived of what they lacked when young
bull This has led to a cultural shift in diet
bull Some African American believe motherrsquos diet during pregnancy cause dental caries in the child
bull Somali refugees Hutterites and Latino immigrant caregivers believed genetics plays a role in development early childhood caries (Prowse 2014)
Practices
bull YorubaHausa community common snacks have assumed local flavours several shapes coloursof sweets sold
bull Natural foods fruits are being sweetened Oke Bankole et al 2011 )
bull Nomadic Fulani sugary diet in between their meals sweetened drinks in bottles Sippy cups (827) and (716) give pacifiers dipped in sweet liquids Reduce temper tantrums with sweets Bankole et al 2015
Infant feeding practices
bull Babies with sweetened drinks in bottles pacifiers dipped in sweet liquidsputting infant to bed with a bottle of sweetened liquid Reported among Mexican Americans and Puerto Ricans Hong Kong Saudi mothers Al-Zahrani et al 2014
bull High risk factors contributing development of early childhood caries in infants
Diet
bull Perception
Animals such as pig are unclean
bull Practices
bull Hindus donrsquot eat beef Muslims donrsquot eat pork
bull Protective prevent taeniasis cystecercosis -edematous oral ulcers gingival bleeding lesions mimicking mucocles in children
(Alves et al 2011)
Dental Fluorosis bull In East and central African countries (tribal
areas of Tanzania Magadi a fluoride rich tronaused in cooking
bull Used as a tenderizer and preservative
bull High Fluoride Concentration 7900 ppm
bull Magadi use may suggest high prevalence of fluorosis in northern Tanzania (Kaseva 2006)
Oral Hygiene
Perceptions among mothers
bull Hausa Fulani- 142 - babyrsquos mouth should be cleaned before teeth erupt
bull Yoruba- Babyrsquos mouthtongue cleaned before teeth erupt to prevent thrush
bull Hausa Fulani- 635 - commencement tooth cleaning between 6 and 12 months of age (Bankole et al 2017)
bull Yoruba- chewing sticks should not be used at night Causes premature death of mother (Oke et al 2011)
Practices
Hausa Fulani- 594 cleaned infants teeth once daily
- 614 children start cleaning their teeth unsupervised before the age of six years
- 751 of supervision was carried out by the grandparents
- Sudan -343 mothers donrsquot clean childrenrsquos teeth below the age of 2 years (Abduljalil et al 2016)
-Hausa - mothers start cleaning childrenrsquos teeth when enough teeth to justify effort (Oke et al 2011)
Oral hygiene practices
Cleaning materials used in infancyearly childhood
CommunityTribe
GlycerinFresh tomato Hydrogen peroxideAluminum sulphateVerona Amygdalina (bitter leaf)Iyere (African black pepper)Alligator pepperCitrus lime Combinations
Yoruba - Nigeria (Aderinokun 2000)
Alum (Aluminum sulphate) Bitter leaf (Verona Amygdalina)
Iyere (African black pepper)
Citrus lime Alligator pepper
Oral hygiene practices
Tooth Cleaning materials
CommunityTribe Side effect
Salt and cotton wool
Hausa (Oke et al 2011)
Finger Nomadic Fulani
Wooden twigSalvadora persiccatwig (miswak) Neem tree Chewing stick
Nomadic Fulani ( Bankole et al 2017)
Somali
India (Kochar et al 2014)
Yoruba Senegal (Diouf 2013)
Improper use ndashgingival trauma
round ceramics omadic ulani
brasion sensiti it
and omadic ulani
shes ood charcoal
Somali (Beveridge
India Senegal
Tooth Cleaning materials
CommunityTribe Side effect
Ground ceramics Nomadic Fulani Tooth abrasion
Sand Nomadic Fulani
AshesWood
Charcoal
Somali India Senegal
Tooth abrasion
IMPORTANCE OF THE PRIMARY DENTITION IN CHILDREN
bull Primary teeth in children are sometimes not regarded as important
bull Mothers of preschool children in Mumbai -436 believed 192 were uncertain that there is no need to visit a dentist for treating milk teeth as they will soon fall off (Jain et al 2014)
COMMON DENTAL DISEASES
Dental Caries
bull Early childhood caries is a significant public health problem caries affecting children globally
bull In recent years in developing countries like Sub-Saharan Africa the prevalence is predicted to increase
bull Early childhood caries is largely untreated in a study in South Africa reported a caries prevalence of 716 and these 675 were untreated (Mohammed and Barnes 2018 )
Dental caries Perceived cause of dental
caries
Community tribe
Worms (resembling
maggots)
Borom bop (master of the
head)
Lagatas
Smaller version of pubu
Worms -removed from
ears
Yoruba Nomadic Fulani
Chinese (Dong et al 2007)
Senegalese ( Diouf et al 2003)
Brazil
Papua New Guinea
Indian (Nagaraj et al2014)
Dental caries -Care remedies Dental care remedies Community tribe Effect
Hydrochloric acid (Wet cell
battery liquid)
Aluminum Phosphate
(Alum)
Tobacco snuff
Charcoal and salt
Gentian violet
Atare (Alligator Pepper)
Yoruba Brazil
Kenya (Mulu Maryanne)
Yoruba (Oke et al 2011)
Chemical burns
mucosal ulceration
Erosion
Tetracycline capsule (topical)
Paracetamol (topical)
Hausa Nomadic Fulani
Hausa
Greyish brown tooth
discolouration
Mucosal ulceration
Traditional concoction
Dental are remedies Dental care remedies Community
tribe
Effect
White wineVinegar Powdered alum musk and frankincense
Chinese (Dong et al 2007)
Herbs traditional medicine
Aborigines (Wong 2005)
Nettles
Hot sweet potato
Wads hot leaves ginger
Residue smoking pipe
White sap of shrub used
to kill maggots
Insecticide ointment
Papua New
Guinea
Predisposition to
oral cancer
Toxic
Dental care remedies Dental care remedies Community Effect
Cooked meat
salt alcohol grease
deodorant
Iran
fingernail polish remover
black tar
Garlic Warm coconut milk
Brazil Toxic
Kawakawa Māori(Pepper Tree
Leaves) chewed
Harakeke -Korari Flax
the gum used for toothache
Maori
GingivitisPeriodontal disease
Perceptions
bull Bleeding gums caused by
bull Child stores food in pouch of mouth and does not clean teeth
Remedies for gingival periodontal disease
Remedies Community tribe
Effect
Aluminium phosphate (Alum ) + Lapalapa sap (Jatropha curcas)Warm water and salt Tomato and alum+polystrene foam or cotton woolHydrogen peroxide
Yoruba
Antibiotics NomadiFulani
Resistant strains Hyper sensitivityreactions
Herbs
ORAL HABITS Kola nut chewing
Common West Central Africa Symbol of hospitality Contains caffeine tannin
bull Helps students keep awakewithstand fatigue
Practices
bull One-year prevalence student use was 291 Erinfolami et al (2011)
bull Majority started at age 14 years or below
bull Dangers -insomnia nausea tooth discolourationcarcinogenic potential for development of oral cancer
Areca Nut Chewing Habitbull Areca nut is the seed of areca palm
bull Widely grown- Asia India Bangladesh Japan
bull Believed to help fatigue
bull Highest period of risk for first use is between 5 and 12 Farrand et al 2001
74 4-16 age group in Karachi indulged in the habit (Shah et al 2002)
Dangers Oral sub mucous fibrosis
bull Risk of oral cancer 99 times( Wollina et al 2004 ) Foreign body aspiration Severe tooth wear -- sensitivity root fractures
Mandibular arch with generalized staining in the deciduous dentition
Prajapati D Nayak R Nayak UA Shah PJ Areca nut chewing habit in preschoolers Two rare case reports and literature review Int J Dent Health Concern 201511-5 (Permission given)
Mandibular arch with generalized staining in the deciduous dentition
Prajapati D Nayak R Nayak UA Shah PJ Areca nut chewing habit in preschoolers Two rare case reports and literature review Int J Dent Health Concern 201511-5 (Permission given)
Oral tobacco use and cigar smoking
bull High prevalence tobacco use in any form is reported among school going adolescents aged 13ndash15 years in India (Arora and Reddy 2005) Smoking Chutta is relatively popular may begin in childhood in India
bull Acts as a stimulant euphoric
bull May sleep with tobacco mixture in mouth
Harmful effects halitosis brown black staining gingival recession if wad is held against gingivaleucoplakia oral squamous cell carcinoma
Tobacco use in children
PRACTICES RELATED TO PUBERTY AND GROOMING
Tooth filing tooth sharpening
Practiced -Nigeria Niger-Delta area (Ukeghesonand Akadiri ) Democratic Republic of Congo Thailand Indonesia
bull Perception Historically -spiritual reasons Contemporary times - aesthetic reasons
bull In Nigeria maxillary midline diastema is regarded as a symbol of beauty (Arigbede and Adesuwa 2012
bull Teeth filed- because represent negative emotions eg anger jealousy (Balinese Indonesia)
30 respondents would not mind having artificially created diastema (Omotosho and Kadri (2010)
Practices
bull Done in adolescence - fashionable
bull Manually done Usually incisors
Harmful effects
bull pain during process
bull Tooth discolouration (teeth -non vital)
bull Infection -pus discharge lip swelling
Tooth filing
Peri-apical x-ray of lower central incisor
Lacquering and staining of teethPerformed in Vietnam Laos Thailand Indonesia and Philippines
Perception For cosmetic reasons
bull Main ingredient dye dark-brown solution of ferric acetate called kanemizu (iron filings in vinegar)
bull Coating the teeth with this liquid helped to prevent tooth decay and enamel decay
bull Practice has slowly declined
Traditional gingival tattooinglips bull Practiced in Africarsquos Sahel region Woddebe
Fulani tribe Senegal Ethiopia middle eastern countries
Perception Reason aesthetic appeal superstition
bull Practices Done when females reach puberty
bull Kanuri females Borno State Nigeria tattooing lip gingiva usually performed thorns of Balanites aegyptiaca (Bukar et al 2004 )
bull Pigments -Mixture charcoal and seeds of Acacia nilotica vartomentosa
Lip plug lip plate
bull The lip plate (lip plug or lip disc) form of body modification
bull Amazonian tribes young males traditionally -rite of passage indicate status and prestige
bull Mursi of Ethiopia girls age 13 to 18
bull At puberty mother cuts her lower lip
bull Held open by a wooden plug - inserted into thereby stretching the lip
bull At times -combined with removal of two or four lower anterior incisal teeth
Lip plug lip plate
TRADITIONAL DENTAL SERVICES
bull Perceptions
Cause of illness determines treatment taken Practices
bull Yoruba community patronize traditional dentists (Oke Bankole et al 2011) Edo state
bull Services rendered include worm extraction tooth extraction drug prescription and offering sacrifices to deities
bull Charges based on the worm count
Northern Nigeria called Serdia Toothache associated with dandruff
Cameroon traditional healers perform atraumatic tooth extraction Agbor et al (2011)
bull Leaves stems of Dichrocephala integrifolia
bull Tooth pulled out fingerssharp instrument
bull No pain Plant has anaesthetic properties
bull Dangers infection sepsis infection with hepatitis B Human Immunodeficiency Virus
bull Jewish Unlikely keep Friday appointment with the dentist for their children
bull Routine appointments on Fridays avoided (Scambler et al )
The traditional healer harvesting the medicinal plant in Cameroon
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J Ethnobiol Ethnomed 2011 715
Tooth extraction by a traditional dentist
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J EthnobiolEthnomed 2011 715
bull Health is a consequence of an individualrsquos lifestyle
bull Essential to Identify cultural factors that are harmful and those that are beneficial
bull As paediatric dentists we should discourage the unhealthy practices through rigorous health education and promote the adoption of healthy practices
bull Need for multicentric research on the cultural influence of the family and peers regarding oral health of children
bull Bankole OO Lawal FB Ibiyemi O (2017) Dispelling myths associated with natalneonatal teeth ldquoAdunnirdquo a health education video in a native Nigerian language Annals of Ibadan Postgraduate Medicine15(2)137-141
Thank you for listening
Practices regarding reversal of eruption sequence of the anterior primary teeth
Practices Bankole and
Lawal(2018 )Effect
Immediate extraction 337 Pain infection HJV
hepatitis B infection
tetanus
HideGet rid of child 613 Infanticide
EFFECT ON CHILD
Strange behavior 227 Stigmatization
Evil powers 417 Stigmatization
Mental retardation 25
Dr Bankole and Dr Lawal with the Traditional Birth Attendants at the Ibadan South West LGA
DIETDental caries has escalated in developing countries
bull Misconception Food and drinks refined processed or modern is best and associated with affluence (Aderinokun et al 2011)
bull Parents donrsquot want their children to be deprived of what they lacked when young
bull This has led to a cultural shift in diet
bull Some African American believe motherrsquos diet during pregnancy cause dental caries in the child
bull Somali refugees Hutterites and Latino immigrant caregivers believed genetics plays a role in development early childhood caries (Prowse 2014)
Practices
bull YorubaHausa community common snacks have assumed local flavours several shapes coloursof sweets sold
bull Natural foods fruits are being sweetened Oke Bankole et al 2011 )
bull Nomadic Fulani sugary diet in between their meals sweetened drinks in bottles Sippy cups (827) and (716) give pacifiers dipped in sweet liquids Reduce temper tantrums with sweets Bankole et al 2015
Infant feeding practices
bull Babies with sweetened drinks in bottles pacifiers dipped in sweet liquidsputting infant to bed with a bottle of sweetened liquid Reported among Mexican Americans and Puerto Ricans Hong Kong Saudi mothers Al-Zahrani et al 2014
bull High risk factors contributing development of early childhood caries in infants
Diet
bull Perception
Animals such as pig are unclean
bull Practices
bull Hindus donrsquot eat beef Muslims donrsquot eat pork
bull Protective prevent taeniasis cystecercosis -edematous oral ulcers gingival bleeding lesions mimicking mucocles in children
(Alves et al 2011)
Dental Fluorosis bull In East and central African countries (tribal
areas of Tanzania Magadi a fluoride rich tronaused in cooking
bull Used as a tenderizer and preservative
bull High Fluoride Concentration 7900 ppm
bull Magadi use may suggest high prevalence of fluorosis in northern Tanzania (Kaseva 2006)
Oral Hygiene
Perceptions among mothers
bull Hausa Fulani- 142 - babyrsquos mouth should be cleaned before teeth erupt
bull Yoruba- Babyrsquos mouthtongue cleaned before teeth erupt to prevent thrush
bull Hausa Fulani- 635 - commencement tooth cleaning between 6 and 12 months of age (Bankole et al 2017)
bull Yoruba- chewing sticks should not be used at night Causes premature death of mother (Oke et al 2011)
Practices
Hausa Fulani- 594 cleaned infants teeth once daily
- 614 children start cleaning their teeth unsupervised before the age of six years
- 751 of supervision was carried out by the grandparents
- Sudan -343 mothers donrsquot clean childrenrsquos teeth below the age of 2 years (Abduljalil et al 2016)
-Hausa - mothers start cleaning childrenrsquos teeth when enough teeth to justify effort (Oke et al 2011)
Oral hygiene practices
Cleaning materials used in infancyearly childhood
CommunityTribe
GlycerinFresh tomato Hydrogen peroxideAluminum sulphateVerona Amygdalina (bitter leaf)Iyere (African black pepper)Alligator pepperCitrus lime Combinations
Yoruba - Nigeria (Aderinokun 2000)
Alum (Aluminum sulphate) Bitter leaf (Verona Amygdalina)
Iyere (African black pepper)
Citrus lime Alligator pepper
Oral hygiene practices
Tooth Cleaning materials
CommunityTribe Side effect
Salt and cotton wool
Hausa (Oke et al 2011)
Finger Nomadic Fulani
Wooden twigSalvadora persiccatwig (miswak) Neem tree Chewing stick
Nomadic Fulani ( Bankole et al 2017)
Somali
India (Kochar et al 2014)
Yoruba Senegal (Diouf 2013)
Improper use ndashgingival trauma
round ceramics omadic ulani
brasion sensiti it
and omadic ulani
shes ood charcoal
Somali (Beveridge
India Senegal
Tooth Cleaning materials
CommunityTribe Side effect
Ground ceramics Nomadic Fulani Tooth abrasion
Sand Nomadic Fulani
AshesWood
Charcoal
Somali India Senegal
Tooth abrasion
IMPORTANCE OF THE PRIMARY DENTITION IN CHILDREN
bull Primary teeth in children are sometimes not regarded as important
bull Mothers of preschool children in Mumbai -436 believed 192 were uncertain that there is no need to visit a dentist for treating milk teeth as they will soon fall off (Jain et al 2014)
COMMON DENTAL DISEASES
Dental Caries
bull Early childhood caries is a significant public health problem caries affecting children globally
bull In recent years in developing countries like Sub-Saharan Africa the prevalence is predicted to increase
bull Early childhood caries is largely untreated in a study in South Africa reported a caries prevalence of 716 and these 675 were untreated (Mohammed and Barnes 2018 )
Dental caries Perceived cause of dental
caries
Community tribe
Worms (resembling
maggots)
Borom bop (master of the
head)
Lagatas
Smaller version of pubu
Worms -removed from
ears
Yoruba Nomadic Fulani
Chinese (Dong et al 2007)
Senegalese ( Diouf et al 2003)
Brazil
Papua New Guinea
Indian (Nagaraj et al2014)
Dental caries -Care remedies Dental care remedies Community tribe Effect
Hydrochloric acid (Wet cell
battery liquid)
Aluminum Phosphate
(Alum)
Tobacco snuff
Charcoal and salt
Gentian violet
Atare (Alligator Pepper)
Yoruba Brazil
Kenya (Mulu Maryanne)
Yoruba (Oke et al 2011)
Chemical burns
mucosal ulceration
Erosion
Tetracycline capsule (topical)
Paracetamol (topical)
Hausa Nomadic Fulani
Hausa
Greyish brown tooth
discolouration
Mucosal ulceration
Traditional concoction
Dental are remedies Dental care remedies Community
tribe
Effect
White wineVinegar Powdered alum musk and frankincense
Chinese (Dong et al 2007)
Herbs traditional medicine
Aborigines (Wong 2005)
Nettles
Hot sweet potato
Wads hot leaves ginger
Residue smoking pipe
White sap of shrub used
to kill maggots
Insecticide ointment
Papua New
Guinea
Predisposition to
oral cancer
Toxic
Dental care remedies Dental care remedies Community Effect
Cooked meat
salt alcohol grease
deodorant
Iran
fingernail polish remover
black tar
Garlic Warm coconut milk
Brazil Toxic
Kawakawa Māori(Pepper Tree
Leaves) chewed
Harakeke -Korari Flax
the gum used for toothache
Maori
GingivitisPeriodontal disease
Perceptions
bull Bleeding gums caused by
bull Child stores food in pouch of mouth and does not clean teeth
Remedies for gingival periodontal disease
Remedies Community tribe
Effect
Aluminium phosphate (Alum ) + Lapalapa sap (Jatropha curcas)Warm water and salt Tomato and alum+polystrene foam or cotton woolHydrogen peroxide
Yoruba
Antibiotics NomadiFulani
Resistant strains Hyper sensitivityreactions
Herbs
ORAL HABITS Kola nut chewing
Common West Central Africa Symbol of hospitality Contains caffeine tannin
bull Helps students keep awakewithstand fatigue
Practices
bull One-year prevalence student use was 291 Erinfolami et al (2011)
bull Majority started at age 14 years or below
bull Dangers -insomnia nausea tooth discolourationcarcinogenic potential for development of oral cancer
Areca Nut Chewing Habitbull Areca nut is the seed of areca palm
bull Widely grown- Asia India Bangladesh Japan
bull Believed to help fatigue
bull Highest period of risk for first use is between 5 and 12 Farrand et al 2001
74 4-16 age group in Karachi indulged in the habit (Shah et al 2002)
Dangers Oral sub mucous fibrosis
bull Risk of oral cancer 99 times( Wollina et al 2004 ) Foreign body aspiration Severe tooth wear -- sensitivity root fractures
Mandibular arch with generalized staining in the deciduous dentition
Prajapati D Nayak R Nayak UA Shah PJ Areca nut chewing habit in preschoolers Two rare case reports and literature review Int J Dent Health Concern 201511-5 (Permission given)
Mandibular arch with generalized staining in the deciduous dentition
Prajapati D Nayak R Nayak UA Shah PJ Areca nut chewing habit in preschoolers Two rare case reports and literature review Int J Dent Health Concern 201511-5 (Permission given)
Oral tobacco use and cigar smoking
bull High prevalence tobacco use in any form is reported among school going adolescents aged 13ndash15 years in India (Arora and Reddy 2005) Smoking Chutta is relatively popular may begin in childhood in India
bull Acts as a stimulant euphoric
bull May sleep with tobacco mixture in mouth
Harmful effects halitosis brown black staining gingival recession if wad is held against gingivaleucoplakia oral squamous cell carcinoma
Tobacco use in children
PRACTICES RELATED TO PUBERTY AND GROOMING
Tooth filing tooth sharpening
Practiced -Nigeria Niger-Delta area (Ukeghesonand Akadiri ) Democratic Republic of Congo Thailand Indonesia
bull Perception Historically -spiritual reasons Contemporary times - aesthetic reasons
bull In Nigeria maxillary midline diastema is regarded as a symbol of beauty (Arigbede and Adesuwa 2012
bull Teeth filed- because represent negative emotions eg anger jealousy (Balinese Indonesia)
30 respondents would not mind having artificially created diastema (Omotosho and Kadri (2010)
Practices
bull Done in adolescence - fashionable
bull Manually done Usually incisors
Harmful effects
bull pain during process
bull Tooth discolouration (teeth -non vital)
bull Infection -pus discharge lip swelling
Tooth filing
Peri-apical x-ray of lower central incisor
Lacquering and staining of teethPerformed in Vietnam Laos Thailand Indonesia and Philippines
Perception For cosmetic reasons
bull Main ingredient dye dark-brown solution of ferric acetate called kanemizu (iron filings in vinegar)
bull Coating the teeth with this liquid helped to prevent tooth decay and enamel decay
bull Practice has slowly declined
Traditional gingival tattooinglips bull Practiced in Africarsquos Sahel region Woddebe
Fulani tribe Senegal Ethiopia middle eastern countries
Perception Reason aesthetic appeal superstition
bull Practices Done when females reach puberty
bull Kanuri females Borno State Nigeria tattooing lip gingiva usually performed thorns of Balanites aegyptiaca (Bukar et al 2004 )
bull Pigments -Mixture charcoal and seeds of Acacia nilotica vartomentosa
Lip plug lip plate
bull The lip plate (lip plug or lip disc) form of body modification
bull Amazonian tribes young males traditionally -rite of passage indicate status and prestige
bull Mursi of Ethiopia girls age 13 to 18
bull At puberty mother cuts her lower lip
bull Held open by a wooden plug - inserted into thereby stretching the lip
bull At times -combined with removal of two or four lower anterior incisal teeth
Lip plug lip plate
TRADITIONAL DENTAL SERVICES
bull Perceptions
Cause of illness determines treatment taken Practices
bull Yoruba community patronize traditional dentists (Oke Bankole et al 2011) Edo state
bull Services rendered include worm extraction tooth extraction drug prescription and offering sacrifices to deities
bull Charges based on the worm count
Northern Nigeria called Serdia Toothache associated with dandruff
Cameroon traditional healers perform atraumatic tooth extraction Agbor et al (2011)
bull Leaves stems of Dichrocephala integrifolia
bull Tooth pulled out fingerssharp instrument
bull No pain Plant has anaesthetic properties
bull Dangers infection sepsis infection with hepatitis B Human Immunodeficiency Virus
bull Jewish Unlikely keep Friday appointment with the dentist for their children
bull Routine appointments on Fridays avoided (Scambler et al )
The traditional healer harvesting the medicinal plant in Cameroon
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J Ethnobiol Ethnomed 2011 715
Tooth extraction by a traditional dentist
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J EthnobiolEthnomed 2011 715
bull Health is a consequence of an individualrsquos lifestyle
bull Essential to Identify cultural factors that are harmful and those that are beneficial
bull As paediatric dentists we should discourage the unhealthy practices through rigorous health education and promote the adoption of healthy practices
bull Need for multicentric research on the cultural influence of the family and peers regarding oral health of children
bull Bankole OO Lawal FB Ibiyemi O (2017) Dispelling myths associated with natalneonatal teeth ldquoAdunnirdquo a health education video in a native Nigerian language Annals of Ibadan Postgraduate Medicine15(2)137-141
Thank you for listening
Dr Bankole and Dr Lawal with the Traditional Birth Attendants at the Ibadan South West LGA
DIETDental caries has escalated in developing countries
bull Misconception Food and drinks refined processed or modern is best and associated with affluence (Aderinokun et al 2011)
bull Parents donrsquot want their children to be deprived of what they lacked when young
bull This has led to a cultural shift in diet
bull Some African American believe motherrsquos diet during pregnancy cause dental caries in the child
bull Somali refugees Hutterites and Latino immigrant caregivers believed genetics plays a role in development early childhood caries (Prowse 2014)
Practices
bull YorubaHausa community common snacks have assumed local flavours several shapes coloursof sweets sold
bull Natural foods fruits are being sweetened Oke Bankole et al 2011 )
bull Nomadic Fulani sugary diet in between their meals sweetened drinks in bottles Sippy cups (827) and (716) give pacifiers dipped in sweet liquids Reduce temper tantrums with sweets Bankole et al 2015
Infant feeding practices
bull Babies with sweetened drinks in bottles pacifiers dipped in sweet liquidsputting infant to bed with a bottle of sweetened liquid Reported among Mexican Americans and Puerto Ricans Hong Kong Saudi mothers Al-Zahrani et al 2014
bull High risk factors contributing development of early childhood caries in infants
Diet
bull Perception
Animals such as pig are unclean
bull Practices
bull Hindus donrsquot eat beef Muslims donrsquot eat pork
bull Protective prevent taeniasis cystecercosis -edematous oral ulcers gingival bleeding lesions mimicking mucocles in children
(Alves et al 2011)
Dental Fluorosis bull In East and central African countries (tribal
areas of Tanzania Magadi a fluoride rich tronaused in cooking
bull Used as a tenderizer and preservative
bull High Fluoride Concentration 7900 ppm
bull Magadi use may suggest high prevalence of fluorosis in northern Tanzania (Kaseva 2006)
Oral Hygiene
Perceptions among mothers
bull Hausa Fulani- 142 - babyrsquos mouth should be cleaned before teeth erupt
bull Yoruba- Babyrsquos mouthtongue cleaned before teeth erupt to prevent thrush
bull Hausa Fulani- 635 - commencement tooth cleaning between 6 and 12 months of age (Bankole et al 2017)
bull Yoruba- chewing sticks should not be used at night Causes premature death of mother (Oke et al 2011)
Practices
Hausa Fulani- 594 cleaned infants teeth once daily
- 614 children start cleaning their teeth unsupervised before the age of six years
- 751 of supervision was carried out by the grandparents
- Sudan -343 mothers donrsquot clean childrenrsquos teeth below the age of 2 years (Abduljalil et al 2016)
-Hausa - mothers start cleaning childrenrsquos teeth when enough teeth to justify effort (Oke et al 2011)
Oral hygiene practices
Cleaning materials used in infancyearly childhood
CommunityTribe
GlycerinFresh tomato Hydrogen peroxideAluminum sulphateVerona Amygdalina (bitter leaf)Iyere (African black pepper)Alligator pepperCitrus lime Combinations
Yoruba - Nigeria (Aderinokun 2000)
Alum (Aluminum sulphate) Bitter leaf (Verona Amygdalina)
Iyere (African black pepper)
Citrus lime Alligator pepper
Oral hygiene practices
Tooth Cleaning materials
CommunityTribe Side effect
Salt and cotton wool
Hausa (Oke et al 2011)
Finger Nomadic Fulani
Wooden twigSalvadora persiccatwig (miswak) Neem tree Chewing stick
Nomadic Fulani ( Bankole et al 2017)
Somali
India (Kochar et al 2014)
Yoruba Senegal (Diouf 2013)
Improper use ndashgingival trauma
round ceramics omadic ulani
brasion sensiti it
and omadic ulani
shes ood charcoal
Somali (Beveridge
India Senegal
Tooth Cleaning materials
CommunityTribe Side effect
Ground ceramics Nomadic Fulani Tooth abrasion
Sand Nomadic Fulani
AshesWood
Charcoal
Somali India Senegal
Tooth abrasion
IMPORTANCE OF THE PRIMARY DENTITION IN CHILDREN
bull Primary teeth in children are sometimes not regarded as important
bull Mothers of preschool children in Mumbai -436 believed 192 were uncertain that there is no need to visit a dentist for treating milk teeth as they will soon fall off (Jain et al 2014)
COMMON DENTAL DISEASES
Dental Caries
bull Early childhood caries is a significant public health problem caries affecting children globally
bull In recent years in developing countries like Sub-Saharan Africa the prevalence is predicted to increase
bull Early childhood caries is largely untreated in a study in South Africa reported a caries prevalence of 716 and these 675 were untreated (Mohammed and Barnes 2018 )
Dental caries Perceived cause of dental
caries
Community tribe
Worms (resembling
maggots)
Borom bop (master of the
head)
Lagatas
Smaller version of pubu
Worms -removed from
ears
Yoruba Nomadic Fulani
Chinese (Dong et al 2007)
Senegalese ( Diouf et al 2003)
Brazil
Papua New Guinea
Indian (Nagaraj et al2014)
Dental caries -Care remedies Dental care remedies Community tribe Effect
Hydrochloric acid (Wet cell
battery liquid)
Aluminum Phosphate
(Alum)
Tobacco snuff
Charcoal and salt
Gentian violet
Atare (Alligator Pepper)
Yoruba Brazil
Kenya (Mulu Maryanne)
Yoruba (Oke et al 2011)
Chemical burns
mucosal ulceration
Erosion
Tetracycline capsule (topical)
Paracetamol (topical)
Hausa Nomadic Fulani
Hausa
Greyish brown tooth
discolouration
Mucosal ulceration
Traditional concoction
Dental are remedies Dental care remedies Community
tribe
Effect
White wineVinegar Powdered alum musk and frankincense
Chinese (Dong et al 2007)
Herbs traditional medicine
Aborigines (Wong 2005)
Nettles
Hot sweet potato
Wads hot leaves ginger
Residue smoking pipe
White sap of shrub used
to kill maggots
Insecticide ointment
Papua New
Guinea
Predisposition to
oral cancer
Toxic
Dental care remedies Dental care remedies Community Effect
Cooked meat
salt alcohol grease
deodorant
Iran
fingernail polish remover
black tar
Garlic Warm coconut milk
Brazil Toxic
Kawakawa Māori(Pepper Tree
Leaves) chewed
Harakeke -Korari Flax
the gum used for toothache
Maori
GingivitisPeriodontal disease
Perceptions
bull Bleeding gums caused by
bull Child stores food in pouch of mouth and does not clean teeth
Remedies for gingival periodontal disease
Remedies Community tribe
Effect
Aluminium phosphate (Alum ) + Lapalapa sap (Jatropha curcas)Warm water and salt Tomato and alum+polystrene foam or cotton woolHydrogen peroxide
Yoruba
Antibiotics NomadiFulani
Resistant strains Hyper sensitivityreactions
Herbs
ORAL HABITS Kola nut chewing
Common West Central Africa Symbol of hospitality Contains caffeine tannin
bull Helps students keep awakewithstand fatigue
Practices
bull One-year prevalence student use was 291 Erinfolami et al (2011)
bull Majority started at age 14 years or below
bull Dangers -insomnia nausea tooth discolourationcarcinogenic potential for development of oral cancer
Areca Nut Chewing Habitbull Areca nut is the seed of areca palm
bull Widely grown- Asia India Bangladesh Japan
bull Believed to help fatigue
bull Highest period of risk for first use is between 5 and 12 Farrand et al 2001
74 4-16 age group in Karachi indulged in the habit (Shah et al 2002)
Dangers Oral sub mucous fibrosis
bull Risk of oral cancer 99 times( Wollina et al 2004 ) Foreign body aspiration Severe tooth wear -- sensitivity root fractures
Mandibular arch with generalized staining in the deciduous dentition
Prajapati D Nayak R Nayak UA Shah PJ Areca nut chewing habit in preschoolers Two rare case reports and literature review Int J Dent Health Concern 201511-5 (Permission given)
Mandibular arch with generalized staining in the deciduous dentition
Prajapati D Nayak R Nayak UA Shah PJ Areca nut chewing habit in preschoolers Two rare case reports and literature review Int J Dent Health Concern 201511-5 (Permission given)
Oral tobacco use and cigar smoking
bull High prevalence tobacco use in any form is reported among school going adolescents aged 13ndash15 years in India (Arora and Reddy 2005) Smoking Chutta is relatively popular may begin in childhood in India
bull Acts as a stimulant euphoric
bull May sleep with tobacco mixture in mouth
Harmful effects halitosis brown black staining gingival recession if wad is held against gingivaleucoplakia oral squamous cell carcinoma
Tobacco use in children
PRACTICES RELATED TO PUBERTY AND GROOMING
Tooth filing tooth sharpening
Practiced -Nigeria Niger-Delta area (Ukeghesonand Akadiri ) Democratic Republic of Congo Thailand Indonesia
bull Perception Historically -spiritual reasons Contemporary times - aesthetic reasons
bull In Nigeria maxillary midline diastema is regarded as a symbol of beauty (Arigbede and Adesuwa 2012
bull Teeth filed- because represent negative emotions eg anger jealousy (Balinese Indonesia)
30 respondents would not mind having artificially created diastema (Omotosho and Kadri (2010)
Practices
bull Done in adolescence - fashionable
bull Manually done Usually incisors
Harmful effects
bull pain during process
bull Tooth discolouration (teeth -non vital)
bull Infection -pus discharge lip swelling
Tooth filing
Peri-apical x-ray of lower central incisor
Lacquering and staining of teethPerformed in Vietnam Laos Thailand Indonesia and Philippines
Perception For cosmetic reasons
bull Main ingredient dye dark-brown solution of ferric acetate called kanemizu (iron filings in vinegar)
bull Coating the teeth with this liquid helped to prevent tooth decay and enamel decay
bull Practice has slowly declined
Traditional gingival tattooinglips bull Practiced in Africarsquos Sahel region Woddebe
Fulani tribe Senegal Ethiopia middle eastern countries
Perception Reason aesthetic appeal superstition
bull Practices Done when females reach puberty
bull Kanuri females Borno State Nigeria tattooing lip gingiva usually performed thorns of Balanites aegyptiaca (Bukar et al 2004 )
bull Pigments -Mixture charcoal and seeds of Acacia nilotica vartomentosa
Lip plug lip plate
bull The lip plate (lip plug or lip disc) form of body modification
bull Amazonian tribes young males traditionally -rite of passage indicate status and prestige
bull Mursi of Ethiopia girls age 13 to 18
bull At puberty mother cuts her lower lip
bull Held open by a wooden plug - inserted into thereby stretching the lip
bull At times -combined with removal of two or four lower anterior incisal teeth
Lip plug lip plate
TRADITIONAL DENTAL SERVICES
bull Perceptions
Cause of illness determines treatment taken Practices
bull Yoruba community patronize traditional dentists (Oke Bankole et al 2011) Edo state
bull Services rendered include worm extraction tooth extraction drug prescription and offering sacrifices to deities
bull Charges based on the worm count
Northern Nigeria called Serdia Toothache associated with dandruff
Cameroon traditional healers perform atraumatic tooth extraction Agbor et al (2011)
bull Leaves stems of Dichrocephala integrifolia
bull Tooth pulled out fingerssharp instrument
bull No pain Plant has anaesthetic properties
bull Dangers infection sepsis infection with hepatitis B Human Immunodeficiency Virus
bull Jewish Unlikely keep Friday appointment with the dentist for their children
bull Routine appointments on Fridays avoided (Scambler et al )
The traditional healer harvesting the medicinal plant in Cameroon
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J Ethnobiol Ethnomed 2011 715
Tooth extraction by a traditional dentist
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J EthnobiolEthnomed 2011 715
bull Health is a consequence of an individualrsquos lifestyle
bull Essential to Identify cultural factors that are harmful and those that are beneficial
bull As paediatric dentists we should discourage the unhealthy practices through rigorous health education and promote the adoption of healthy practices
bull Need for multicentric research on the cultural influence of the family and peers regarding oral health of children
bull Bankole OO Lawal FB Ibiyemi O (2017) Dispelling myths associated with natalneonatal teeth ldquoAdunnirdquo a health education video in a native Nigerian language Annals of Ibadan Postgraduate Medicine15(2)137-141
Thank you for listening
DIETDental caries has escalated in developing countries
bull Misconception Food and drinks refined processed or modern is best and associated with affluence (Aderinokun et al 2011)
bull Parents donrsquot want their children to be deprived of what they lacked when young
bull This has led to a cultural shift in diet
bull Some African American believe motherrsquos diet during pregnancy cause dental caries in the child
bull Somali refugees Hutterites and Latino immigrant caregivers believed genetics plays a role in development early childhood caries (Prowse 2014)
Practices
bull YorubaHausa community common snacks have assumed local flavours several shapes coloursof sweets sold
bull Natural foods fruits are being sweetened Oke Bankole et al 2011 )
bull Nomadic Fulani sugary diet in between their meals sweetened drinks in bottles Sippy cups (827) and (716) give pacifiers dipped in sweet liquids Reduce temper tantrums with sweets Bankole et al 2015
Infant feeding practices
bull Babies with sweetened drinks in bottles pacifiers dipped in sweet liquidsputting infant to bed with a bottle of sweetened liquid Reported among Mexican Americans and Puerto Ricans Hong Kong Saudi mothers Al-Zahrani et al 2014
bull High risk factors contributing development of early childhood caries in infants
Diet
bull Perception
Animals such as pig are unclean
bull Practices
bull Hindus donrsquot eat beef Muslims donrsquot eat pork
bull Protective prevent taeniasis cystecercosis -edematous oral ulcers gingival bleeding lesions mimicking mucocles in children
(Alves et al 2011)
Dental Fluorosis bull In East and central African countries (tribal
areas of Tanzania Magadi a fluoride rich tronaused in cooking
bull Used as a tenderizer and preservative
bull High Fluoride Concentration 7900 ppm
bull Magadi use may suggest high prevalence of fluorosis in northern Tanzania (Kaseva 2006)
Oral Hygiene
Perceptions among mothers
bull Hausa Fulani- 142 - babyrsquos mouth should be cleaned before teeth erupt
bull Yoruba- Babyrsquos mouthtongue cleaned before teeth erupt to prevent thrush
bull Hausa Fulani- 635 - commencement tooth cleaning between 6 and 12 months of age (Bankole et al 2017)
bull Yoruba- chewing sticks should not be used at night Causes premature death of mother (Oke et al 2011)
Practices
Hausa Fulani- 594 cleaned infants teeth once daily
- 614 children start cleaning their teeth unsupervised before the age of six years
- 751 of supervision was carried out by the grandparents
- Sudan -343 mothers donrsquot clean childrenrsquos teeth below the age of 2 years (Abduljalil et al 2016)
-Hausa - mothers start cleaning childrenrsquos teeth when enough teeth to justify effort (Oke et al 2011)
Oral hygiene practices
Cleaning materials used in infancyearly childhood
CommunityTribe
GlycerinFresh tomato Hydrogen peroxideAluminum sulphateVerona Amygdalina (bitter leaf)Iyere (African black pepper)Alligator pepperCitrus lime Combinations
Yoruba - Nigeria (Aderinokun 2000)
Alum (Aluminum sulphate) Bitter leaf (Verona Amygdalina)
Iyere (African black pepper)
Citrus lime Alligator pepper
Oral hygiene practices
Tooth Cleaning materials
CommunityTribe Side effect
Salt and cotton wool
Hausa (Oke et al 2011)
Finger Nomadic Fulani
Wooden twigSalvadora persiccatwig (miswak) Neem tree Chewing stick
Nomadic Fulani ( Bankole et al 2017)
Somali
India (Kochar et al 2014)
Yoruba Senegal (Diouf 2013)
Improper use ndashgingival trauma
round ceramics omadic ulani
brasion sensiti it
and omadic ulani
shes ood charcoal
Somali (Beveridge
India Senegal
Tooth Cleaning materials
CommunityTribe Side effect
Ground ceramics Nomadic Fulani Tooth abrasion
Sand Nomadic Fulani
AshesWood
Charcoal
Somali India Senegal
Tooth abrasion
IMPORTANCE OF THE PRIMARY DENTITION IN CHILDREN
bull Primary teeth in children are sometimes not regarded as important
bull Mothers of preschool children in Mumbai -436 believed 192 were uncertain that there is no need to visit a dentist for treating milk teeth as they will soon fall off (Jain et al 2014)
COMMON DENTAL DISEASES
Dental Caries
bull Early childhood caries is a significant public health problem caries affecting children globally
bull In recent years in developing countries like Sub-Saharan Africa the prevalence is predicted to increase
bull Early childhood caries is largely untreated in a study in South Africa reported a caries prevalence of 716 and these 675 were untreated (Mohammed and Barnes 2018 )
Dental caries Perceived cause of dental
caries
Community tribe
Worms (resembling
maggots)
Borom bop (master of the
head)
Lagatas
Smaller version of pubu
Worms -removed from
ears
Yoruba Nomadic Fulani
Chinese (Dong et al 2007)
Senegalese ( Diouf et al 2003)
Brazil
Papua New Guinea
Indian (Nagaraj et al2014)
Dental caries -Care remedies Dental care remedies Community tribe Effect
Hydrochloric acid (Wet cell
battery liquid)
Aluminum Phosphate
(Alum)
Tobacco snuff
Charcoal and salt
Gentian violet
Atare (Alligator Pepper)
Yoruba Brazil
Kenya (Mulu Maryanne)
Yoruba (Oke et al 2011)
Chemical burns
mucosal ulceration
Erosion
Tetracycline capsule (topical)
Paracetamol (topical)
Hausa Nomadic Fulani
Hausa
Greyish brown tooth
discolouration
Mucosal ulceration
Traditional concoction
Dental are remedies Dental care remedies Community
tribe
Effect
White wineVinegar Powdered alum musk and frankincense
Chinese (Dong et al 2007)
Herbs traditional medicine
Aborigines (Wong 2005)
Nettles
Hot sweet potato
Wads hot leaves ginger
Residue smoking pipe
White sap of shrub used
to kill maggots
Insecticide ointment
Papua New
Guinea
Predisposition to
oral cancer
Toxic
Dental care remedies Dental care remedies Community Effect
Cooked meat
salt alcohol grease
deodorant
Iran
fingernail polish remover
black tar
Garlic Warm coconut milk
Brazil Toxic
Kawakawa Māori(Pepper Tree
Leaves) chewed
Harakeke -Korari Flax
the gum used for toothache
Maori
GingivitisPeriodontal disease
Perceptions
bull Bleeding gums caused by
bull Child stores food in pouch of mouth and does not clean teeth
Remedies for gingival periodontal disease
Remedies Community tribe
Effect
Aluminium phosphate (Alum ) + Lapalapa sap (Jatropha curcas)Warm water and salt Tomato and alum+polystrene foam or cotton woolHydrogen peroxide
Yoruba
Antibiotics NomadiFulani
Resistant strains Hyper sensitivityreactions
Herbs
ORAL HABITS Kola nut chewing
Common West Central Africa Symbol of hospitality Contains caffeine tannin
bull Helps students keep awakewithstand fatigue
Practices
bull One-year prevalence student use was 291 Erinfolami et al (2011)
bull Majority started at age 14 years or below
bull Dangers -insomnia nausea tooth discolourationcarcinogenic potential for development of oral cancer
Areca Nut Chewing Habitbull Areca nut is the seed of areca palm
bull Widely grown- Asia India Bangladesh Japan
bull Believed to help fatigue
bull Highest period of risk for first use is between 5 and 12 Farrand et al 2001
74 4-16 age group in Karachi indulged in the habit (Shah et al 2002)
Dangers Oral sub mucous fibrosis
bull Risk of oral cancer 99 times( Wollina et al 2004 ) Foreign body aspiration Severe tooth wear -- sensitivity root fractures
Mandibular arch with generalized staining in the deciduous dentition
Prajapati D Nayak R Nayak UA Shah PJ Areca nut chewing habit in preschoolers Two rare case reports and literature review Int J Dent Health Concern 201511-5 (Permission given)
Mandibular arch with generalized staining in the deciduous dentition
Prajapati D Nayak R Nayak UA Shah PJ Areca nut chewing habit in preschoolers Two rare case reports and literature review Int J Dent Health Concern 201511-5 (Permission given)
Oral tobacco use and cigar smoking
bull High prevalence tobacco use in any form is reported among school going adolescents aged 13ndash15 years in India (Arora and Reddy 2005) Smoking Chutta is relatively popular may begin in childhood in India
bull Acts as a stimulant euphoric
bull May sleep with tobacco mixture in mouth
Harmful effects halitosis brown black staining gingival recession if wad is held against gingivaleucoplakia oral squamous cell carcinoma
Tobacco use in children
PRACTICES RELATED TO PUBERTY AND GROOMING
Tooth filing tooth sharpening
Practiced -Nigeria Niger-Delta area (Ukeghesonand Akadiri ) Democratic Republic of Congo Thailand Indonesia
bull Perception Historically -spiritual reasons Contemporary times - aesthetic reasons
bull In Nigeria maxillary midline diastema is regarded as a symbol of beauty (Arigbede and Adesuwa 2012
bull Teeth filed- because represent negative emotions eg anger jealousy (Balinese Indonesia)
30 respondents would not mind having artificially created diastema (Omotosho and Kadri (2010)
Practices
bull Done in adolescence - fashionable
bull Manually done Usually incisors
Harmful effects
bull pain during process
bull Tooth discolouration (teeth -non vital)
bull Infection -pus discharge lip swelling
Tooth filing
Peri-apical x-ray of lower central incisor
Lacquering and staining of teethPerformed in Vietnam Laos Thailand Indonesia and Philippines
Perception For cosmetic reasons
bull Main ingredient dye dark-brown solution of ferric acetate called kanemizu (iron filings in vinegar)
bull Coating the teeth with this liquid helped to prevent tooth decay and enamel decay
bull Practice has slowly declined
Traditional gingival tattooinglips bull Practiced in Africarsquos Sahel region Woddebe
Fulani tribe Senegal Ethiopia middle eastern countries
Perception Reason aesthetic appeal superstition
bull Practices Done when females reach puberty
bull Kanuri females Borno State Nigeria tattooing lip gingiva usually performed thorns of Balanites aegyptiaca (Bukar et al 2004 )
bull Pigments -Mixture charcoal and seeds of Acacia nilotica vartomentosa
Lip plug lip plate
bull The lip plate (lip plug or lip disc) form of body modification
bull Amazonian tribes young males traditionally -rite of passage indicate status and prestige
bull Mursi of Ethiopia girls age 13 to 18
bull At puberty mother cuts her lower lip
bull Held open by a wooden plug - inserted into thereby stretching the lip
bull At times -combined with removal of two or four lower anterior incisal teeth
Lip plug lip plate
TRADITIONAL DENTAL SERVICES
bull Perceptions
Cause of illness determines treatment taken Practices
bull Yoruba community patronize traditional dentists (Oke Bankole et al 2011) Edo state
bull Services rendered include worm extraction tooth extraction drug prescription and offering sacrifices to deities
bull Charges based on the worm count
Northern Nigeria called Serdia Toothache associated with dandruff
Cameroon traditional healers perform atraumatic tooth extraction Agbor et al (2011)
bull Leaves stems of Dichrocephala integrifolia
bull Tooth pulled out fingerssharp instrument
bull No pain Plant has anaesthetic properties
bull Dangers infection sepsis infection with hepatitis B Human Immunodeficiency Virus
bull Jewish Unlikely keep Friday appointment with the dentist for their children
bull Routine appointments on Fridays avoided (Scambler et al )
The traditional healer harvesting the medicinal plant in Cameroon
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J Ethnobiol Ethnomed 2011 715
Tooth extraction by a traditional dentist
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J EthnobiolEthnomed 2011 715
bull Health is a consequence of an individualrsquos lifestyle
bull Essential to Identify cultural factors that are harmful and those that are beneficial
bull As paediatric dentists we should discourage the unhealthy practices through rigorous health education and promote the adoption of healthy practices
bull Need for multicentric research on the cultural influence of the family and peers regarding oral health of children
bull Bankole OO Lawal FB Ibiyemi O (2017) Dispelling myths associated with natalneonatal teeth ldquoAdunnirdquo a health education video in a native Nigerian language Annals of Ibadan Postgraduate Medicine15(2)137-141
Thank you for listening
bull Some African American believe motherrsquos diet during pregnancy cause dental caries in the child
bull Somali refugees Hutterites and Latino immigrant caregivers believed genetics plays a role in development early childhood caries (Prowse 2014)
Practices
bull YorubaHausa community common snacks have assumed local flavours several shapes coloursof sweets sold
bull Natural foods fruits are being sweetened Oke Bankole et al 2011 )
bull Nomadic Fulani sugary diet in between their meals sweetened drinks in bottles Sippy cups (827) and (716) give pacifiers dipped in sweet liquids Reduce temper tantrums with sweets Bankole et al 2015
Infant feeding practices
bull Babies with sweetened drinks in bottles pacifiers dipped in sweet liquidsputting infant to bed with a bottle of sweetened liquid Reported among Mexican Americans and Puerto Ricans Hong Kong Saudi mothers Al-Zahrani et al 2014
bull High risk factors contributing development of early childhood caries in infants
Diet
bull Perception
Animals such as pig are unclean
bull Practices
bull Hindus donrsquot eat beef Muslims donrsquot eat pork
bull Protective prevent taeniasis cystecercosis -edematous oral ulcers gingival bleeding lesions mimicking mucocles in children
(Alves et al 2011)
Dental Fluorosis bull In East and central African countries (tribal
areas of Tanzania Magadi a fluoride rich tronaused in cooking
bull Used as a tenderizer and preservative
bull High Fluoride Concentration 7900 ppm
bull Magadi use may suggest high prevalence of fluorosis in northern Tanzania (Kaseva 2006)
Oral Hygiene
Perceptions among mothers
bull Hausa Fulani- 142 - babyrsquos mouth should be cleaned before teeth erupt
bull Yoruba- Babyrsquos mouthtongue cleaned before teeth erupt to prevent thrush
bull Hausa Fulani- 635 - commencement tooth cleaning between 6 and 12 months of age (Bankole et al 2017)
bull Yoruba- chewing sticks should not be used at night Causes premature death of mother (Oke et al 2011)
Practices
Hausa Fulani- 594 cleaned infants teeth once daily
- 614 children start cleaning their teeth unsupervised before the age of six years
- 751 of supervision was carried out by the grandparents
- Sudan -343 mothers donrsquot clean childrenrsquos teeth below the age of 2 years (Abduljalil et al 2016)
-Hausa - mothers start cleaning childrenrsquos teeth when enough teeth to justify effort (Oke et al 2011)
Oral hygiene practices
Cleaning materials used in infancyearly childhood
CommunityTribe
GlycerinFresh tomato Hydrogen peroxideAluminum sulphateVerona Amygdalina (bitter leaf)Iyere (African black pepper)Alligator pepperCitrus lime Combinations
Yoruba - Nigeria (Aderinokun 2000)
Alum (Aluminum sulphate) Bitter leaf (Verona Amygdalina)
Iyere (African black pepper)
Citrus lime Alligator pepper
Oral hygiene practices
Tooth Cleaning materials
CommunityTribe Side effect
Salt and cotton wool
Hausa (Oke et al 2011)
Finger Nomadic Fulani
Wooden twigSalvadora persiccatwig (miswak) Neem tree Chewing stick
Nomadic Fulani ( Bankole et al 2017)
Somali
India (Kochar et al 2014)
Yoruba Senegal (Diouf 2013)
Improper use ndashgingival trauma
round ceramics omadic ulani
brasion sensiti it
and omadic ulani
shes ood charcoal
Somali (Beveridge
India Senegal
Tooth Cleaning materials
CommunityTribe Side effect
Ground ceramics Nomadic Fulani Tooth abrasion
Sand Nomadic Fulani
AshesWood
Charcoal
Somali India Senegal
Tooth abrasion
IMPORTANCE OF THE PRIMARY DENTITION IN CHILDREN
bull Primary teeth in children are sometimes not regarded as important
bull Mothers of preschool children in Mumbai -436 believed 192 were uncertain that there is no need to visit a dentist for treating milk teeth as they will soon fall off (Jain et al 2014)
COMMON DENTAL DISEASES
Dental Caries
bull Early childhood caries is a significant public health problem caries affecting children globally
bull In recent years in developing countries like Sub-Saharan Africa the prevalence is predicted to increase
bull Early childhood caries is largely untreated in a study in South Africa reported a caries prevalence of 716 and these 675 were untreated (Mohammed and Barnes 2018 )
Dental caries Perceived cause of dental
caries
Community tribe
Worms (resembling
maggots)
Borom bop (master of the
head)
Lagatas
Smaller version of pubu
Worms -removed from
ears
Yoruba Nomadic Fulani
Chinese (Dong et al 2007)
Senegalese ( Diouf et al 2003)
Brazil
Papua New Guinea
Indian (Nagaraj et al2014)
Dental caries -Care remedies Dental care remedies Community tribe Effect
Hydrochloric acid (Wet cell
battery liquid)
Aluminum Phosphate
(Alum)
Tobacco snuff
Charcoal and salt
Gentian violet
Atare (Alligator Pepper)
Yoruba Brazil
Kenya (Mulu Maryanne)
Yoruba (Oke et al 2011)
Chemical burns
mucosal ulceration
Erosion
Tetracycline capsule (topical)
Paracetamol (topical)
Hausa Nomadic Fulani
Hausa
Greyish brown tooth
discolouration
Mucosal ulceration
Traditional concoction
Dental are remedies Dental care remedies Community
tribe
Effect
White wineVinegar Powdered alum musk and frankincense
Chinese (Dong et al 2007)
Herbs traditional medicine
Aborigines (Wong 2005)
Nettles
Hot sweet potato
Wads hot leaves ginger
Residue smoking pipe
White sap of shrub used
to kill maggots
Insecticide ointment
Papua New
Guinea
Predisposition to
oral cancer
Toxic
Dental care remedies Dental care remedies Community Effect
Cooked meat
salt alcohol grease
deodorant
Iran
fingernail polish remover
black tar
Garlic Warm coconut milk
Brazil Toxic
Kawakawa Māori(Pepper Tree
Leaves) chewed
Harakeke -Korari Flax
the gum used for toothache
Maori
GingivitisPeriodontal disease
Perceptions
bull Bleeding gums caused by
bull Child stores food in pouch of mouth and does not clean teeth
Remedies for gingival periodontal disease
Remedies Community tribe
Effect
Aluminium phosphate (Alum ) + Lapalapa sap (Jatropha curcas)Warm water and salt Tomato and alum+polystrene foam or cotton woolHydrogen peroxide
Yoruba
Antibiotics NomadiFulani
Resistant strains Hyper sensitivityreactions
Herbs
ORAL HABITS Kola nut chewing
Common West Central Africa Symbol of hospitality Contains caffeine tannin
bull Helps students keep awakewithstand fatigue
Practices
bull One-year prevalence student use was 291 Erinfolami et al (2011)
bull Majority started at age 14 years or below
bull Dangers -insomnia nausea tooth discolourationcarcinogenic potential for development of oral cancer
Areca Nut Chewing Habitbull Areca nut is the seed of areca palm
bull Widely grown- Asia India Bangladesh Japan
bull Believed to help fatigue
bull Highest period of risk for first use is between 5 and 12 Farrand et al 2001
74 4-16 age group in Karachi indulged in the habit (Shah et al 2002)
Dangers Oral sub mucous fibrosis
bull Risk of oral cancer 99 times( Wollina et al 2004 ) Foreign body aspiration Severe tooth wear -- sensitivity root fractures
Mandibular arch with generalized staining in the deciduous dentition
Prajapati D Nayak R Nayak UA Shah PJ Areca nut chewing habit in preschoolers Two rare case reports and literature review Int J Dent Health Concern 201511-5 (Permission given)
Mandibular arch with generalized staining in the deciduous dentition
Prajapati D Nayak R Nayak UA Shah PJ Areca nut chewing habit in preschoolers Two rare case reports and literature review Int J Dent Health Concern 201511-5 (Permission given)
Oral tobacco use and cigar smoking
bull High prevalence tobacco use in any form is reported among school going adolescents aged 13ndash15 years in India (Arora and Reddy 2005) Smoking Chutta is relatively popular may begin in childhood in India
bull Acts as a stimulant euphoric
bull May sleep with tobacco mixture in mouth
Harmful effects halitosis brown black staining gingival recession if wad is held against gingivaleucoplakia oral squamous cell carcinoma
Tobacco use in children
PRACTICES RELATED TO PUBERTY AND GROOMING
Tooth filing tooth sharpening
Practiced -Nigeria Niger-Delta area (Ukeghesonand Akadiri ) Democratic Republic of Congo Thailand Indonesia
bull Perception Historically -spiritual reasons Contemporary times - aesthetic reasons
bull In Nigeria maxillary midline diastema is regarded as a symbol of beauty (Arigbede and Adesuwa 2012
bull Teeth filed- because represent negative emotions eg anger jealousy (Balinese Indonesia)
30 respondents would not mind having artificially created diastema (Omotosho and Kadri (2010)
Practices
bull Done in adolescence - fashionable
bull Manually done Usually incisors
Harmful effects
bull pain during process
bull Tooth discolouration (teeth -non vital)
bull Infection -pus discharge lip swelling
Tooth filing
Peri-apical x-ray of lower central incisor
Lacquering and staining of teethPerformed in Vietnam Laos Thailand Indonesia and Philippines
Perception For cosmetic reasons
bull Main ingredient dye dark-brown solution of ferric acetate called kanemizu (iron filings in vinegar)
bull Coating the teeth with this liquid helped to prevent tooth decay and enamel decay
bull Practice has slowly declined
Traditional gingival tattooinglips bull Practiced in Africarsquos Sahel region Woddebe
Fulani tribe Senegal Ethiopia middle eastern countries
Perception Reason aesthetic appeal superstition
bull Practices Done when females reach puberty
bull Kanuri females Borno State Nigeria tattooing lip gingiva usually performed thorns of Balanites aegyptiaca (Bukar et al 2004 )
bull Pigments -Mixture charcoal and seeds of Acacia nilotica vartomentosa
Lip plug lip plate
bull The lip plate (lip plug or lip disc) form of body modification
bull Amazonian tribes young males traditionally -rite of passage indicate status and prestige
bull Mursi of Ethiopia girls age 13 to 18
bull At puberty mother cuts her lower lip
bull Held open by a wooden plug - inserted into thereby stretching the lip
bull At times -combined with removal of two or four lower anterior incisal teeth
Lip plug lip plate
TRADITIONAL DENTAL SERVICES
bull Perceptions
Cause of illness determines treatment taken Practices
bull Yoruba community patronize traditional dentists (Oke Bankole et al 2011) Edo state
bull Services rendered include worm extraction tooth extraction drug prescription and offering sacrifices to deities
bull Charges based on the worm count
Northern Nigeria called Serdia Toothache associated with dandruff
Cameroon traditional healers perform atraumatic tooth extraction Agbor et al (2011)
bull Leaves stems of Dichrocephala integrifolia
bull Tooth pulled out fingerssharp instrument
bull No pain Plant has anaesthetic properties
bull Dangers infection sepsis infection with hepatitis B Human Immunodeficiency Virus
bull Jewish Unlikely keep Friday appointment with the dentist for their children
bull Routine appointments on Fridays avoided (Scambler et al )
The traditional healer harvesting the medicinal plant in Cameroon
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J Ethnobiol Ethnomed 2011 715
Tooth extraction by a traditional dentist
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J EthnobiolEthnomed 2011 715
bull Health is a consequence of an individualrsquos lifestyle
bull Essential to Identify cultural factors that are harmful and those that are beneficial
bull As paediatric dentists we should discourage the unhealthy practices through rigorous health education and promote the adoption of healthy practices
bull Need for multicentric research on the cultural influence of the family and peers regarding oral health of children
bull Bankole OO Lawal FB Ibiyemi O (2017) Dispelling myths associated with natalneonatal teeth ldquoAdunnirdquo a health education video in a native Nigerian language Annals of Ibadan Postgraduate Medicine15(2)137-141
Thank you for listening
Practices
bull YorubaHausa community common snacks have assumed local flavours several shapes coloursof sweets sold
bull Natural foods fruits are being sweetened Oke Bankole et al 2011 )
bull Nomadic Fulani sugary diet in between their meals sweetened drinks in bottles Sippy cups (827) and (716) give pacifiers dipped in sweet liquids Reduce temper tantrums with sweets Bankole et al 2015
Infant feeding practices
bull Babies with sweetened drinks in bottles pacifiers dipped in sweet liquidsputting infant to bed with a bottle of sweetened liquid Reported among Mexican Americans and Puerto Ricans Hong Kong Saudi mothers Al-Zahrani et al 2014
bull High risk factors contributing development of early childhood caries in infants
Diet
bull Perception
Animals such as pig are unclean
bull Practices
bull Hindus donrsquot eat beef Muslims donrsquot eat pork
bull Protective prevent taeniasis cystecercosis -edematous oral ulcers gingival bleeding lesions mimicking mucocles in children
(Alves et al 2011)
Dental Fluorosis bull In East and central African countries (tribal
areas of Tanzania Magadi a fluoride rich tronaused in cooking
bull Used as a tenderizer and preservative
bull High Fluoride Concentration 7900 ppm
bull Magadi use may suggest high prevalence of fluorosis in northern Tanzania (Kaseva 2006)
Oral Hygiene
Perceptions among mothers
bull Hausa Fulani- 142 - babyrsquos mouth should be cleaned before teeth erupt
bull Yoruba- Babyrsquos mouthtongue cleaned before teeth erupt to prevent thrush
bull Hausa Fulani- 635 - commencement tooth cleaning between 6 and 12 months of age (Bankole et al 2017)
bull Yoruba- chewing sticks should not be used at night Causes premature death of mother (Oke et al 2011)
Practices
Hausa Fulani- 594 cleaned infants teeth once daily
- 614 children start cleaning their teeth unsupervised before the age of six years
- 751 of supervision was carried out by the grandparents
- Sudan -343 mothers donrsquot clean childrenrsquos teeth below the age of 2 years (Abduljalil et al 2016)
-Hausa - mothers start cleaning childrenrsquos teeth when enough teeth to justify effort (Oke et al 2011)
Oral hygiene practices
Cleaning materials used in infancyearly childhood
CommunityTribe
GlycerinFresh tomato Hydrogen peroxideAluminum sulphateVerona Amygdalina (bitter leaf)Iyere (African black pepper)Alligator pepperCitrus lime Combinations
Yoruba - Nigeria (Aderinokun 2000)
Alum (Aluminum sulphate) Bitter leaf (Verona Amygdalina)
Iyere (African black pepper)
Citrus lime Alligator pepper
Oral hygiene practices
Tooth Cleaning materials
CommunityTribe Side effect
Salt and cotton wool
Hausa (Oke et al 2011)
Finger Nomadic Fulani
Wooden twigSalvadora persiccatwig (miswak) Neem tree Chewing stick
Nomadic Fulani ( Bankole et al 2017)
Somali
India (Kochar et al 2014)
Yoruba Senegal (Diouf 2013)
Improper use ndashgingival trauma
round ceramics omadic ulani
brasion sensiti it
and omadic ulani
shes ood charcoal
Somali (Beveridge
India Senegal
Tooth Cleaning materials
CommunityTribe Side effect
Ground ceramics Nomadic Fulani Tooth abrasion
Sand Nomadic Fulani
AshesWood
Charcoal
Somali India Senegal
Tooth abrasion
IMPORTANCE OF THE PRIMARY DENTITION IN CHILDREN
bull Primary teeth in children are sometimes not regarded as important
bull Mothers of preschool children in Mumbai -436 believed 192 were uncertain that there is no need to visit a dentist for treating milk teeth as they will soon fall off (Jain et al 2014)
COMMON DENTAL DISEASES
Dental Caries
bull Early childhood caries is a significant public health problem caries affecting children globally
bull In recent years in developing countries like Sub-Saharan Africa the prevalence is predicted to increase
bull Early childhood caries is largely untreated in a study in South Africa reported a caries prevalence of 716 and these 675 were untreated (Mohammed and Barnes 2018 )
Dental caries Perceived cause of dental
caries
Community tribe
Worms (resembling
maggots)
Borom bop (master of the
head)
Lagatas
Smaller version of pubu
Worms -removed from
ears
Yoruba Nomadic Fulani
Chinese (Dong et al 2007)
Senegalese ( Diouf et al 2003)
Brazil
Papua New Guinea
Indian (Nagaraj et al2014)
Dental caries -Care remedies Dental care remedies Community tribe Effect
Hydrochloric acid (Wet cell
battery liquid)
Aluminum Phosphate
(Alum)
Tobacco snuff
Charcoal and salt
Gentian violet
Atare (Alligator Pepper)
Yoruba Brazil
Kenya (Mulu Maryanne)
Yoruba (Oke et al 2011)
Chemical burns
mucosal ulceration
Erosion
Tetracycline capsule (topical)
Paracetamol (topical)
Hausa Nomadic Fulani
Hausa
Greyish brown tooth
discolouration
Mucosal ulceration
Traditional concoction
Dental are remedies Dental care remedies Community
tribe
Effect
White wineVinegar Powdered alum musk and frankincense
Chinese (Dong et al 2007)
Herbs traditional medicine
Aborigines (Wong 2005)
Nettles
Hot sweet potato
Wads hot leaves ginger
Residue smoking pipe
White sap of shrub used
to kill maggots
Insecticide ointment
Papua New
Guinea
Predisposition to
oral cancer
Toxic
Dental care remedies Dental care remedies Community Effect
Cooked meat
salt alcohol grease
deodorant
Iran
fingernail polish remover
black tar
Garlic Warm coconut milk
Brazil Toxic
Kawakawa Māori(Pepper Tree
Leaves) chewed
Harakeke -Korari Flax
the gum used for toothache
Maori
GingivitisPeriodontal disease
Perceptions
bull Bleeding gums caused by
bull Child stores food in pouch of mouth and does not clean teeth
Remedies for gingival periodontal disease
Remedies Community tribe
Effect
Aluminium phosphate (Alum ) + Lapalapa sap (Jatropha curcas)Warm water and salt Tomato and alum+polystrene foam or cotton woolHydrogen peroxide
Yoruba
Antibiotics NomadiFulani
Resistant strains Hyper sensitivityreactions
Herbs
ORAL HABITS Kola nut chewing
Common West Central Africa Symbol of hospitality Contains caffeine tannin
bull Helps students keep awakewithstand fatigue
Practices
bull One-year prevalence student use was 291 Erinfolami et al (2011)
bull Majority started at age 14 years or below
bull Dangers -insomnia nausea tooth discolourationcarcinogenic potential for development of oral cancer
Areca Nut Chewing Habitbull Areca nut is the seed of areca palm
bull Widely grown- Asia India Bangladesh Japan
bull Believed to help fatigue
bull Highest period of risk for first use is between 5 and 12 Farrand et al 2001
74 4-16 age group in Karachi indulged in the habit (Shah et al 2002)
Dangers Oral sub mucous fibrosis
bull Risk of oral cancer 99 times( Wollina et al 2004 ) Foreign body aspiration Severe tooth wear -- sensitivity root fractures
Mandibular arch with generalized staining in the deciduous dentition
Prajapati D Nayak R Nayak UA Shah PJ Areca nut chewing habit in preschoolers Two rare case reports and literature review Int J Dent Health Concern 201511-5 (Permission given)
Mandibular arch with generalized staining in the deciduous dentition
Prajapati D Nayak R Nayak UA Shah PJ Areca nut chewing habit in preschoolers Two rare case reports and literature review Int J Dent Health Concern 201511-5 (Permission given)
Oral tobacco use and cigar smoking
bull High prevalence tobacco use in any form is reported among school going adolescents aged 13ndash15 years in India (Arora and Reddy 2005) Smoking Chutta is relatively popular may begin in childhood in India
bull Acts as a stimulant euphoric
bull May sleep with tobacco mixture in mouth
Harmful effects halitosis brown black staining gingival recession if wad is held against gingivaleucoplakia oral squamous cell carcinoma
Tobacco use in children
PRACTICES RELATED TO PUBERTY AND GROOMING
Tooth filing tooth sharpening
Practiced -Nigeria Niger-Delta area (Ukeghesonand Akadiri ) Democratic Republic of Congo Thailand Indonesia
bull Perception Historically -spiritual reasons Contemporary times - aesthetic reasons
bull In Nigeria maxillary midline diastema is regarded as a symbol of beauty (Arigbede and Adesuwa 2012
bull Teeth filed- because represent negative emotions eg anger jealousy (Balinese Indonesia)
30 respondents would not mind having artificially created diastema (Omotosho and Kadri (2010)
Practices
bull Done in adolescence - fashionable
bull Manually done Usually incisors
Harmful effects
bull pain during process
bull Tooth discolouration (teeth -non vital)
bull Infection -pus discharge lip swelling
Tooth filing
Peri-apical x-ray of lower central incisor
Lacquering and staining of teethPerformed in Vietnam Laos Thailand Indonesia and Philippines
Perception For cosmetic reasons
bull Main ingredient dye dark-brown solution of ferric acetate called kanemizu (iron filings in vinegar)
bull Coating the teeth with this liquid helped to prevent tooth decay and enamel decay
bull Practice has slowly declined
Traditional gingival tattooinglips bull Practiced in Africarsquos Sahel region Woddebe
Fulani tribe Senegal Ethiopia middle eastern countries
Perception Reason aesthetic appeal superstition
bull Practices Done when females reach puberty
bull Kanuri females Borno State Nigeria tattooing lip gingiva usually performed thorns of Balanites aegyptiaca (Bukar et al 2004 )
bull Pigments -Mixture charcoal and seeds of Acacia nilotica vartomentosa
Lip plug lip plate
bull The lip plate (lip plug or lip disc) form of body modification
bull Amazonian tribes young males traditionally -rite of passage indicate status and prestige
bull Mursi of Ethiopia girls age 13 to 18
bull At puberty mother cuts her lower lip
bull Held open by a wooden plug - inserted into thereby stretching the lip
bull At times -combined with removal of two or four lower anterior incisal teeth
Lip plug lip plate
TRADITIONAL DENTAL SERVICES
bull Perceptions
Cause of illness determines treatment taken Practices
bull Yoruba community patronize traditional dentists (Oke Bankole et al 2011) Edo state
bull Services rendered include worm extraction tooth extraction drug prescription and offering sacrifices to deities
bull Charges based on the worm count
Northern Nigeria called Serdia Toothache associated with dandruff
Cameroon traditional healers perform atraumatic tooth extraction Agbor et al (2011)
bull Leaves stems of Dichrocephala integrifolia
bull Tooth pulled out fingerssharp instrument
bull No pain Plant has anaesthetic properties
bull Dangers infection sepsis infection with hepatitis B Human Immunodeficiency Virus
bull Jewish Unlikely keep Friday appointment with the dentist for their children
bull Routine appointments on Fridays avoided (Scambler et al )
The traditional healer harvesting the medicinal plant in Cameroon
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J Ethnobiol Ethnomed 2011 715
Tooth extraction by a traditional dentist
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J EthnobiolEthnomed 2011 715
bull Health is a consequence of an individualrsquos lifestyle
bull Essential to Identify cultural factors that are harmful and those that are beneficial
bull As paediatric dentists we should discourage the unhealthy practices through rigorous health education and promote the adoption of healthy practices
bull Need for multicentric research on the cultural influence of the family and peers regarding oral health of children
bull Bankole OO Lawal FB Ibiyemi O (2017) Dispelling myths associated with natalneonatal teeth ldquoAdunnirdquo a health education video in a native Nigerian language Annals of Ibadan Postgraduate Medicine15(2)137-141
Thank you for listening
Infant feeding practices
bull Babies with sweetened drinks in bottles pacifiers dipped in sweet liquidsputting infant to bed with a bottle of sweetened liquid Reported among Mexican Americans and Puerto Ricans Hong Kong Saudi mothers Al-Zahrani et al 2014
bull High risk factors contributing development of early childhood caries in infants
Diet
bull Perception
Animals such as pig are unclean
bull Practices
bull Hindus donrsquot eat beef Muslims donrsquot eat pork
bull Protective prevent taeniasis cystecercosis -edematous oral ulcers gingival bleeding lesions mimicking mucocles in children
(Alves et al 2011)
Dental Fluorosis bull In East and central African countries (tribal
areas of Tanzania Magadi a fluoride rich tronaused in cooking
bull Used as a tenderizer and preservative
bull High Fluoride Concentration 7900 ppm
bull Magadi use may suggest high prevalence of fluorosis in northern Tanzania (Kaseva 2006)
Oral Hygiene
Perceptions among mothers
bull Hausa Fulani- 142 - babyrsquos mouth should be cleaned before teeth erupt
bull Yoruba- Babyrsquos mouthtongue cleaned before teeth erupt to prevent thrush
bull Hausa Fulani- 635 - commencement tooth cleaning between 6 and 12 months of age (Bankole et al 2017)
bull Yoruba- chewing sticks should not be used at night Causes premature death of mother (Oke et al 2011)
Practices
Hausa Fulani- 594 cleaned infants teeth once daily
- 614 children start cleaning their teeth unsupervised before the age of six years
- 751 of supervision was carried out by the grandparents
- Sudan -343 mothers donrsquot clean childrenrsquos teeth below the age of 2 years (Abduljalil et al 2016)
-Hausa - mothers start cleaning childrenrsquos teeth when enough teeth to justify effort (Oke et al 2011)
Oral hygiene practices
Cleaning materials used in infancyearly childhood
CommunityTribe
GlycerinFresh tomato Hydrogen peroxideAluminum sulphateVerona Amygdalina (bitter leaf)Iyere (African black pepper)Alligator pepperCitrus lime Combinations
Yoruba - Nigeria (Aderinokun 2000)
Alum (Aluminum sulphate) Bitter leaf (Verona Amygdalina)
Iyere (African black pepper)
Citrus lime Alligator pepper
Oral hygiene practices
Tooth Cleaning materials
CommunityTribe Side effect
Salt and cotton wool
Hausa (Oke et al 2011)
Finger Nomadic Fulani
Wooden twigSalvadora persiccatwig (miswak) Neem tree Chewing stick
Nomadic Fulani ( Bankole et al 2017)
Somali
India (Kochar et al 2014)
Yoruba Senegal (Diouf 2013)
Improper use ndashgingival trauma
round ceramics omadic ulani
brasion sensiti it
and omadic ulani
shes ood charcoal
Somali (Beveridge
India Senegal
Tooth Cleaning materials
CommunityTribe Side effect
Ground ceramics Nomadic Fulani Tooth abrasion
Sand Nomadic Fulani
AshesWood
Charcoal
Somali India Senegal
Tooth abrasion
IMPORTANCE OF THE PRIMARY DENTITION IN CHILDREN
bull Primary teeth in children are sometimes not regarded as important
bull Mothers of preschool children in Mumbai -436 believed 192 were uncertain that there is no need to visit a dentist for treating milk teeth as they will soon fall off (Jain et al 2014)
COMMON DENTAL DISEASES
Dental Caries
bull Early childhood caries is a significant public health problem caries affecting children globally
bull In recent years in developing countries like Sub-Saharan Africa the prevalence is predicted to increase
bull Early childhood caries is largely untreated in a study in South Africa reported a caries prevalence of 716 and these 675 were untreated (Mohammed and Barnes 2018 )
Dental caries Perceived cause of dental
caries
Community tribe
Worms (resembling
maggots)
Borom bop (master of the
head)
Lagatas
Smaller version of pubu
Worms -removed from
ears
Yoruba Nomadic Fulani
Chinese (Dong et al 2007)
Senegalese ( Diouf et al 2003)
Brazil
Papua New Guinea
Indian (Nagaraj et al2014)
Dental caries -Care remedies Dental care remedies Community tribe Effect
Hydrochloric acid (Wet cell
battery liquid)
Aluminum Phosphate
(Alum)
Tobacco snuff
Charcoal and salt
Gentian violet
Atare (Alligator Pepper)
Yoruba Brazil
Kenya (Mulu Maryanne)
Yoruba (Oke et al 2011)
Chemical burns
mucosal ulceration
Erosion
Tetracycline capsule (topical)
Paracetamol (topical)
Hausa Nomadic Fulani
Hausa
Greyish brown tooth
discolouration
Mucosal ulceration
Traditional concoction
Dental are remedies Dental care remedies Community
tribe
Effect
White wineVinegar Powdered alum musk and frankincense
Chinese (Dong et al 2007)
Herbs traditional medicine
Aborigines (Wong 2005)
Nettles
Hot sweet potato
Wads hot leaves ginger
Residue smoking pipe
White sap of shrub used
to kill maggots
Insecticide ointment
Papua New
Guinea
Predisposition to
oral cancer
Toxic
Dental care remedies Dental care remedies Community Effect
Cooked meat
salt alcohol grease
deodorant
Iran
fingernail polish remover
black tar
Garlic Warm coconut milk
Brazil Toxic
Kawakawa Māori(Pepper Tree
Leaves) chewed
Harakeke -Korari Flax
the gum used for toothache
Maori
GingivitisPeriodontal disease
Perceptions
bull Bleeding gums caused by
bull Child stores food in pouch of mouth and does not clean teeth
Remedies for gingival periodontal disease
Remedies Community tribe
Effect
Aluminium phosphate (Alum ) + Lapalapa sap (Jatropha curcas)Warm water and salt Tomato and alum+polystrene foam or cotton woolHydrogen peroxide
Yoruba
Antibiotics NomadiFulani
Resistant strains Hyper sensitivityreactions
Herbs
ORAL HABITS Kola nut chewing
Common West Central Africa Symbol of hospitality Contains caffeine tannin
bull Helps students keep awakewithstand fatigue
Practices
bull One-year prevalence student use was 291 Erinfolami et al (2011)
bull Majority started at age 14 years or below
bull Dangers -insomnia nausea tooth discolourationcarcinogenic potential for development of oral cancer
Areca Nut Chewing Habitbull Areca nut is the seed of areca palm
bull Widely grown- Asia India Bangladesh Japan
bull Believed to help fatigue
bull Highest period of risk for first use is between 5 and 12 Farrand et al 2001
74 4-16 age group in Karachi indulged in the habit (Shah et al 2002)
Dangers Oral sub mucous fibrosis
bull Risk of oral cancer 99 times( Wollina et al 2004 ) Foreign body aspiration Severe tooth wear -- sensitivity root fractures
Mandibular arch with generalized staining in the deciduous dentition
Prajapati D Nayak R Nayak UA Shah PJ Areca nut chewing habit in preschoolers Two rare case reports and literature review Int J Dent Health Concern 201511-5 (Permission given)
Mandibular arch with generalized staining in the deciduous dentition
Prajapati D Nayak R Nayak UA Shah PJ Areca nut chewing habit in preschoolers Two rare case reports and literature review Int J Dent Health Concern 201511-5 (Permission given)
Oral tobacco use and cigar smoking
bull High prevalence tobacco use in any form is reported among school going adolescents aged 13ndash15 years in India (Arora and Reddy 2005) Smoking Chutta is relatively popular may begin in childhood in India
bull Acts as a stimulant euphoric
bull May sleep with tobacco mixture in mouth
Harmful effects halitosis brown black staining gingival recession if wad is held against gingivaleucoplakia oral squamous cell carcinoma
Tobacco use in children
PRACTICES RELATED TO PUBERTY AND GROOMING
Tooth filing tooth sharpening
Practiced -Nigeria Niger-Delta area (Ukeghesonand Akadiri ) Democratic Republic of Congo Thailand Indonesia
bull Perception Historically -spiritual reasons Contemporary times - aesthetic reasons
bull In Nigeria maxillary midline diastema is regarded as a symbol of beauty (Arigbede and Adesuwa 2012
bull Teeth filed- because represent negative emotions eg anger jealousy (Balinese Indonesia)
30 respondents would not mind having artificially created diastema (Omotosho and Kadri (2010)
Practices
bull Done in adolescence - fashionable
bull Manually done Usually incisors
Harmful effects
bull pain during process
bull Tooth discolouration (teeth -non vital)
bull Infection -pus discharge lip swelling
Tooth filing
Peri-apical x-ray of lower central incisor
Lacquering and staining of teethPerformed in Vietnam Laos Thailand Indonesia and Philippines
Perception For cosmetic reasons
bull Main ingredient dye dark-brown solution of ferric acetate called kanemizu (iron filings in vinegar)
bull Coating the teeth with this liquid helped to prevent tooth decay and enamel decay
bull Practice has slowly declined
Traditional gingival tattooinglips bull Practiced in Africarsquos Sahel region Woddebe
Fulani tribe Senegal Ethiopia middle eastern countries
Perception Reason aesthetic appeal superstition
bull Practices Done when females reach puberty
bull Kanuri females Borno State Nigeria tattooing lip gingiva usually performed thorns of Balanites aegyptiaca (Bukar et al 2004 )
bull Pigments -Mixture charcoal and seeds of Acacia nilotica vartomentosa
Lip plug lip plate
bull The lip plate (lip plug or lip disc) form of body modification
bull Amazonian tribes young males traditionally -rite of passage indicate status and prestige
bull Mursi of Ethiopia girls age 13 to 18
bull At puberty mother cuts her lower lip
bull Held open by a wooden plug - inserted into thereby stretching the lip
bull At times -combined with removal of two or four lower anterior incisal teeth
Lip plug lip plate
TRADITIONAL DENTAL SERVICES
bull Perceptions
Cause of illness determines treatment taken Practices
bull Yoruba community patronize traditional dentists (Oke Bankole et al 2011) Edo state
bull Services rendered include worm extraction tooth extraction drug prescription and offering sacrifices to deities
bull Charges based on the worm count
Northern Nigeria called Serdia Toothache associated with dandruff
Cameroon traditional healers perform atraumatic tooth extraction Agbor et al (2011)
bull Leaves stems of Dichrocephala integrifolia
bull Tooth pulled out fingerssharp instrument
bull No pain Plant has anaesthetic properties
bull Dangers infection sepsis infection with hepatitis B Human Immunodeficiency Virus
bull Jewish Unlikely keep Friday appointment with the dentist for their children
bull Routine appointments on Fridays avoided (Scambler et al )
The traditional healer harvesting the medicinal plant in Cameroon
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J Ethnobiol Ethnomed 2011 715
Tooth extraction by a traditional dentist
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J EthnobiolEthnomed 2011 715
bull Health is a consequence of an individualrsquos lifestyle
bull Essential to Identify cultural factors that are harmful and those that are beneficial
bull As paediatric dentists we should discourage the unhealthy practices through rigorous health education and promote the adoption of healthy practices
bull Need for multicentric research on the cultural influence of the family and peers regarding oral health of children
bull Bankole OO Lawal FB Ibiyemi O (2017) Dispelling myths associated with natalneonatal teeth ldquoAdunnirdquo a health education video in a native Nigerian language Annals of Ibadan Postgraduate Medicine15(2)137-141
Thank you for listening
Diet
bull Perception
Animals such as pig are unclean
bull Practices
bull Hindus donrsquot eat beef Muslims donrsquot eat pork
bull Protective prevent taeniasis cystecercosis -edematous oral ulcers gingival bleeding lesions mimicking mucocles in children
(Alves et al 2011)
Dental Fluorosis bull In East and central African countries (tribal
areas of Tanzania Magadi a fluoride rich tronaused in cooking
bull Used as a tenderizer and preservative
bull High Fluoride Concentration 7900 ppm
bull Magadi use may suggest high prevalence of fluorosis in northern Tanzania (Kaseva 2006)
Oral Hygiene
Perceptions among mothers
bull Hausa Fulani- 142 - babyrsquos mouth should be cleaned before teeth erupt
bull Yoruba- Babyrsquos mouthtongue cleaned before teeth erupt to prevent thrush
bull Hausa Fulani- 635 - commencement tooth cleaning between 6 and 12 months of age (Bankole et al 2017)
bull Yoruba- chewing sticks should not be used at night Causes premature death of mother (Oke et al 2011)
Practices
Hausa Fulani- 594 cleaned infants teeth once daily
- 614 children start cleaning their teeth unsupervised before the age of six years
- 751 of supervision was carried out by the grandparents
- Sudan -343 mothers donrsquot clean childrenrsquos teeth below the age of 2 years (Abduljalil et al 2016)
-Hausa - mothers start cleaning childrenrsquos teeth when enough teeth to justify effort (Oke et al 2011)
Oral hygiene practices
Cleaning materials used in infancyearly childhood
CommunityTribe
GlycerinFresh tomato Hydrogen peroxideAluminum sulphateVerona Amygdalina (bitter leaf)Iyere (African black pepper)Alligator pepperCitrus lime Combinations
Yoruba - Nigeria (Aderinokun 2000)
Alum (Aluminum sulphate) Bitter leaf (Verona Amygdalina)
Iyere (African black pepper)
Citrus lime Alligator pepper
Oral hygiene practices
Tooth Cleaning materials
CommunityTribe Side effect
Salt and cotton wool
Hausa (Oke et al 2011)
Finger Nomadic Fulani
Wooden twigSalvadora persiccatwig (miswak) Neem tree Chewing stick
Nomadic Fulani ( Bankole et al 2017)
Somali
India (Kochar et al 2014)
Yoruba Senegal (Diouf 2013)
Improper use ndashgingival trauma
round ceramics omadic ulani
brasion sensiti it
and omadic ulani
shes ood charcoal
Somali (Beveridge
India Senegal
Tooth Cleaning materials
CommunityTribe Side effect
Ground ceramics Nomadic Fulani Tooth abrasion
Sand Nomadic Fulani
AshesWood
Charcoal
Somali India Senegal
Tooth abrasion
IMPORTANCE OF THE PRIMARY DENTITION IN CHILDREN
bull Primary teeth in children are sometimes not regarded as important
bull Mothers of preschool children in Mumbai -436 believed 192 were uncertain that there is no need to visit a dentist for treating milk teeth as they will soon fall off (Jain et al 2014)
COMMON DENTAL DISEASES
Dental Caries
bull Early childhood caries is a significant public health problem caries affecting children globally
bull In recent years in developing countries like Sub-Saharan Africa the prevalence is predicted to increase
bull Early childhood caries is largely untreated in a study in South Africa reported a caries prevalence of 716 and these 675 were untreated (Mohammed and Barnes 2018 )
Dental caries Perceived cause of dental
caries
Community tribe
Worms (resembling
maggots)
Borom bop (master of the
head)
Lagatas
Smaller version of pubu
Worms -removed from
ears
Yoruba Nomadic Fulani
Chinese (Dong et al 2007)
Senegalese ( Diouf et al 2003)
Brazil
Papua New Guinea
Indian (Nagaraj et al2014)
Dental caries -Care remedies Dental care remedies Community tribe Effect
Hydrochloric acid (Wet cell
battery liquid)
Aluminum Phosphate
(Alum)
Tobacco snuff
Charcoal and salt
Gentian violet
Atare (Alligator Pepper)
Yoruba Brazil
Kenya (Mulu Maryanne)
Yoruba (Oke et al 2011)
Chemical burns
mucosal ulceration
Erosion
Tetracycline capsule (topical)
Paracetamol (topical)
Hausa Nomadic Fulani
Hausa
Greyish brown tooth
discolouration
Mucosal ulceration
Traditional concoction
Dental are remedies Dental care remedies Community
tribe
Effect
White wineVinegar Powdered alum musk and frankincense
Chinese (Dong et al 2007)
Herbs traditional medicine
Aborigines (Wong 2005)
Nettles
Hot sweet potato
Wads hot leaves ginger
Residue smoking pipe
White sap of shrub used
to kill maggots
Insecticide ointment
Papua New
Guinea
Predisposition to
oral cancer
Toxic
Dental care remedies Dental care remedies Community Effect
Cooked meat
salt alcohol grease
deodorant
Iran
fingernail polish remover
black tar
Garlic Warm coconut milk
Brazil Toxic
Kawakawa Māori(Pepper Tree
Leaves) chewed
Harakeke -Korari Flax
the gum used for toothache
Maori
GingivitisPeriodontal disease
Perceptions
bull Bleeding gums caused by
bull Child stores food in pouch of mouth and does not clean teeth
Remedies for gingival periodontal disease
Remedies Community tribe
Effect
Aluminium phosphate (Alum ) + Lapalapa sap (Jatropha curcas)Warm water and salt Tomato and alum+polystrene foam or cotton woolHydrogen peroxide
Yoruba
Antibiotics NomadiFulani
Resistant strains Hyper sensitivityreactions
Herbs
ORAL HABITS Kola nut chewing
Common West Central Africa Symbol of hospitality Contains caffeine tannin
bull Helps students keep awakewithstand fatigue
Practices
bull One-year prevalence student use was 291 Erinfolami et al (2011)
bull Majority started at age 14 years or below
bull Dangers -insomnia nausea tooth discolourationcarcinogenic potential for development of oral cancer
Areca Nut Chewing Habitbull Areca nut is the seed of areca palm
bull Widely grown- Asia India Bangladesh Japan
bull Believed to help fatigue
bull Highest period of risk for first use is between 5 and 12 Farrand et al 2001
74 4-16 age group in Karachi indulged in the habit (Shah et al 2002)
Dangers Oral sub mucous fibrosis
bull Risk of oral cancer 99 times( Wollina et al 2004 ) Foreign body aspiration Severe tooth wear -- sensitivity root fractures
Mandibular arch with generalized staining in the deciduous dentition
Prajapati D Nayak R Nayak UA Shah PJ Areca nut chewing habit in preschoolers Two rare case reports and literature review Int J Dent Health Concern 201511-5 (Permission given)
Mandibular arch with generalized staining in the deciduous dentition
Prajapati D Nayak R Nayak UA Shah PJ Areca nut chewing habit in preschoolers Two rare case reports and literature review Int J Dent Health Concern 201511-5 (Permission given)
Oral tobacco use and cigar smoking
bull High prevalence tobacco use in any form is reported among school going adolescents aged 13ndash15 years in India (Arora and Reddy 2005) Smoking Chutta is relatively popular may begin in childhood in India
bull Acts as a stimulant euphoric
bull May sleep with tobacco mixture in mouth
Harmful effects halitosis brown black staining gingival recession if wad is held against gingivaleucoplakia oral squamous cell carcinoma
Tobacco use in children
PRACTICES RELATED TO PUBERTY AND GROOMING
Tooth filing tooth sharpening
Practiced -Nigeria Niger-Delta area (Ukeghesonand Akadiri ) Democratic Republic of Congo Thailand Indonesia
bull Perception Historically -spiritual reasons Contemporary times - aesthetic reasons
bull In Nigeria maxillary midline diastema is regarded as a symbol of beauty (Arigbede and Adesuwa 2012
bull Teeth filed- because represent negative emotions eg anger jealousy (Balinese Indonesia)
30 respondents would not mind having artificially created diastema (Omotosho and Kadri (2010)
Practices
bull Done in adolescence - fashionable
bull Manually done Usually incisors
Harmful effects
bull pain during process
bull Tooth discolouration (teeth -non vital)
bull Infection -pus discharge lip swelling
Tooth filing
Peri-apical x-ray of lower central incisor
Lacquering and staining of teethPerformed in Vietnam Laos Thailand Indonesia and Philippines
Perception For cosmetic reasons
bull Main ingredient dye dark-brown solution of ferric acetate called kanemizu (iron filings in vinegar)
bull Coating the teeth with this liquid helped to prevent tooth decay and enamel decay
bull Practice has slowly declined
Traditional gingival tattooinglips bull Practiced in Africarsquos Sahel region Woddebe
Fulani tribe Senegal Ethiopia middle eastern countries
Perception Reason aesthetic appeal superstition
bull Practices Done when females reach puberty
bull Kanuri females Borno State Nigeria tattooing lip gingiva usually performed thorns of Balanites aegyptiaca (Bukar et al 2004 )
bull Pigments -Mixture charcoal and seeds of Acacia nilotica vartomentosa
Lip plug lip plate
bull The lip plate (lip plug or lip disc) form of body modification
bull Amazonian tribes young males traditionally -rite of passage indicate status and prestige
bull Mursi of Ethiopia girls age 13 to 18
bull At puberty mother cuts her lower lip
bull Held open by a wooden plug - inserted into thereby stretching the lip
bull At times -combined with removal of two or four lower anterior incisal teeth
Lip plug lip plate
TRADITIONAL DENTAL SERVICES
bull Perceptions
Cause of illness determines treatment taken Practices
bull Yoruba community patronize traditional dentists (Oke Bankole et al 2011) Edo state
bull Services rendered include worm extraction tooth extraction drug prescription and offering sacrifices to deities
bull Charges based on the worm count
Northern Nigeria called Serdia Toothache associated with dandruff
Cameroon traditional healers perform atraumatic tooth extraction Agbor et al (2011)
bull Leaves stems of Dichrocephala integrifolia
bull Tooth pulled out fingerssharp instrument
bull No pain Plant has anaesthetic properties
bull Dangers infection sepsis infection with hepatitis B Human Immunodeficiency Virus
bull Jewish Unlikely keep Friday appointment with the dentist for their children
bull Routine appointments on Fridays avoided (Scambler et al )
The traditional healer harvesting the medicinal plant in Cameroon
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J Ethnobiol Ethnomed 2011 715
Tooth extraction by a traditional dentist
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J EthnobiolEthnomed 2011 715
bull Health is a consequence of an individualrsquos lifestyle
bull Essential to Identify cultural factors that are harmful and those that are beneficial
bull As paediatric dentists we should discourage the unhealthy practices through rigorous health education and promote the adoption of healthy practices
bull Need for multicentric research on the cultural influence of the family and peers regarding oral health of children
bull Bankole OO Lawal FB Ibiyemi O (2017) Dispelling myths associated with natalneonatal teeth ldquoAdunnirdquo a health education video in a native Nigerian language Annals of Ibadan Postgraduate Medicine15(2)137-141
Thank you for listening
Dental Fluorosis bull In East and central African countries (tribal
areas of Tanzania Magadi a fluoride rich tronaused in cooking
bull Used as a tenderizer and preservative
bull High Fluoride Concentration 7900 ppm
bull Magadi use may suggest high prevalence of fluorosis in northern Tanzania (Kaseva 2006)
Oral Hygiene
Perceptions among mothers
bull Hausa Fulani- 142 - babyrsquos mouth should be cleaned before teeth erupt
bull Yoruba- Babyrsquos mouthtongue cleaned before teeth erupt to prevent thrush
bull Hausa Fulani- 635 - commencement tooth cleaning between 6 and 12 months of age (Bankole et al 2017)
bull Yoruba- chewing sticks should not be used at night Causes premature death of mother (Oke et al 2011)
Practices
Hausa Fulani- 594 cleaned infants teeth once daily
- 614 children start cleaning their teeth unsupervised before the age of six years
- 751 of supervision was carried out by the grandparents
- Sudan -343 mothers donrsquot clean childrenrsquos teeth below the age of 2 years (Abduljalil et al 2016)
-Hausa - mothers start cleaning childrenrsquos teeth when enough teeth to justify effort (Oke et al 2011)
Oral hygiene practices
Cleaning materials used in infancyearly childhood
CommunityTribe
GlycerinFresh tomato Hydrogen peroxideAluminum sulphateVerona Amygdalina (bitter leaf)Iyere (African black pepper)Alligator pepperCitrus lime Combinations
Yoruba - Nigeria (Aderinokun 2000)
Alum (Aluminum sulphate) Bitter leaf (Verona Amygdalina)
Iyere (African black pepper)
Citrus lime Alligator pepper
Oral hygiene practices
Tooth Cleaning materials
CommunityTribe Side effect
Salt and cotton wool
Hausa (Oke et al 2011)
Finger Nomadic Fulani
Wooden twigSalvadora persiccatwig (miswak) Neem tree Chewing stick
Nomadic Fulani ( Bankole et al 2017)
Somali
India (Kochar et al 2014)
Yoruba Senegal (Diouf 2013)
Improper use ndashgingival trauma
round ceramics omadic ulani
brasion sensiti it
and omadic ulani
shes ood charcoal
Somali (Beveridge
India Senegal
Tooth Cleaning materials
CommunityTribe Side effect
Ground ceramics Nomadic Fulani Tooth abrasion
Sand Nomadic Fulani
AshesWood
Charcoal
Somali India Senegal
Tooth abrasion
IMPORTANCE OF THE PRIMARY DENTITION IN CHILDREN
bull Primary teeth in children are sometimes not regarded as important
bull Mothers of preschool children in Mumbai -436 believed 192 were uncertain that there is no need to visit a dentist for treating milk teeth as they will soon fall off (Jain et al 2014)
COMMON DENTAL DISEASES
Dental Caries
bull Early childhood caries is a significant public health problem caries affecting children globally
bull In recent years in developing countries like Sub-Saharan Africa the prevalence is predicted to increase
bull Early childhood caries is largely untreated in a study in South Africa reported a caries prevalence of 716 and these 675 were untreated (Mohammed and Barnes 2018 )
Dental caries Perceived cause of dental
caries
Community tribe
Worms (resembling
maggots)
Borom bop (master of the
head)
Lagatas
Smaller version of pubu
Worms -removed from
ears
Yoruba Nomadic Fulani
Chinese (Dong et al 2007)
Senegalese ( Diouf et al 2003)
Brazil
Papua New Guinea
Indian (Nagaraj et al2014)
Dental caries -Care remedies Dental care remedies Community tribe Effect
Hydrochloric acid (Wet cell
battery liquid)
Aluminum Phosphate
(Alum)
Tobacco snuff
Charcoal and salt
Gentian violet
Atare (Alligator Pepper)
Yoruba Brazil
Kenya (Mulu Maryanne)
Yoruba (Oke et al 2011)
Chemical burns
mucosal ulceration
Erosion
Tetracycline capsule (topical)
Paracetamol (topical)
Hausa Nomadic Fulani
Hausa
Greyish brown tooth
discolouration
Mucosal ulceration
Traditional concoction
Dental are remedies Dental care remedies Community
tribe
Effect
White wineVinegar Powdered alum musk and frankincense
Chinese (Dong et al 2007)
Herbs traditional medicine
Aborigines (Wong 2005)
Nettles
Hot sweet potato
Wads hot leaves ginger
Residue smoking pipe
White sap of shrub used
to kill maggots
Insecticide ointment
Papua New
Guinea
Predisposition to
oral cancer
Toxic
Dental care remedies Dental care remedies Community Effect
Cooked meat
salt alcohol grease
deodorant
Iran
fingernail polish remover
black tar
Garlic Warm coconut milk
Brazil Toxic
Kawakawa Māori(Pepper Tree
Leaves) chewed
Harakeke -Korari Flax
the gum used for toothache
Maori
GingivitisPeriodontal disease
Perceptions
bull Bleeding gums caused by
bull Child stores food in pouch of mouth and does not clean teeth
Remedies for gingival periodontal disease
Remedies Community tribe
Effect
Aluminium phosphate (Alum ) + Lapalapa sap (Jatropha curcas)Warm water and salt Tomato and alum+polystrene foam or cotton woolHydrogen peroxide
Yoruba
Antibiotics NomadiFulani
Resistant strains Hyper sensitivityreactions
Herbs
ORAL HABITS Kola nut chewing
Common West Central Africa Symbol of hospitality Contains caffeine tannin
bull Helps students keep awakewithstand fatigue
Practices
bull One-year prevalence student use was 291 Erinfolami et al (2011)
bull Majority started at age 14 years or below
bull Dangers -insomnia nausea tooth discolourationcarcinogenic potential for development of oral cancer
Areca Nut Chewing Habitbull Areca nut is the seed of areca palm
bull Widely grown- Asia India Bangladesh Japan
bull Believed to help fatigue
bull Highest period of risk for first use is between 5 and 12 Farrand et al 2001
74 4-16 age group in Karachi indulged in the habit (Shah et al 2002)
Dangers Oral sub mucous fibrosis
bull Risk of oral cancer 99 times( Wollina et al 2004 ) Foreign body aspiration Severe tooth wear -- sensitivity root fractures
Mandibular arch with generalized staining in the deciduous dentition
Prajapati D Nayak R Nayak UA Shah PJ Areca nut chewing habit in preschoolers Two rare case reports and literature review Int J Dent Health Concern 201511-5 (Permission given)
Mandibular arch with generalized staining in the deciduous dentition
Prajapati D Nayak R Nayak UA Shah PJ Areca nut chewing habit in preschoolers Two rare case reports and literature review Int J Dent Health Concern 201511-5 (Permission given)
Oral tobacco use and cigar smoking
bull High prevalence tobacco use in any form is reported among school going adolescents aged 13ndash15 years in India (Arora and Reddy 2005) Smoking Chutta is relatively popular may begin in childhood in India
bull Acts as a stimulant euphoric
bull May sleep with tobacco mixture in mouth
Harmful effects halitosis brown black staining gingival recession if wad is held against gingivaleucoplakia oral squamous cell carcinoma
Tobacco use in children
PRACTICES RELATED TO PUBERTY AND GROOMING
Tooth filing tooth sharpening
Practiced -Nigeria Niger-Delta area (Ukeghesonand Akadiri ) Democratic Republic of Congo Thailand Indonesia
bull Perception Historically -spiritual reasons Contemporary times - aesthetic reasons
bull In Nigeria maxillary midline diastema is regarded as a symbol of beauty (Arigbede and Adesuwa 2012
bull Teeth filed- because represent negative emotions eg anger jealousy (Balinese Indonesia)
30 respondents would not mind having artificially created diastema (Omotosho and Kadri (2010)
Practices
bull Done in adolescence - fashionable
bull Manually done Usually incisors
Harmful effects
bull pain during process
bull Tooth discolouration (teeth -non vital)
bull Infection -pus discharge lip swelling
Tooth filing
Peri-apical x-ray of lower central incisor
Lacquering and staining of teethPerformed in Vietnam Laos Thailand Indonesia and Philippines
Perception For cosmetic reasons
bull Main ingredient dye dark-brown solution of ferric acetate called kanemizu (iron filings in vinegar)
bull Coating the teeth with this liquid helped to prevent tooth decay and enamel decay
bull Practice has slowly declined
Traditional gingival tattooinglips bull Practiced in Africarsquos Sahel region Woddebe
Fulani tribe Senegal Ethiopia middle eastern countries
Perception Reason aesthetic appeal superstition
bull Practices Done when females reach puberty
bull Kanuri females Borno State Nigeria tattooing lip gingiva usually performed thorns of Balanites aegyptiaca (Bukar et al 2004 )
bull Pigments -Mixture charcoal and seeds of Acacia nilotica vartomentosa
Lip plug lip plate
bull The lip plate (lip plug or lip disc) form of body modification
bull Amazonian tribes young males traditionally -rite of passage indicate status and prestige
bull Mursi of Ethiopia girls age 13 to 18
bull At puberty mother cuts her lower lip
bull Held open by a wooden plug - inserted into thereby stretching the lip
bull At times -combined with removal of two or four lower anterior incisal teeth
Lip plug lip plate
TRADITIONAL DENTAL SERVICES
bull Perceptions
Cause of illness determines treatment taken Practices
bull Yoruba community patronize traditional dentists (Oke Bankole et al 2011) Edo state
bull Services rendered include worm extraction tooth extraction drug prescription and offering sacrifices to deities
bull Charges based on the worm count
Northern Nigeria called Serdia Toothache associated with dandruff
Cameroon traditional healers perform atraumatic tooth extraction Agbor et al (2011)
bull Leaves stems of Dichrocephala integrifolia
bull Tooth pulled out fingerssharp instrument
bull No pain Plant has anaesthetic properties
bull Dangers infection sepsis infection with hepatitis B Human Immunodeficiency Virus
bull Jewish Unlikely keep Friday appointment with the dentist for their children
bull Routine appointments on Fridays avoided (Scambler et al )
The traditional healer harvesting the medicinal plant in Cameroon
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J Ethnobiol Ethnomed 2011 715
Tooth extraction by a traditional dentist
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J EthnobiolEthnomed 2011 715
bull Health is a consequence of an individualrsquos lifestyle
bull Essential to Identify cultural factors that are harmful and those that are beneficial
bull As paediatric dentists we should discourage the unhealthy practices through rigorous health education and promote the adoption of healthy practices
bull Need for multicentric research on the cultural influence of the family and peers regarding oral health of children
bull Bankole OO Lawal FB Ibiyemi O (2017) Dispelling myths associated with natalneonatal teeth ldquoAdunnirdquo a health education video in a native Nigerian language Annals of Ibadan Postgraduate Medicine15(2)137-141
Thank you for listening
Oral Hygiene
Perceptions among mothers
bull Hausa Fulani- 142 - babyrsquos mouth should be cleaned before teeth erupt
bull Yoruba- Babyrsquos mouthtongue cleaned before teeth erupt to prevent thrush
bull Hausa Fulani- 635 - commencement tooth cleaning between 6 and 12 months of age (Bankole et al 2017)
bull Yoruba- chewing sticks should not be used at night Causes premature death of mother (Oke et al 2011)
Practices
Hausa Fulani- 594 cleaned infants teeth once daily
- 614 children start cleaning their teeth unsupervised before the age of six years
- 751 of supervision was carried out by the grandparents
- Sudan -343 mothers donrsquot clean childrenrsquos teeth below the age of 2 years (Abduljalil et al 2016)
-Hausa - mothers start cleaning childrenrsquos teeth when enough teeth to justify effort (Oke et al 2011)
Oral hygiene practices
Cleaning materials used in infancyearly childhood
CommunityTribe
GlycerinFresh tomato Hydrogen peroxideAluminum sulphateVerona Amygdalina (bitter leaf)Iyere (African black pepper)Alligator pepperCitrus lime Combinations
Yoruba - Nigeria (Aderinokun 2000)
Alum (Aluminum sulphate) Bitter leaf (Verona Amygdalina)
Iyere (African black pepper)
Citrus lime Alligator pepper
Oral hygiene practices
Tooth Cleaning materials
CommunityTribe Side effect
Salt and cotton wool
Hausa (Oke et al 2011)
Finger Nomadic Fulani
Wooden twigSalvadora persiccatwig (miswak) Neem tree Chewing stick
Nomadic Fulani ( Bankole et al 2017)
Somali
India (Kochar et al 2014)
Yoruba Senegal (Diouf 2013)
Improper use ndashgingival trauma
round ceramics omadic ulani
brasion sensiti it
and omadic ulani
shes ood charcoal
Somali (Beveridge
India Senegal
Tooth Cleaning materials
CommunityTribe Side effect
Ground ceramics Nomadic Fulani Tooth abrasion
Sand Nomadic Fulani
AshesWood
Charcoal
Somali India Senegal
Tooth abrasion
IMPORTANCE OF THE PRIMARY DENTITION IN CHILDREN
bull Primary teeth in children are sometimes not regarded as important
bull Mothers of preschool children in Mumbai -436 believed 192 were uncertain that there is no need to visit a dentist for treating milk teeth as they will soon fall off (Jain et al 2014)
COMMON DENTAL DISEASES
Dental Caries
bull Early childhood caries is a significant public health problem caries affecting children globally
bull In recent years in developing countries like Sub-Saharan Africa the prevalence is predicted to increase
bull Early childhood caries is largely untreated in a study in South Africa reported a caries prevalence of 716 and these 675 were untreated (Mohammed and Barnes 2018 )
Dental caries Perceived cause of dental
caries
Community tribe
Worms (resembling
maggots)
Borom bop (master of the
head)
Lagatas
Smaller version of pubu
Worms -removed from
ears
Yoruba Nomadic Fulani
Chinese (Dong et al 2007)
Senegalese ( Diouf et al 2003)
Brazil
Papua New Guinea
Indian (Nagaraj et al2014)
Dental caries -Care remedies Dental care remedies Community tribe Effect
Hydrochloric acid (Wet cell
battery liquid)
Aluminum Phosphate
(Alum)
Tobacco snuff
Charcoal and salt
Gentian violet
Atare (Alligator Pepper)
Yoruba Brazil
Kenya (Mulu Maryanne)
Yoruba (Oke et al 2011)
Chemical burns
mucosal ulceration
Erosion
Tetracycline capsule (topical)
Paracetamol (topical)
Hausa Nomadic Fulani
Hausa
Greyish brown tooth
discolouration
Mucosal ulceration
Traditional concoction
Dental are remedies Dental care remedies Community
tribe
Effect
White wineVinegar Powdered alum musk and frankincense
Chinese (Dong et al 2007)
Herbs traditional medicine
Aborigines (Wong 2005)
Nettles
Hot sweet potato
Wads hot leaves ginger
Residue smoking pipe
White sap of shrub used
to kill maggots
Insecticide ointment
Papua New
Guinea
Predisposition to
oral cancer
Toxic
Dental care remedies Dental care remedies Community Effect
Cooked meat
salt alcohol grease
deodorant
Iran
fingernail polish remover
black tar
Garlic Warm coconut milk
Brazil Toxic
Kawakawa Māori(Pepper Tree
Leaves) chewed
Harakeke -Korari Flax
the gum used for toothache
Maori
GingivitisPeriodontal disease
Perceptions
bull Bleeding gums caused by
bull Child stores food in pouch of mouth and does not clean teeth
Remedies for gingival periodontal disease
Remedies Community tribe
Effect
Aluminium phosphate (Alum ) + Lapalapa sap (Jatropha curcas)Warm water and salt Tomato and alum+polystrene foam or cotton woolHydrogen peroxide
Yoruba
Antibiotics NomadiFulani
Resistant strains Hyper sensitivityreactions
Herbs
ORAL HABITS Kola nut chewing
Common West Central Africa Symbol of hospitality Contains caffeine tannin
bull Helps students keep awakewithstand fatigue
Practices
bull One-year prevalence student use was 291 Erinfolami et al (2011)
bull Majority started at age 14 years or below
bull Dangers -insomnia nausea tooth discolourationcarcinogenic potential for development of oral cancer
Areca Nut Chewing Habitbull Areca nut is the seed of areca palm
bull Widely grown- Asia India Bangladesh Japan
bull Believed to help fatigue
bull Highest period of risk for first use is between 5 and 12 Farrand et al 2001
74 4-16 age group in Karachi indulged in the habit (Shah et al 2002)
Dangers Oral sub mucous fibrosis
bull Risk of oral cancer 99 times( Wollina et al 2004 ) Foreign body aspiration Severe tooth wear -- sensitivity root fractures
Mandibular arch with generalized staining in the deciduous dentition
Prajapati D Nayak R Nayak UA Shah PJ Areca nut chewing habit in preschoolers Two rare case reports and literature review Int J Dent Health Concern 201511-5 (Permission given)
Mandibular arch with generalized staining in the deciduous dentition
Prajapati D Nayak R Nayak UA Shah PJ Areca nut chewing habit in preschoolers Two rare case reports and literature review Int J Dent Health Concern 201511-5 (Permission given)
Oral tobacco use and cigar smoking
bull High prevalence tobacco use in any form is reported among school going adolescents aged 13ndash15 years in India (Arora and Reddy 2005) Smoking Chutta is relatively popular may begin in childhood in India
bull Acts as a stimulant euphoric
bull May sleep with tobacco mixture in mouth
Harmful effects halitosis brown black staining gingival recession if wad is held against gingivaleucoplakia oral squamous cell carcinoma
Tobacco use in children
PRACTICES RELATED TO PUBERTY AND GROOMING
Tooth filing tooth sharpening
Practiced -Nigeria Niger-Delta area (Ukeghesonand Akadiri ) Democratic Republic of Congo Thailand Indonesia
bull Perception Historically -spiritual reasons Contemporary times - aesthetic reasons
bull In Nigeria maxillary midline diastema is regarded as a symbol of beauty (Arigbede and Adesuwa 2012
bull Teeth filed- because represent negative emotions eg anger jealousy (Balinese Indonesia)
30 respondents would not mind having artificially created diastema (Omotosho and Kadri (2010)
Practices
bull Done in adolescence - fashionable
bull Manually done Usually incisors
Harmful effects
bull pain during process
bull Tooth discolouration (teeth -non vital)
bull Infection -pus discharge lip swelling
Tooth filing
Peri-apical x-ray of lower central incisor
Lacquering and staining of teethPerformed in Vietnam Laos Thailand Indonesia and Philippines
Perception For cosmetic reasons
bull Main ingredient dye dark-brown solution of ferric acetate called kanemizu (iron filings in vinegar)
bull Coating the teeth with this liquid helped to prevent tooth decay and enamel decay
bull Practice has slowly declined
Traditional gingival tattooinglips bull Practiced in Africarsquos Sahel region Woddebe
Fulani tribe Senegal Ethiopia middle eastern countries
Perception Reason aesthetic appeal superstition
bull Practices Done when females reach puberty
bull Kanuri females Borno State Nigeria tattooing lip gingiva usually performed thorns of Balanites aegyptiaca (Bukar et al 2004 )
bull Pigments -Mixture charcoal and seeds of Acacia nilotica vartomentosa
Lip plug lip plate
bull The lip plate (lip plug or lip disc) form of body modification
bull Amazonian tribes young males traditionally -rite of passage indicate status and prestige
bull Mursi of Ethiopia girls age 13 to 18
bull At puberty mother cuts her lower lip
bull Held open by a wooden plug - inserted into thereby stretching the lip
bull At times -combined with removal of two or four lower anterior incisal teeth
Lip plug lip plate
TRADITIONAL DENTAL SERVICES
bull Perceptions
Cause of illness determines treatment taken Practices
bull Yoruba community patronize traditional dentists (Oke Bankole et al 2011) Edo state
bull Services rendered include worm extraction tooth extraction drug prescription and offering sacrifices to deities
bull Charges based on the worm count
Northern Nigeria called Serdia Toothache associated with dandruff
Cameroon traditional healers perform atraumatic tooth extraction Agbor et al (2011)
bull Leaves stems of Dichrocephala integrifolia
bull Tooth pulled out fingerssharp instrument
bull No pain Plant has anaesthetic properties
bull Dangers infection sepsis infection with hepatitis B Human Immunodeficiency Virus
bull Jewish Unlikely keep Friday appointment with the dentist for their children
bull Routine appointments on Fridays avoided (Scambler et al )
The traditional healer harvesting the medicinal plant in Cameroon
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J Ethnobiol Ethnomed 2011 715
Tooth extraction by a traditional dentist
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J EthnobiolEthnomed 2011 715
bull Health is a consequence of an individualrsquos lifestyle
bull Essential to Identify cultural factors that are harmful and those that are beneficial
bull As paediatric dentists we should discourage the unhealthy practices through rigorous health education and promote the adoption of healthy practices
bull Need for multicentric research on the cultural influence of the family and peers regarding oral health of children
bull Bankole OO Lawal FB Ibiyemi O (2017) Dispelling myths associated with natalneonatal teeth ldquoAdunnirdquo a health education video in a native Nigerian language Annals of Ibadan Postgraduate Medicine15(2)137-141
Thank you for listening
Practices
Hausa Fulani- 594 cleaned infants teeth once daily
- 614 children start cleaning their teeth unsupervised before the age of six years
- 751 of supervision was carried out by the grandparents
- Sudan -343 mothers donrsquot clean childrenrsquos teeth below the age of 2 years (Abduljalil et al 2016)
-Hausa - mothers start cleaning childrenrsquos teeth when enough teeth to justify effort (Oke et al 2011)
Oral hygiene practices
Cleaning materials used in infancyearly childhood
CommunityTribe
GlycerinFresh tomato Hydrogen peroxideAluminum sulphateVerona Amygdalina (bitter leaf)Iyere (African black pepper)Alligator pepperCitrus lime Combinations
Yoruba - Nigeria (Aderinokun 2000)
Alum (Aluminum sulphate) Bitter leaf (Verona Amygdalina)
Iyere (African black pepper)
Citrus lime Alligator pepper
Oral hygiene practices
Tooth Cleaning materials
CommunityTribe Side effect
Salt and cotton wool
Hausa (Oke et al 2011)
Finger Nomadic Fulani
Wooden twigSalvadora persiccatwig (miswak) Neem tree Chewing stick
Nomadic Fulani ( Bankole et al 2017)
Somali
India (Kochar et al 2014)
Yoruba Senegal (Diouf 2013)
Improper use ndashgingival trauma
round ceramics omadic ulani
brasion sensiti it
and omadic ulani
shes ood charcoal
Somali (Beveridge
India Senegal
Tooth Cleaning materials
CommunityTribe Side effect
Ground ceramics Nomadic Fulani Tooth abrasion
Sand Nomadic Fulani
AshesWood
Charcoal
Somali India Senegal
Tooth abrasion
IMPORTANCE OF THE PRIMARY DENTITION IN CHILDREN
bull Primary teeth in children are sometimes not regarded as important
bull Mothers of preschool children in Mumbai -436 believed 192 were uncertain that there is no need to visit a dentist for treating milk teeth as they will soon fall off (Jain et al 2014)
COMMON DENTAL DISEASES
Dental Caries
bull Early childhood caries is a significant public health problem caries affecting children globally
bull In recent years in developing countries like Sub-Saharan Africa the prevalence is predicted to increase
bull Early childhood caries is largely untreated in a study in South Africa reported a caries prevalence of 716 and these 675 were untreated (Mohammed and Barnes 2018 )
Dental caries Perceived cause of dental
caries
Community tribe
Worms (resembling
maggots)
Borom bop (master of the
head)
Lagatas
Smaller version of pubu
Worms -removed from
ears
Yoruba Nomadic Fulani
Chinese (Dong et al 2007)
Senegalese ( Diouf et al 2003)
Brazil
Papua New Guinea
Indian (Nagaraj et al2014)
Dental caries -Care remedies Dental care remedies Community tribe Effect
Hydrochloric acid (Wet cell
battery liquid)
Aluminum Phosphate
(Alum)
Tobacco snuff
Charcoal and salt
Gentian violet
Atare (Alligator Pepper)
Yoruba Brazil
Kenya (Mulu Maryanne)
Yoruba (Oke et al 2011)
Chemical burns
mucosal ulceration
Erosion
Tetracycline capsule (topical)
Paracetamol (topical)
Hausa Nomadic Fulani
Hausa
Greyish brown tooth
discolouration
Mucosal ulceration
Traditional concoction
Dental are remedies Dental care remedies Community
tribe
Effect
White wineVinegar Powdered alum musk and frankincense
Chinese (Dong et al 2007)
Herbs traditional medicine
Aborigines (Wong 2005)
Nettles
Hot sweet potato
Wads hot leaves ginger
Residue smoking pipe
White sap of shrub used
to kill maggots
Insecticide ointment
Papua New
Guinea
Predisposition to
oral cancer
Toxic
Dental care remedies Dental care remedies Community Effect
Cooked meat
salt alcohol grease
deodorant
Iran
fingernail polish remover
black tar
Garlic Warm coconut milk
Brazil Toxic
Kawakawa Māori(Pepper Tree
Leaves) chewed
Harakeke -Korari Flax
the gum used for toothache
Maori
GingivitisPeriodontal disease
Perceptions
bull Bleeding gums caused by
bull Child stores food in pouch of mouth and does not clean teeth
Remedies for gingival periodontal disease
Remedies Community tribe
Effect
Aluminium phosphate (Alum ) + Lapalapa sap (Jatropha curcas)Warm water and salt Tomato and alum+polystrene foam or cotton woolHydrogen peroxide
Yoruba
Antibiotics NomadiFulani
Resistant strains Hyper sensitivityreactions
Herbs
ORAL HABITS Kola nut chewing
Common West Central Africa Symbol of hospitality Contains caffeine tannin
bull Helps students keep awakewithstand fatigue
Practices
bull One-year prevalence student use was 291 Erinfolami et al (2011)
bull Majority started at age 14 years or below
bull Dangers -insomnia nausea tooth discolourationcarcinogenic potential for development of oral cancer
Areca Nut Chewing Habitbull Areca nut is the seed of areca palm
bull Widely grown- Asia India Bangladesh Japan
bull Believed to help fatigue
bull Highest period of risk for first use is between 5 and 12 Farrand et al 2001
74 4-16 age group in Karachi indulged in the habit (Shah et al 2002)
Dangers Oral sub mucous fibrosis
bull Risk of oral cancer 99 times( Wollina et al 2004 ) Foreign body aspiration Severe tooth wear -- sensitivity root fractures
Mandibular arch with generalized staining in the deciduous dentition
Prajapati D Nayak R Nayak UA Shah PJ Areca nut chewing habit in preschoolers Two rare case reports and literature review Int J Dent Health Concern 201511-5 (Permission given)
Mandibular arch with generalized staining in the deciduous dentition
Prajapati D Nayak R Nayak UA Shah PJ Areca nut chewing habit in preschoolers Two rare case reports and literature review Int J Dent Health Concern 201511-5 (Permission given)
Oral tobacco use and cigar smoking
bull High prevalence tobacco use in any form is reported among school going adolescents aged 13ndash15 years in India (Arora and Reddy 2005) Smoking Chutta is relatively popular may begin in childhood in India
bull Acts as a stimulant euphoric
bull May sleep with tobacco mixture in mouth
Harmful effects halitosis brown black staining gingival recession if wad is held against gingivaleucoplakia oral squamous cell carcinoma
Tobacco use in children
PRACTICES RELATED TO PUBERTY AND GROOMING
Tooth filing tooth sharpening
Practiced -Nigeria Niger-Delta area (Ukeghesonand Akadiri ) Democratic Republic of Congo Thailand Indonesia
bull Perception Historically -spiritual reasons Contemporary times - aesthetic reasons
bull In Nigeria maxillary midline diastema is regarded as a symbol of beauty (Arigbede and Adesuwa 2012
bull Teeth filed- because represent negative emotions eg anger jealousy (Balinese Indonesia)
30 respondents would not mind having artificially created diastema (Omotosho and Kadri (2010)
Practices
bull Done in adolescence - fashionable
bull Manually done Usually incisors
Harmful effects
bull pain during process
bull Tooth discolouration (teeth -non vital)
bull Infection -pus discharge lip swelling
Tooth filing
Peri-apical x-ray of lower central incisor
Lacquering and staining of teethPerformed in Vietnam Laos Thailand Indonesia and Philippines
Perception For cosmetic reasons
bull Main ingredient dye dark-brown solution of ferric acetate called kanemizu (iron filings in vinegar)
bull Coating the teeth with this liquid helped to prevent tooth decay and enamel decay
bull Practice has slowly declined
Traditional gingival tattooinglips bull Practiced in Africarsquos Sahel region Woddebe
Fulani tribe Senegal Ethiopia middle eastern countries
Perception Reason aesthetic appeal superstition
bull Practices Done when females reach puberty
bull Kanuri females Borno State Nigeria tattooing lip gingiva usually performed thorns of Balanites aegyptiaca (Bukar et al 2004 )
bull Pigments -Mixture charcoal and seeds of Acacia nilotica vartomentosa
Lip plug lip plate
bull The lip plate (lip plug or lip disc) form of body modification
bull Amazonian tribes young males traditionally -rite of passage indicate status and prestige
bull Mursi of Ethiopia girls age 13 to 18
bull At puberty mother cuts her lower lip
bull Held open by a wooden plug - inserted into thereby stretching the lip
bull At times -combined with removal of two or four lower anterior incisal teeth
Lip plug lip plate
TRADITIONAL DENTAL SERVICES
bull Perceptions
Cause of illness determines treatment taken Practices
bull Yoruba community patronize traditional dentists (Oke Bankole et al 2011) Edo state
bull Services rendered include worm extraction tooth extraction drug prescription and offering sacrifices to deities
bull Charges based on the worm count
Northern Nigeria called Serdia Toothache associated with dandruff
Cameroon traditional healers perform atraumatic tooth extraction Agbor et al (2011)
bull Leaves stems of Dichrocephala integrifolia
bull Tooth pulled out fingerssharp instrument
bull No pain Plant has anaesthetic properties
bull Dangers infection sepsis infection with hepatitis B Human Immunodeficiency Virus
bull Jewish Unlikely keep Friday appointment with the dentist for their children
bull Routine appointments on Fridays avoided (Scambler et al )
The traditional healer harvesting the medicinal plant in Cameroon
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J Ethnobiol Ethnomed 2011 715
Tooth extraction by a traditional dentist
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J EthnobiolEthnomed 2011 715
bull Health is a consequence of an individualrsquos lifestyle
bull Essential to Identify cultural factors that are harmful and those that are beneficial
bull As paediatric dentists we should discourage the unhealthy practices through rigorous health education and promote the adoption of healthy practices
bull Need for multicentric research on the cultural influence of the family and peers regarding oral health of children
bull Bankole OO Lawal FB Ibiyemi O (2017) Dispelling myths associated with natalneonatal teeth ldquoAdunnirdquo a health education video in a native Nigerian language Annals of Ibadan Postgraduate Medicine15(2)137-141
Thank you for listening
Oral hygiene practices
Cleaning materials used in infancyearly childhood
CommunityTribe
GlycerinFresh tomato Hydrogen peroxideAluminum sulphateVerona Amygdalina (bitter leaf)Iyere (African black pepper)Alligator pepperCitrus lime Combinations
Yoruba - Nigeria (Aderinokun 2000)
Alum (Aluminum sulphate) Bitter leaf (Verona Amygdalina)
Iyere (African black pepper)
Citrus lime Alligator pepper
Oral hygiene practices
Tooth Cleaning materials
CommunityTribe Side effect
Salt and cotton wool
Hausa (Oke et al 2011)
Finger Nomadic Fulani
Wooden twigSalvadora persiccatwig (miswak) Neem tree Chewing stick
Nomadic Fulani ( Bankole et al 2017)
Somali
India (Kochar et al 2014)
Yoruba Senegal (Diouf 2013)
Improper use ndashgingival trauma
round ceramics omadic ulani
brasion sensiti it
and omadic ulani
shes ood charcoal
Somali (Beveridge
India Senegal
Tooth Cleaning materials
CommunityTribe Side effect
Ground ceramics Nomadic Fulani Tooth abrasion
Sand Nomadic Fulani
AshesWood
Charcoal
Somali India Senegal
Tooth abrasion
IMPORTANCE OF THE PRIMARY DENTITION IN CHILDREN
bull Primary teeth in children are sometimes not regarded as important
bull Mothers of preschool children in Mumbai -436 believed 192 were uncertain that there is no need to visit a dentist for treating milk teeth as they will soon fall off (Jain et al 2014)
COMMON DENTAL DISEASES
Dental Caries
bull Early childhood caries is a significant public health problem caries affecting children globally
bull In recent years in developing countries like Sub-Saharan Africa the prevalence is predicted to increase
bull Early childhood caries is largely untreated in a study in South Africa reported a caries prevalence of 716 and these 675 were untreated (Mohammed and Barnes 2018 )
Dental caries Perceived cause of dental
caries
Community tribe
Worms (resembling
maggots)
Borom bop (master of the
head)
Lagatas
Smaller version of pubu
Worms -removed from
ears
Yoruba Nomadic Fulani
Chinese (Dong et al 2007)
Senegalese ( Diouf et al 2003)
Brazil
Papua New Guinea
Indian (Nagaraj et al2014)
Dental caries -Care remedies Dental care remedies Community tribe Effect
Hydrochloric acid (Wet cell
battery liquid)
Aluminum Phosphate
(Alum)
Tobacco snuff
Charcoal and salt
Gentian violet
Atare (Alligator Pepper)
Yoruba Brazil
Kenya (Mulu Maryanne)
Yoruba (Oke et al 2011)
Chemical burns
mucosal ulceration
Erosion
Tetracycline capsule (topical)
Paracetamol (topical)
Hausa Nomadic Fulani
Hausa
Greyish brown tooth
discolouration
Mucosal ulceration
Traditional concoction
Dental are remedies Dental care remedies Community
tribe
Effect
White wineVinegar Powdered alum musk and frankincense
Chinese (Dong et al 2007)
Herbs traditional medicine
Aborigines (Wong 2005)
Nettles
Hot sweet potato
Wads hot leaves ginger
Residue smoking pipe
White sap of shrub used
to kill maggots
Insecticide ointment
Papua New
Guinea
Predisposition to
oral cancer
Toxic
Dental care remedies Dental care remedies Community Effect
Cooked meat
salt alcohol grease
deodorant
Iran
fingernail polish remover
black tar
Garlic Warm coconut milk
Brazil Toxic
Kawakawa Māori(Pepper Tree
Leaves) chewed
Harakeke -Korari Flax
the gum used for toothache
Maori
GingivitisPeriodontal disease
Perceptions
bull Bleeding gums caused by
bull Child stores food in pouch of mouth and does not clean teeth
Remedies for gingival periodontal disease
Remedies Community tribe
Effect
Aluminium phosphate (Alum ) + Lapalapa sap (Jatropha curcas)Warm water and salt Tomato and alum+polystrene foam or cotton woolHydrogen peroxide
Yoruba
Antibiotics NomadiFulani
Resistant strains Hyper sensitivityreactions
Herbs
ORAL HABITS Kola nut chewing
Common West Central Africa Symbol of hospitality Contains caffeine tannin
bull Helps students keep awakewithstand fatigue
Practices
bull One-year prevalence student use was 291 Erinfolami et al (2011)
bull Majority started at age 14 years or below
bull Dangers -insomnia nausea tooth discolourationcarcinogenic potential for development of oral cancer
Areca Nut Chewing Habitbull Areca nut is the seed of areca palm
bull Widely grown- Asia India Bangladesh Japan
bull Believed to help fatigue
bull Highest period of risk for first use is between 5 and 12 Farrand et al 2001
74 4-16 age group in Karachi indulged in the habit (Shah et al 2002)
Dangers Oral sub mucous fibrosis
bull Risk of oral cancer 99 times( Wollina et al 2004 ) Foreign body aspiration Severe tooth wear -- sensitivity root fractures
Mandibular arch with generalized staining in the deciduous dentition
Prajapati D Nayak R Nayak UA Shah PJ Areca nut chewing habit in preschoolers Two rare case reports and literature review Int J Dent Health Concern 201511-5 (Permission given)
Mandibular arch with generalized staining in the deciduous dentition
Prajapati D Nayak R Nayak UA Shah PJ Areca nut chewing habit in preschoolers Two rare case reports and literature review Int J Dent Health Concern 201511-5 (Permission given)
Oral tobacco use and cigar smoking
bull High prevalence tobacco use in any form is reported among school going adolescents aged 13ndash15 years in India (Arora and Reddy 2005) Smoking Chutta is relatively popular may begin in childhood in India
bull Acts as a stimulant euphoric
bull May sleep with tobacco mixture in mouth
Harmful effects halitosis brown black staining gingival recession if wad is held against gingivaleucoplakia oral squamous cell carcinoma
Tobacco use in children
PRACTICES RELATED TO PUBERTY AND GROOMING
Tooth filing tooth sharpening
Practiced -Nigeria Niger-Delta area (Ukeghesonand Akadiri ) Democratic Republic of Congo Thailand Indonesia
bull Perception Historically -spiritual reasons Contemporary times - aesthetic reasons
bull In Nigeria maxillary midline diastema is regarded as a symbol of beauty (Arigbede and Adesuwa 2012
bull Teeth filed- because represent negative emotions eg anger jealousy (Balinese Indonesia)
30 respondents would not mind having artificially created diastema (Omotosho and Kadri (2010)
Practices
bull Done in adolescence - fashionable
bull Manually done Usually incisors
Harmful effects
bull pain during process
bull Tooth discolouration (teeth -non vital)
bull Infection -pus discharge lip swelling
Tooth filing
Peri-apical x-ray of lower central incisor
Lacquering and staining of teethPerformed in Vietnam Laos Thailand Indonesia and Philippines
Perception For cosmetic reasons
bull Main ingredient dye dark-brown solution of ferric acetate called kanemizu (iron filings in vinegar)
bull Coating the teeth with this liquid helped to prevent tooth decay and enamel decay
bull Practice has slowly declined
Traditional gingival tattooinglips bull Practiced in Africarsquos Sahel region Woddebe
Fulani tribe Senegal Ethiopia middle eastern countries
Perception Reason aesthetic appeal superstition
bull Practices Done when females reach puberty
bull Kanuri females Borno State Nigeria tattooing lip gingiva usually performed thorns of Balanites aegyptiaca (Bukar et al 2004 )
bull Pigments -Mixture charcoal and seeds of Acacia nilotica vartomentosa
Lip plug lip plate
bull The lip plate (lip plug or lip disc) form of body modification
bull Amazonian tribes young males traditionally -rite of passage indicate status and prestige
bull Mursi of Ethiopia girls age 13 to 18
bull At puberty mother cuts her lower lip
bull Held open by a wooden plug - inserted into thereby stretching the lip
bull At times -combined with removal of two or four lower anterior incisal teeth
Lip plug lip plate
TRADITIONAL DENTAL SERVICES
bull Perceptions
Cause of illness determines treatment taken Practices
bull Yoruba community patronize traditional dentists (Oke Bankole et al 2011) Edo state
bull Services rendered include worm extraction tooth extraction drug prescription and offering sacrifices to deities
bull Charges based on the worm count
Northern Nigeria called Serdia Toothache associated with dandruff
Cameroon traditional healers perform atraumatic tooth extraction Agbor et al (2011)
bull Leaves stems of Dichrocephala integrifolia
bull Tooth pulled out fingerssharp instrument
bull No pain Plant has anaesthetic properties
bull Dangers infection sepsis infection with hepatitis B Human Immunodeficiency Virus
bull Jewish Unlikely keep Friday appointment with the dentist for their children
bull Routine appointments on Fridays avoided (Scambler et al )
The traditional healer harvesting the medicinal plant in Cameroon
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J Ethnobiol Ethnomed 2011 715
Tooth extraction by a traditional dentist
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J EthnobiolEthnomed 2011 715
bull Health is a consequence of an individualrsquos lifestyle
bull Essential to Identify cultural factors that are harmful and those that are beneficial
bull As paediatric dentists we should discourage the unhealthy practices through rigorous health education and promote the adoption of healthy practices
bull Need for multicentric research on the cultural influence of the family and peers regarding oral health of children
bull Bankole OO Lawal FB Ibiyemi O (2017) Dispelling myths associated with natalneonatal teeth ldquoAdunnirdquo a health education video in a native Nigerian language Annals of Ibadan Postgraduate Medicine15(2)137-141
Thank you for listening
Alum (Aluminum sulphate) Bitter leaf (Verona Amygdalina)
Iyere (African black pepper)
Citrus lime Alligator pepper
Oral hygiene practices
Tooth Cleaning materials
CommunityTribe Side effect
Salt and cotton wool
Hausa (Oke et al 2011)
Finger Nomadic Fulani
Wooden twigSalvadora persiccatwig (miswak) Neem tree Chewing stick
Nomadic Fulani ( Bankole et al 2017)
Somali
India (Kochar et al 2014)
Yoruba Senegal (Diouf 2013)
Improper use ndashgingival trauma
round ceramics omadic ulani
brasion sensiti it
and omadic ulani
shes ood charcoal
Somali (Beveridge
India Senegal
Tooth Cleaning materials
CommunityTribe Side effect
Ground ceramics Nomadic Fulani Tooth abrasion
Sand Nomadic Fulani
AshesWood
Charcoal
Somali India Senegal
Tooth abrasion
IMPORTANCE OF THE PRIMARY DENTITION IN CHILDREN
bull Primary teeth in children are sometimes not regarded as important
bull Mothers of preschool children in Mumbai -436 believed 192 were uncertain that there is no need to visit a dentist for treating milk teeth as they will soon fall off (Jain et al 2014)
COMMON DENTAL DISEASES
Dental Caries
bull Early childhood caries is a significant public health problem caries affecting children globally
bull In recent years in developing countries like Sub-Saharan Africa the prevalence is predicted to increase
bull Early childhood caries is largely untreated in a study in South Africa reported a caries prevalence of 716 and these 675 were untreated (Mohammed and Barnes 2018 )
Dental caries Perceived cause of dental
caries
Community tribe
Worms (resembling
maggots)
Borom bop (master of the
head)
Lagatas
Smaller version of pubu
Worms -removed from
ears
Yoruba Nomadic Fulani
Chinese (Dong et al 2007)
Senegalese ( Diouf et al 2003)
Brazil
Papua New Guinea
Indian (Nagaraj et al2014)
Dental caries -Care remedies Dental care remedies Community tribe Effect
Hydrochloric acid (Wet cell
battery liquid)
Aluminum Phosphate
(Alum)
Tobacco snuff
Charcoal and salt
Gentian violet
Atare (Alligator Pepper)
Yoruba Brazil
Kenya (Mulu Maryanne)
Yoruba (Oke et al 2011)
Chemical burns
mucosal ulceration
Erosion
Tetracycline capsule (topical)
Paracetamol (topical)
Hausa Nomadic Fulani
Hausa
Greyish brown tooth
discolouration
Mucosal ulceration
Traditional concoction
Dental are remedies Dental care remedies Community
tribe
Effect
White wineVinegar Powdered alum musk and frankincense
Chinese (Dong et al 2007)
Herbs traditional medicine
Aborigines (Wong 2005)
Nettles
Hot sweet potato
Wads hot leaves ginger
Residue smoking pipe
White sap of shrub used
to kill maggots
Insecticide ointment
Papua New
Guinea
Predisposition to
oral cancer
Toxic
Dental care remedies Dental care remedies Community Effect
Cooked meat
salt alcohol grease
deodorant
Iran
fingernail polish remover
black tar
Garlic Warm coconut milk
Brazil Toxic
Kawakawa Māori(Pepper Tree
Leaves) chewed
Harakeke -Korari Flax
the gum used for toothache
Maori
GingivitisPeriodontal disease
Perceptions
bull Bleeding gums caused by
bull Child stores food in pouch of mouth and does not clean teeth
Remedies for gingival periodontal disease
Remedies Community tribe
Effect
Aluminium phosphate (Alum ) + Lapalapa sap (Jatropha curcas)Warm water and salt Tomato and alum+polystrene foam or cotton woolHydrogen peroxide
Yoruba
Antibiotics NomadiFulani
Resistant strains Hyper sensitivityreactions
Herbs
ORAL HABITS Kola nut chewing
Common West Central Africa Symbol of hospitality Contains caffeine tannin
bull Helps students keep awakewithstand fatigue
Practices
bull One-year prevalence student use was 291 Erinfolami et al (2011)
bull Majority started at age 14 years or below
bull Dangers -insomnia nausea tooth discolourationcarcinogenic potential for development of oral cancer
Areca Nut Chewing Habitbull Areca nut is the seed of areca palm
bull Widely grown- Asia India Bangladesh Japan
bull Believed to help fatigue
bull Highest period of risk for first use is between 5 and 12 Farrand et al 2001
74 4-16 age group in Karachi indulged in the habit (Shah et al 2002)
Dangers Oral sub mucous fibrosis
bull Risk of oral cancer 99 times( Wollina et al 2004 ) Foreign body aspiration Severe tooth wear -- sensitivity root fractures
Mandibular arch with generalized staining in the deciduous dentition
Prajapati D Nayak R Nayak UA Shah PJ Areca nut chewing habit in preschoolers Two rare case reports and literature review Int J Dent Health Concern 201511-5 (Permission given)
Mandibular arch with generalized staining in the deciduous dentition
Prajapati D Nayak R Nayak UA Shah PJ Areca nut chewing habit in preschoolers Two rare case reports and literature review Int J Dent Health Concern 201511-5 (Permission given)
Oral tobacco use and cigar smoking
bull High prevalence tobacco use in any form is reported among school going adolescents aged 13ndash15 years in India (Arora and Reddy 2005) Smoking Chutta is relatively popular may begin in childhood in India
bull Acts as a stimulant euphoric
bull May sleep with tobacco mixture in mouth
Harmful effects halitosis brown black staining gingival recession if wad is held against gingivaleucoplakia oral squamous cell carcinoma
Tobacco use in children
PRACTICES RELATED TO PUBERTY AND GROOMING
Tooth filing tooth sharpening
Practiced -Nigeria Niger-Delta area (Ukeghesonand Akadiri ) Democratic Republic of Congo Thailand Indonesia
bull Perception Historically -spiritual reasons Contemporary times - aesthetic reasons
bull In Nigeria maxillary midline diastema is regarded as a symbol of beauty (Arigbede and Adesuwa 2012
bull Teeth filed- because represent negative emotions eg anger jealousy (Balinese Indonesia)
30 respondents would not mind having artificially created diastema (Omotosho and Kadri (2010)
Practices
bull Done in adolescence - fashionable
bull Manually done Usually incisors
Harmful effects
bull pain during process
bull Tooth discolouration (teeth -non vital)
bull Infection -pus discharge lip swelling
Tooth filing
Peri-apical x-ray of lower central incisor
Lacquering and staining of teethPerformed in Vietnam Laos Thailand Indonesia and Philippines
Perception For cosmetic reasons
bull Main ingredient dye dark-brown solution of ferric acetate called kanemizu (iron filings in vinegar)
bull Coating the teeth with this liquid helped to prevent tooth decay and enamel decay
bull Practice has slowly declined
Traditional gingival tattooinglips bull Practiced in Africarsquos Sahel region Woddebe
Fulani tribe Senegal Ethiopia middle eastern countries
Perception Reason aesthetic appeal superstition
bull Practices Done when females reach puberty
bull Kanuri females Borno State Nigeria tattooing lip gingiva usually performed thorns of Balanites aegyptiaca (Bukar et al 2004 )
bull Pigments -Mixture charcoal and seeds of Acacia nilotica vartomentosa
Lip plug lip plate
bull The lip plate (lip plug or lip disc) form of body modification
bull Amazonian tribes young males traditionally -rite of passage indicate status and prestige
bull Mursi of Ethiopia girls age 13 to 18
bull At puberty mother cuts her lower lip
bull Held open by a wooden plug - inserted into thereby stretching the lip
bull At times -combined with removal of two or four lower anterior incisal teeth
Lip plug lip plate
TRADITIONAL DENTAL SERVICES
bull Perceptions
Cause of illness determines treatment taken Practices
bull Yoruba community patronize traditional dentists (Oke Bankole et al 2011) Edo state
bull Services rendered include worm extraction tooth extraction drug prescription and offering sacrifices to deities
bull Charges based on the worm count
Northern Nigeria called Serdia Toothache associated with dandruff
Cameroon traditional healers perform atraumatic tooth extraction Agbor et al (2011)
bull Leaves stems of Dichrocephala integrifolia
bull Tooth pulled out fingerssharp instrument
bull No pain Plant has anaesthetic properties
bull Dangers infection sepsis infection with hepatitis B Human Immunodeficiency Virus
bull Jewish Unlikely keep Friday appointment with the dentist for their children
bull Routine appointments on Fridays avoided (Scambler et al )
The traditional healer harvesting the medicinal plant in Cameroon
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J Ethnobiol Ethnomed 2011 715
Tooth extraction by a traditional dentist
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J EthnobiolEthnomed 2011 715
bull Health is a consequence of an individualrsquos lifestyle
bull Essential to Identify cultural factors that are harmful and those that are beneficial
bull As paediatric dentists we should discourage the unhealthy practices through rigorous health education and promote the adoption of healthy practices
bull Need for multicentric research on the cultural influence of the family and peers regarding oral health of children
bull Bankole OO Lawal FB Ibiyemi O (2017) Dispelling myths associated with natalneonatal teeth ldquoAdunnirdquo a health education video in a native Nigerian language Annals of Ibadan Postgraduate Medicine15(2)137-141
Thank you for listening
Iyere (African black pepper)
Citrus lime Alligator pepper
Oral hygiene practices
Tooth Cleaning materials
CommunityTribe Side effect
Salt and cotton wool
Hausa (Oke et al 2011)
Finger Nomadic Fulani
Wooden twigSalvadora persiccatwig (miswak) Neem tree Chewing stick
Nomadic Fulani ( Bankole et al 2017)
Somali
India (Kochar et al 2014)
Yoruba Senegal (Diouf 2013)
Improper use ndashgingival trauma
round ceramics omadic ulani
brasion sensiti it
and omadic ulani
shes ood charcoal
Somali (Beveridge
India Senegal
Tooth Cleaning materials
CommunityTribe Side effect
Ground ceramics Nomadic Fulani Tooth abrasion
Sand Nomadic Fulani
AshesWood
Charcoal
Somali India Senegal
Tooth abrasion
IMPORTANCE OF THE PRIMARY DENTITION IN CHILDREN
bull Primary teeth in children are sometimes not regarded as important
bull Mothers of preschool children in Mumbai -436 believed 192 were uncertain that there is no need to visit a dentist for treating milk teeth as they will soon fall off (Jain et al 2014)
COMMON DENTAL DISEASES
Dental Caries
bull Early childhood caries is a significant public health problem caries affecting children globally
bull In recent years in developing countries like Sub-Saharan Africa the prevalence is predicted to increase
bull Early childhood caries is largely untreated in a study in South Africa reported a caries prevalence of 716 and these 675 were untreated (Mohammed and Barnes 2018 )
Dental caries Perceived cause of dental
caries
Community tribe
Worms (resembling
maggots)
Borom bop (master of the
head)
Lagatas
Smaller version of pubu
Worms -removed from
ears
Yoruba Nomadic Fulani
Chinese (Dong et al 2007)
Senegalese ( Diouf et al 2003)
Brazil
Papua New Guinea
Indian (Nagaraj et al2014)
Dental caries -Care remedies Dental care remedies Community tribe Effect
Hydrochloric acid (Wet cell
battery liquid)
Aluminum Phosphate
(Alum)
Tobacco snuff
Charcoal and salt
Gentian violet
Atare (Alligator Pepper)
Yoruba Brazil
Kenya (Mulu Maryanne)
Yoruba (Oke et al 2011)
Chemical burns
mucosal ulceration
Erosion
Tetracycline capsule (topical)
Paracetamol (topical)
Hausa Nomadic Fulani
Hausa
Greyish brown tooth
discolouration
Mucosal ulceration
Traditional concoction
Dental are remedies Dental care remedies Community
tribe
Effect
White wineVinegar Powdered alum musk and frankincense
Chinese (Dong et al 2007)
Herbs traditional medicine
Aborigines (Wong 2005)
Nettles
Hot sweet potato
Wads hot leaves ginger
Residue smoking pipe
White sap of shrub used
to kill maggots
Insecticide ointment
Papua New
Guinea
Predisposition to
oral cancer
Toxic
Dental care remedies Dental care remedies Community Effect
Cooked meat
salt alcohol grease
deodorant
Iran
fingernail polish remover
black tar
Garlic Warm coconut milk
Brazil Toxic
Kawakawa Māori(Pepper Tree
Leaves) chewed
Harakeke -Korari Flax
the gum used for toothache
Maori
GingivitisPeriodontal disease
Perceptions
bull Bleeding gums caused by
bull Child stores food in pouch of mouth and does not clean teeth
Remedies for gingival periodontal disease
Remedies Community tribe
Effect
Aluminium phosphate (Alum ) + Lapalapa sap (Jatropha curcas)Warm water and salt Tomato and alum+polystrene foam or cotton woolHydrogen peroxide
Yoruba
Antibiotics NomadiFulani
Resistant strains Hyper sensitivityreactions
Herbs
ORAL HABITS Kola nut chewing
Common West Central Africa Symbol of hospitality Contains caffeine tannin
bull Helps students keep awakewithstand fatigue
Practices
bull One-year prevalence student use was 291 Erinfolami et al (2011)
bull Majority started at age 14 years or below
bull Dangers -insomnia nausea tooth discolourationcarcinogenic potential for development of oral cancer
Areca Nut Chewing Habitbull Areca nut is the seed of areca palm
bull Widely grown- Asia India Bangladesh Japan
bull Believed to help fatigue
bull Highest period of risk for first use is between 5 and 12 Farrand et al 2001
74 4-16 age group in Karachi indulged in the habit (Shah et al 2002)
Dangers Oral sub mucous fibrosis
bull Risk of oral cancer 99 times( Wollina et al 2004 ) Foreign body aspiration Severe tooth wear -- sensitivity root fractures
Mandibular arch with generalized staining in the deciduous dentition
Prajapati D Nayak R Nayak UA Shah PJ Areca nut chewing habit in preschoolers Two rare case reports and literature review Int J Dent Health Concern 201511-5 (Permission given)
Mandibular arch with generalized staining in the deciduous dentition
Prajapati D Nayak R Nayak UA Shah PJ Areca nut chewing habit in preschoolers Two rare case reports and literature review Int J Dent Health Concern 201511-5 (Permission given)
Oral tobacco use and cigar smoking
bull High prevalence tobacco use in any form is reported among school going adolescents aged 13ndash15 years in India (Arora and Reddy 2005) Smoking Chutta is relatively popular may begin in childhood in India
bull Acts as a stimulant euphoric
bull May sleep with tobacco mixture in mouth
Harmful effects halitosis brown black staining gingival recession if wad is held against gingivaleucoplakia oral squamous cell carcinoma
Tobacco use in children
PRACTICES RELATED TO PUBERTY AND GROOMING
Tooth filing tooth sharpening
Practiced -Nigeria Niger-Delta area (Ukeghesonand Akadiri ) Democratic Republic of Congo Thailand Indonesia
bull Perception Historically -spiritual reasons Contemporary times - aesthetic reasons
bull In Nigeria maxillary midline diastema is regarded as a symbol of beauty (Arigbede and Adesuwa 2012
bull Teeth filed- because represent negative emotions eg anger jealousy (Balinese Indonesia)
30 respondents would not mind having artificially created diastema (Omotosho and Kadri (2010)
Practices
bull Done in adolescence - fashionable
bull Manually done Usually incisors
Harmful effects
bull pain during process
bull Tooth discolouration (teeth -non vital)
bull Infection -pus discharge lip swelling
Tooth filing
Peri-apical x-ray of lower central incisor
Lacquering and staining of teethPerformed in Vietnam Laos Thailand Indonesia and Philippines
Perception For cosmetic reasons
bull Main ingredient dye dark-brown solution of ferric acetate called kanemizu (iron filings in vinegar)
bull Coating the teeth with this liquid helped to prevent tooth decay and enamel decay
bull Practice has slowly declined
Traditional gingival tattooinglips bull Practiced in Africarsquos Sahel region Woddebe
Fulani tribe Senegal Ethiopia middle eastern countries
Perception Reason aesthetic appeal superstition
bull Practices Done when females reach puberty
bull Kanuri females Borno State Nigeria tattooing lip gingiva usually performed thorns of Balanites aegyptiaca (Bukar et al 2004 )
bull Pigments -Mixture charcoal and seeds of Acacia nilotica vartomentosa
Lip plug lip plate
bull The lip plate (lip plug or lip disc) form of body modification
bull Amazonian tribes young males traditionally -rite of passage indicate status and prestige
bull Mursi of Ethiopia girls age 13 to 18
bull At puberty mother cuts her lower lip
bull Held open by a wooden plug - inserted into thereby stretching the lip
bull At times -combined with removal of two or four lower anterior incisal teeth
Lip plug lip plate
TRADITIONAL DENTAL SERVICES
bull Perceptions
Cause of illness determines treatment taken Practices
bull Yoruba community patronize traditional dentists (Oke Bankole et al 2011) Edo state
bull Services rendered include worm extraction tooth extraction drug prescription and offering sacrifices to deities
bull Charges based on the worm count
Northern Nigeria called Serdia Toothache associated with dandruff
Cameroon traditional healers perform atraumatic tooth extraction Agbor et al (2011)
bull Leaves stems of Dichrocephala integrifolia
bull Tooth pulled out fingerssharp instrument
bull No pain Plant has anaesthetic properties
bull Dangers infection sepsis infection with hepatitis B Human Immunodeficiency Virus
bull Jewish Unlikely keep Friday appointment with the dentist for their children
bull Routine appointments on Fridays avoided (Scambler et al )
The traditional healer harvesting the medicinal plant in Cameroon
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J Ethnobiol Ethnomed 2011 715
Tooth extraction by a traditional dentist
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J EthnobiolEthnomed 2011 715
bull Health is a consequence of an individualrsquos lifestyle
bull Essential to Identify cultural factors that are harmful and those that are beneficial
bull As paediatric dentists we should discourage the unhealthy practices through rigorous health education and promote the adoption of healthy practices
bull Need for multicentric research on the cultural influence of the family and peers regarding oral health of children
bull Bankole OO Lawal FB Ibiyemi O (2017) Dispelling myths associated with natalneonatal teeth ldquoAdunnirdquo a health education video in a native Nigerian language Annals of Ibadan Postgraduate Medicine15(2)137-141
Thank you for listening
Citrus lime Alligator pepper
Oral hygiene practices
Tooth Cleaning materials
CommunityTribe Side effect
Salt and cotton wool
Hausa (Oke et al 2011)
Finger Nomadic Fulani
Wooden twigSalvadora persiccatwig (miswak) Neem tree Chewing stick
Nomadic Fulani ( Bankole et al 2017)
Somali
India (Kochar et al 2014)
Yoruba Senegal (Diouf 2013)
Improper use ndashgingival trauma
round ceramics omadic ulani
brasion sensiti it
and omadic ulani
shes ood charcoal
Somali (Beveridge
India Senegal
Tooth Cleaning materials
CommunityTribe Side effect
Ground ceramics Nomadic Fulani Tooth abrasion
Sand Nomadic Fulani
AshesWood
Charcoal
Somali India Senegal
Tooth abrasion
IMPORTANCE OF THE PRIMARY DENTITION IN CHILDREN
bull Primary teeth in children are sometimes not regarded as important
bull Mothers of preschool children in Mumbai -436 believed 192 were uncertain that there is no need to visit a dentist for treating milk teeth as they will soon fall off (Jain et al 2014)
COMMON DENTAL DISEASES
Dental Caries
bull Early childhood caries is a significant public health problem caries affecting children globally
bull In recent years in developing countries like Sub-Saharan Africa the prevalence is predicted to increase
bull Early childhood caries is largely untreated in a study in South Africa reported a caries prevalence of 716 and these 675 were untreated (Mohammed and Barnes 2018 )
Dental caries Perceived cause of dental
caries
Community tribe
Worms (resembling
maggots)
Borom bop (master of the
head)
Lagatas
Smaller version of pubu
Worms -removed from
ears
Yoruba Nomadic Fulani
Chinese (Dong et al 2007)
Senegalese ( Diouf et al 2003)
Brazil
Papua New Guinea
Indian (Nagaraj et al2014)
Dental caries -Care remedies Dental care remedies Community tribe Effect
Hydrochloric acid (Wet cell
battery liquid)
Aluminum Phosphate
(Alum)
Tobacco snuff
Charcoal and salt
Gentian violet
Atare (Alligator Pepper)
Yoruba Brazil
Kenya (Mulu Maryanne)
Yoruba (Oke et al 2011)
Chemical burns
mucosal ulceration
Erosion
Tetracycline capsule (topical)
Paracetamol (topical)
Hausa Nomadic Fulani
Hausa
Greyish brown tooth
discolouration
Mucosal ulceration
Traditional concoction
Dental are remedies Dental care remedies Community
tribe
Effect
White wineVinegar Powdered alum musk and frankincense
Chinese (Dong et al 2007)
Herbs traditional medicine
Aborigines (Wong 2005)
Nettles
Hot sweet potato
Wads hot leaves ginger
Residue smoking pipe
White sap of shrub used
to kill maggots
Insecticide ointment
Papua New
Guinea
Predisposition to
oral cancer
Toxic
Dental care remedies Dental care remedies Community Effect
Cooked meat
salt alcohol grease
deodorant
Iran
fingernail polish remover
black tar
Garlic Warm coconut milk
Brazil Toxic
Kawakawa Māori(Pepper Tree
Leaves) chewed
Harakeke -Korari Flax
the gum used for toothache
Maori
GingivitisPeriodontal disease
Perceptions
bull Bleeding gums caused by
bull Child stores food in pouch of mouth and does not clean teeth
Remedies for gingival periodontal disease
Remedies Community tribe
Effect
Aluminium phosphate (Alum ) + Lapalapa sap (Jatropha curcas)Warm water and salt Tomato and alum+polystrene foam or cotton woolHydrogen peroxide
Yoruba
Antibiotics NomadiFulani
Resistant strains Hyper sensitivityreactions
Herbs
ORAL HABITS Kola nut chewing
Common West Central Africa Symbol of hospitality Contains caffeine tannin
bull Helps students keep awakewithstand fatigue
Practices
bull One-year prevalence student use was 291 Erinfolami et al (2011)
bull Majority started at age 14 years or below
bull Dangers -insomnia nausea tooth discolourationcarcinogenic potential for development of oral cancer
Areca Nut Chewing Habitbull Areca nut is the seed of areca palm
bull Widely grown- Asia India Bangladesh Japan
bull Believed to help fatigue
bull Highest period of risk for first use is between 5 and 12 Farrand et al 2001
74 4-16 age group in Karachi indulged in the habit (Shah et al 2002)
Dangers Oral sub mucous fibrosis
bull Risk of oral cancer 99 times( Wollina et al 2004 ) Foreign body aspiration Severe tooth wear -- sensitivity root fractures
Mandibular arch with generalized staining in the deciduous dentition
Prajapati D Nayak R Nayak UA Shah PJ Areca nut chewing habit in preschoolers Two rare case reports and literature review Int J Dent Health Concern 201511-5 (Permission given)
Mandibular arch with generalized staining in the deciduous dentition
Prajapati D Nayak R Nayak UA Shah PJ Areca nut chewing habit in preschoolers Two rare case reports and literature review Int J Dent Health Concern 201511-5 (Permission given)
Oral tobacco use and cigar smoking
bull High prevalence tobacco use in any form is reported among school going adolescents aged 13ndash15 years in India (Arora and Reddy 2005) Smoking Chutta is relatively popular may begin in childhood in India
bull Acts as a stimulant euphoric
bull May sleep with tobacco mixture in mouth
Harmful effects halitosis brown black staining gingival recession if wad is held against gingivaleucoplakia oral squamous cell carcinoma
Tobacco use in children
PRACTICES RELATED TO PUBERTY AND GROOMING
Tooth filing tooth sharpening
Practiced -Nigeria Niger-Delta area (Ukeghesonand Akadiri ) Democratic Republic of Congo Thailand Indonesia
bull Perception Historically -spiritual reasons Contemporary times - aesthetic reasons
bull In Nigeria maxillary midline diastema is regarded as a symbol of beauty (Arigbede and Adesuwa 2012
bull Teeth filed- because represent negative emotions eg anger jealousy (Balinese Indonesia)
30 respondents would not mind having artificially created diastema (Omotosho and Kadri (2010)
Practices
bull Done in adolescence - fashionable
bull Manually done Usually incisors
Harmful effects
bull pain during process
bull Tooth discolouration (teeth -non vital)
bull Infection -pus discharge lip swelling
Tooth filing
Peri-apical x-ray of lower central incisor
Lacquering and staining of teethPerformed in Vietnam Laos Thailand Indonesia and Philippines
Perception For cosmetic reasons
bull Main ingredient dye dark-brown solution of ferric acetate called kanemizu (iron filings in vinegar)
bull Coating the teeth with this liquid helped to prevent tooth decay and enamel decay
bull Practice has slowly declined
Traditional gingival tattooinglips bull Practiced in Africarsquos Sahel region Woddebe
Fulani tribe Senegal Ethiopia middle eastern countries
Perception Reason aesthetic appeal superstition
bull Practices Done when females reach puberty
bull Kanuri females Borno State Nigeria tattooing lip gingiva usually performed thorns of Balanites aegyptiaca (Bukar et al 2004 )
bull Pigments -Mixture charcoal and seeds of Acacia nilotica vartomentosa
Lip plug lip plate
bull The lip plate (lip plug or lip disc) form of body modification
bull Amazonian tribes young males traditionally -rite of passage indicate status and prestige
bull Mursi of Ethiopia girls age 13 to 18
bull At puberty mother cuts her lower lip
bull Held open by a wooden plug - inserted into thereby stretching the lip
bull At times -combined with removal of two or four lower anterior incisal teeth
Lip plug lip plate
TRADITIONAL DENTAL SERVICES
bull Perceptions
Cause of illness determines treatment taken Practices
bull Yoruba community patronize traditional dentists (Oke Bankole et al 2011) Edo state
bull Services rendered include worm extraction tooth extraction drug prescription and offering sacrifices to deities
bull Charges based on the worm count
Northern Nigeria called Serdia Toothache associated with dandruff
Cameroon traditional healers perform atraumatic tooth extraction Agbor et al (2011)
bull Leaves stems of Dichrocephala integrifolia
bull Tooth pulled out fingerssharp instrument
bull No pain Plant has anaesthetic properties
bull Dangers infection sepsis infection with hepatitis B Human Immunodeficiency Virus
bull Jewish Unlikely keep Friday appointment with the dentist for their children
bull Routine appointments on Fridays avoided (Scambler et al )
The traditional healer harvesting the medicinal plant in Cameroon
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J Ethnobiol Ethnomed 2011 715
Tooth extraction by a traditional dentist
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J EthnobiolEthnomed 2011 715
bull Health is a consequence of an individualrsquos lifestyle
bull Essential to Identify cultural factors that are harmful and those that are beneficial
bull As paediatric dentists we should discourage the unhealthy practices through rigorous health education and promote the adoption of healthy practices
bull Need for multicentric research on the cultural influence of the family and peers regarding oral health of children
bull Bankole OO Lawal FB Ibiyemi O (2017) Dispelling myths associated with natalneonatal teeth ldquoAdunnirdquo a health education video in a native Nigerian language Annals of Ibadan Postgraduate Medicine15(2)137-141
Thank you for listening
Oral hygiene practices
Tooth Cleaning materials
CommunityTribe Side effect
Salt and cotton wool
Hausa (Oke et al 2011)
Finger Nomadic Fulani
Wooden twigSalvadora persiccatwig (miswak) Neem tree Chewing stick
Nomadic Fulani ( Bankole et al 2017)
Somali
India (Kochar et al 2014)
Yoruba Senegal (Diouf 2013)
Improper use ndashgingival trauma
round ceramics omadic ulani
brasion sensiti it
and omadic ulani
shes ood charcoal
Somali (Beveridge
India Senegal
Tooth Cleaning materials
CommunityTribe Side effect
Ground ceramics Nomadic Fulani Tooth abrasion
Sand Nomadic Fulani
AshesWood
Charcoal
Somali India Senegal
Tooth abrasion
IMPORTANCE OF THE PRIMARY DENTITION IN CHILDREN
bull Primary teeth in children are sometimes not regarded as important
bull Mothers of preschool children in Mumbai -436 believed 192 were uncertain that there is no need to visit a dentist for treating milk teeth as they will soon fall off (Jain et al 2014)
COMMON DENTAL DISEASES
Dental Caries
bull Early childhood caries is a significant public health problem caries affecting children globally
bull In recent years in developing countries like Sub-Saharan Africa the prevalence is predicted to increase
bull Early childhood caries is largely untreated in a study in South Africa reported a caries prevalence of 716 and these 675 were untreated (Mohammed and Barnes 2018 )
Dental caries Perceived cause of dental
caries
Community tribe
Worms (resembling
maggots)
Borom bop (master of the
head)
Lagatas
Smaller version of pubu
Worms -removed from
ears
Yoruba Nomadic Fulani
Chinese (Dong et al 2007)
Senegalese ( Diouf et al 2003)
Brazil
Papua New Guinea
Indian (Nagaraj et al2014)
Dental caries -Care remedies Dental care remedies Community tribe Effect
Hydrochloric acid (Wet cell
battery liquid)
Aluminum Phosphate
(Alum)
Tobacco snuff
Charcoal and salt
Gentian violet
Atare (Alligator Pepper)
Yoruba Brazil
Kenya (Mulu Maryanne)
Yoruba (Oke et al 2011)
Chemical burns
mucosal ulceration
Erosion
Tetracycline capsule (topical)
Paracetamol (topical)
Hausa Nomadic Fulani
Hausa
Greyish brown tooth
discolouration
Mucosal ulceration
Traditional concoction
Dental are remedies Dental care remedies Community
tribe
Effect
White wineVinegar Powdered alum musk and frankincense
Chinese (Dong et al 2007)
Herbs traditional medicine
Aborigines (Wong 2005)
Nettles
Hot sweet potato
Wads hot leaves ginger
Residue smoking pipe
White sap of shrub used
to kill maggots
Insecticide ointment
Papua New
Guinea
Predisposition to
oral cancer
Toxic
Dental care remedies Dental care remedies Community Effect
Cooked meat
salt alcohol grease
deodorant
Iran
fingernail polish remover
black tar
Garlic Warm coconut milk
Brazil Toxic
Kawakawa Māori(Pepper Tree
Leaves) chewed
Harakeke -Korari Flax
the gum used for toothache
Maori
GingivitisPeriodontal disease
Perceptions
bull Bleeding gums caused by
bull Child stores food in pouch of mouth and does not clean teeth
Remedies for gingival periodontal disease
Remedies Community tribe
Effect
Aluminium phosphate (Alum ) + Lapalapa sap (Jatropha curcas)Warm water and salt Tomato and alum+polystrene foam or cotton woolHydrogen peroxide
Yoruba
Antibiotics NomadiFulani
Resistant strains Hyper sensitivityreactions
Herbs
ORAL HABITS Kola nut chewing
Common West Central Africa Symbol of hospitality Contains caffeine tannin
bull Helps students keep awakewithstand fatigue
Practices
bull One-year prevalence student use was 291 Erinfolami et al (2011)
bull Majority started at age 14 years or below
bull Dangers -insomnia nausea tooth discolourationcarcinogenic potential for development of oral cancer
Areca Nut Chewing Habitbull Areca nut is the seed of areca palm
bull Widely grown- Asia India Bangladesh Japan
bull Believed to help fatigue
bull Highest period of risk for first use is between 5 and 12 Farrand et al 2001
74 4-16 age group in Karachi indulged in the habit (Shah et al 2002)
Dangers Oral sub mucous fibrosis
bull Risk of oral cancer 99 times( Wollina et al 2004 ) Foreign body aspiration Severe tooth wear -- sensitivity root fractures
Mandibular arch with generalized staining in the deciduous dentition
Prajapati D Nayak R Nayak UA Shah PJ Areca nut chewing habit in preschoolers Two rare case reports and literature review Int J Dent Health Concern 201511-5 (Permission given)
Mandibular arch with generalized staining in the deciduous dentition
Prajapati D Nayak R Nayak UA Shah PJ Areca nut chewing habit in preschoolers Two rare case reports and literature review Int J Dent Health Concern 201511-5 (Permission given)
Oral tobacco use and cigar smoking
bull High prevalence tobacco use in any form is reported among school going adolescents aged 13ndash15 years in India (Arora and Reddy 2005) Smoking Chutta is relatively popular may begin in childhood in India
bull Acts as a stimulant euphoric
bull May sleep with tobacco mixture in mouth
Harmful effects halitosis brown black staining gingival recession if wad is held against gingivaleucoplakia oral squamous cell carcinoma
Tobacco use in children
PRACTICES RELATED TO PUBERTY AND GROOMING
Tooth filing tooth sharpening
Practiced -Nigeria Niger-Delta area (Ukeghesonand Akadiri ) Democratic Republic of Congo Thailand Indonesia
bull Perception Historically -spiritual reasons Contemporary times - aesthetic reasons
bull In Nigeria maxillary midline diastema is regarded as a symbol of beauty (Arigbede and Adesuwa 2012
bull Teeth filed- because represent negative emotions eg anger jealousy (Balinese Indonesia)
30 respondents would not mind having artificially created diastema (Omotosho and Kadri (2010)
Practices
bull Done in adolescence - fashionable
bull Manually done Usually incisors
Harmful effects
bull pain during process
bull Tooth discolouration (teeth -non vital)
bull Infection -pus discharge lip swelling
Tooth filing
Peri-apical x-ray of lower central incisor
Lacquering and staining of teethPerformed in Vietnam Laos Thailand Indonesia and Philippines
Perception For cosmetic reasons
bull Main ingredient dye dark-brown solution of ferric acetate called kanemizu (iron filings in vinegar)
bull Coating the teeth with this liquid helped to prevent tooth decay and enamel decay
bull Practice has slowly declined
Traditional gingival tattooinglips bull Practiced in Africarsquos Sahel region Woddebe
Fulani tribe Senegal Ethiopia middle eastern countries
Perception Reason aesthetic appeal superstition
bull Practices Done when females reach puberty
bull Kanuri females Borno State Nigeria tattooing lip gingiva usually performed thorns of Balanites aegyptiaca (Bukar et al 2004 )
bull Pigments -Mixture charcoal and seeds of Acacia nilotica vartomentosa
Lip plug lip plate
bull The lip plate (lip plug or lip disc) form of body modification
bull Amazonian tribes young males traditionally -rite of passage indicate status and prestige
bull Mursi of Ethiopia girls age 13 to 18
bull At puberty mother cuts her lower lip
bull Held open by a wooden plug - inserted into thereby stretching the lip
bull At times -combined with removal of two or four lower anterior incisal teeth
Lip plug lip plate
TRADITIONAL DENTAL SERVICES
bull Perceptions
Cause of illness determines treatment taken Practices
bull Yoruba community patronize traditional dentists (Oke Bankole et al 2011) Edo state
bull Services rendered include worm extraction tooth extraction drug prescription and offering sacrifices to deities
bull Charges based on the worm count
Northern Nigeria called Serdia Toothache associated with dandruff
Cameroon traditional healers perform atraumatic tooth extraction Agbor et al (2011)
bull Leaves stems of Dichrocephala integrifolia
bull Tooth pulled out fingerssharp instrument
bull No pain Plant has anaesthetic properties
bull Dangers infection sepsis infection with hepatitis B Human Immunodeficiency Virus
bull Jewish Unlikely keep Friday appointment with the dentist for their children
bull Routine appointments on Fridays avoided (Scambler et al )
The traditional healer harvesting the medicinal plant in Cameroon
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J Ethnobiol Ethnomed 2011 715
Tooth extraction by a traditional dentist
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J EthnobiolEthnomed 2011 715
bull Health is a consequence of an individualrsquos lifestyle
bull Essential to Identify cultural factors that are harmful and those that are beneficial
bull As paediatric dentists we should discourage the unhealthy practices through rigorous health education and promote the adoption of healthy practices
bull Need for multicentric research on the cultural influence of the family and peers regarding oral health of children
bull Bankole OO Lawal FB Ibiyemi O (2017) Dispelling myths associated with natalneonatal teeth ldquoAdunnirdquo a health education video in a native Nigerian language Annals of Ibadan Postgraduate Medicine15(2)137-141
Thank you for listening
round ceramics omadic ulani
brasion sensiti it
and omadic ulani
shes ood charcoal
Somali (Beveridge
India Senegal
Tooth Cleaning materials
CommunityTribe Side effect
Ground ceramics Nomadic Fulani Tooth abrasion
Sand Nomadic Fulani
AshesWood
Charcoal
Somali India Senegal
Tooth abrasion
IMPORTANCE OF THE PRIMARY DENTITION IN CHILDREN
bull Primary teeth in children are sometimes not regarded as important
bull Mothers of preschool children in Mumbai -436 believed 192 were uncertain that there is no need to visit a dentist for treating milk teeth as they will soon fall off (Jain et al 2014)
COMMON DENTAL DISEASES
Dental Caries
bull Early childhood caries is a significant public health problem caries affecting children globally
bull In recent years in developing countries like Sub-Saharan Africa the prevalence is predicted to increase
bull Early childhood caries is largely untreated in a study in South Africa reported a caries prevalence of 716 and these 675 were untreated (Mohammed and Barnes 2018 )
Dental caries Perceived cause of dental
caries
Community tribe
Worms (resembling
maggots)
Borom bop (master of the
head)
Lagatas
Smaller version of pubu
Worms -removed from
ears
Yoruba Nomadic Fulani
Chinese (Dong et al 2007)
Senegalese ( Diouf et al 2003)
Brazil
Papua New Guinea
Indian (Nagaraj et al2014)
Dental caries -Care remedies Dental care remedies Community tribe Effect
Hydrochloric acid (Wet cell
battery liquid)
Aluminum Phosphate
(Alum)
Tobacco snuff
Charcoal and salt
Gentian violet
Atare (Alligator Pepper)
Yoruba Brazil
Kenya (Mulu Maryanne)
Yoruba (Oke et al 2011)
Chemical burns
mucosal ulceration
Erosion
Tetracycline capsule (topical)
Paracetamol (topical)
Hausa Nomadic Fulani
Hausa
Greyish brown tooth
discolouration
Mucosal ulceration
Traditional concoction
Dental are remedies Dental care remedies Community
tribe
Effect
White wineVinegar Powdered alum musk and frankincense
Chinese (Dong et al 2007)
Herbs traditional medicine
Aborigines (Wong 2005)
Nettles
Hot sweet potato
Wads hot leaves ginger
Residue smoking pipe
White sap of shrub used
to kill maggots
Insecticide ointment
Papua New
Guinea
Predisposition to
oral cancer
Toxic
Dental care remedies Dental care remedies Community Effect
Cooked meat
salt alcohol grease
deodorant
Iran
fingernail polish remover
black tar
Garlic Warm coconut milk
Brazil Toxic
Kawakawa Māori(Pepper Tree
Leaves) chewed
Harakeke -Korari Flax
the gum used for toothache
Maori
GingivitisPeriodontal disease
Perceptions
bull Bleeding gums caused by
bull Child stores food in pouch of mouth and does not clean teeth
Remedies for gingival periodontal disease
Remedies Community tribe
Effect
Aluminium phosphate (Alum ) + Lapalapa sap (Jatropha curcas)Warm water and salt Tomato and alum+polystrene foam or cotton woolHydrogen peroxide
Yoruba
Antibiotics NomadiFulani
Resistant strains Hyper sensitivityreactions
Herbs
ORAL HABITS Kola nut chewing
Common West Central Africa Symbol of hospitality Contains caffeine tannin
bull Helps students keep awakewithstand fatigue
Practices
bull One-year prevalence student use was 291 Erinfolami et al (2011)
bull Majority started at age 14 years or below
bull Dangers -insomnia nausea tooth discolourationcarcinogenic potential for development of oral cancer
Areca Nut Chewing Habitbull Areca nut is the seed of areca palm
bull Widely grown- Asia India Bangladesh Japan
bull Believed to help fatigue
bull Highest period of risk for first use is between 5 and 12 Farrand et al 2001
74 4-16 age group in Karachi indulged in the habit (Shah et al 2002)
Dangers Oral sub mucous fibrosis
bull Risk of oral cancer 99 times( Wollina et al 2004 ) Foreign body aspiration Severe tooth wear -- sensitivity root fractures
Mandibular arch with generalized staining in the deciduous dentition
Prajapati D Nayak R Nayak UA Shah PJ Areca nut chewing habit in preschoolers Two rare case reports and literature review Int J Dent Health Concern 201511-5 (Permission given)
Mandibular arch with generalized staining in the deciduous dentition
Prajapati D Nayak R Nayak UA Shah PJ Areca nut chewing habit in preschoolers Two rare case reports and literature review Int J Dent Health Concern 201511-5 (Permission given)
Oral tobacco use and cigar smoking
bull High prevalence tobacco use in any form is reported among school going adolescents aged 13ndash15 years in India (Arora and Reddy 2005) Smoking Chutta is relatively popular may begin in childhood in India
bull Acts as a stimulant euphoric
bull May sleep with tobacco mixture in mouth
Harmful effects halitosis brown black staining gingival recession if wad is held against gingivaleucoplakia oral squamous cell carcinoma
Tobacco use in children
PRACTICES RELATED TO PUBERTY AND GROOMING
Tooth filing tooth sharpening
Practiced -Nigeria Niger-Delta area (Ukeghesonand Akadiri ) Democratic Republic of Congo Thailand Indonesia
bull Perception Historically -spiritual reasons Contemporary times - aesthetic reasons
bull In Nigeria maxillary midline diastema is regarded as a symbol of beauty (Arigbede and Adesuwa 2012
bull Teeth filed- because represent negative emotions eg anger jealousy (Balinese Indonesia)
30 respondents would not mind having artificially created diastema (Omotosho and Kadri (2010)
Practices
bull Done in adolescence - fashionable
bull Manually done Usually incisors
Harmful effects
bull pain during process
bull Tooth discolouration (teeth -non vital)
bull Infection -pus discharge lip swelling
Tooth filing
Peri-apical x-ray of lower central incisor
Lacquering and staining of teethPerformed in Vietnam Laos Thailand Indonesia and Philippines
Perception For cosmetic reasons
bull Main ingredient dye dark-brown solution of ferric acetate called kanemizu (iron filings in vinegar)
bull Coating the teeth with this liquid helped to prevent tooth decay and enamel decay
bull Practice has slowly declined
Traditional gingival tattooinglips bull Practiced in Africarsquos Sahel region Woddebe
Fulani tribe Senegal Ethiopia middle eastern countries
Perception Reason aesthetic appeal superstition
bull Practices Done when females reach puberty
bull Kanuri females Borno State Nigeria tattooing lip gingiva usually performed thorns of Balanites aegyptiaca (Bukar et al 2004 )
bull Pigments -Mixture charcoal and seeds of Acacia nilotica vartomentosa
Lip plug lip plate
bull The lip plate (lip plug or lip disc) form of body modification
bull Amazonian tribes young males traditionally -rite of passage indicate status and prestige
bull Mursi of Ethiopia girls age 13 to 18
bull At puberty mother cuts her lower lip
bull Held open by a wooden plug - inserted into thereby stretching the lip
bull At times -combined with removal of two or four lower anterior incisal teeth
Lip plug lip plate
TRADITIONAL DENTAL SERVICES
bull Perceptions
Cause of illness determines treatment taken Practices
bull Yoruba community patronize traditional dentists (Oke Bankole et al 2011) Edo state
bull Services rendered include worm extraction tooth extraction drug prescription and offering sacrifices to deities
bull Charges based on the worm count
Northern Nigeria called Serdia Toothache associated with dandruff
Cameroon traditional healers perform atraumatic tooth extraction Agbor et al (2011)
bull Leaves stems of Dichrocephala integrifolia
bull Tooth pulled out fingerssharp instrument
bull No pain Plant has anaesthetic properties
bull Dangers infection sepsis infection with hepatitis B Human Immunodeficiency Virus
bull Jewish Unlikely keep Friday appointment with the dentist for their children
bull Routine appointments on Fridays avoided (Scambler et al )
The traditional healer harvesting the medicinal plant in Cameroon
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J Ethnobiol Ethnomed 2011 715
Tooth extraction by a traditional dentist
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J EthnobiolEthnomed 2011 715
bull Health is a consequence of an individualrsquos lifestyle
bull Essential to Identify cultural factors that are harmful and those that are beneficial
bull As paediatric dentists we should discourage the unhealthy practices through rigorous health education and promote the adoption of healthy practices
bull Need for multicentric research on the cultural influence of the family and peers regarding oral health of children
bull Bankole OO Lawal FB Ibiyemi O (2017) Dispelling myths associated with natalneonatal teeth ldquoAdunnirdquo a health education video in a native Nigerian language Annals of Ibadan Postgraduate Medicine15(2)137-141
Thank you for listening
IMPORTANCE OF THE PRIMARY DENTITION IN CHILDREN
bull Primary teeth in children are sometimes not regarded as important
bull Mothers of preschool children in Mumbai -436 believed 192 were uncertain that there is no need to visit a dentist for treating milk teeth as they will soon fall off (Jain et al 2014)
COMMON DENTAL DISEASES
Dental Caries
bull Early childhood caries is a significant public health problem caries affecting children globally
bull In recent years in developing countries like Sub-Saharan Africa the prevalence is predicted to increase
bull Early childhood caries is largely untreated in a study in South Africa reported a caries prevalence of 716 and these 675 were untreated (Mohammed and Barnes 2018 )
Dental caries Perceived cause of dental
caries
Community tribe
Worms (resembling
maggots)
Borom bop (master of the
head)
Lagatas
Smaller version of pubu
Worms -removed from
ears
Yoruba Nomadic Fulani
Chinese (Dong et al 2007)
Senegalese ( Diouf et al 2003)
Brazil
Papua New Guinea
Indian (Nagaraj et al2014)
Dental caries -Care remedies Dental care remedies Community tribe Effect
Hydrochloric acid (Wet cell
battery liquid)
Aluminum Phosphate
(Alum)
Tobacco snuff
Charcoal and salt
Gentian violet
Atare (Alligator Pepper)
Yoruba Brazil
Kenya (Mulu Maryanne)
Yoruba (Oke et al 2011)
Chemical burns
mucosal ulceration
Erosion
Tetracycline capsule (topical)
Paracetamol (topical)
Hausa Nomadic Fulani
Hausa
Greyish brown tooth
discolouration
Mucosal ulceration
Traditional concoction
Dental are remedies Dental care remedies Community
tribe
Effect
White wineVinegar Powdered alum musk and frankincense
Chinese (Dong et al 2007)
Herbs traditional medicine
Aborigines (Wong 2005)
Nettles
Hot sweet potato
Wads hot leaves ginger
Residue smoking pipe
White sap of shrub used
to kill maggots
Insecticide ointment
Papua New
Guinea
Predisposition to
oral cancer
Toxic
Dental care remedies Dental care remedies Community Effect
Cooked meat
salt alcohol grease
deodorant
Iran
fingernail polish remover
black tar
Garlic Warm coconut milk
Brazil Toxic
Kawakawa Māori(Pepper Tree
Leaves) chewed
Harakeke -Korari Flax
the gum used for toothache
Maori
GingivitisPeriodontal disease
Perceptions
bull Bleeding gums caused by
bull Child stores food in pouch of mouth and does not clean teeth
Remedies for gingival periodontal disease
Remedies Community tribe
Effect
Aluminium phosphate (Alum ) + Lapalapa sap (Jatropha curcas)Warm water and salt Tomato and alum+polystrene foam or cotton woolHydrogen peroxide
Yoruba
Antibiotics NomadiFulani
Resistant strains Hyper sensitivityreactions
Herbs
ORAL HABITS Kola nut chewing
Common West Central Africa Symbol of hospitality Contains caffeine tannin
bull Helps students keep awakewithstand fatigue
Practices
bull One-year prevalence student use was 291 Erinfolami et al (2011)
bull Majority started at age 14 years or below
bull Dangers -insomnia nausea tooth discolourationcarcinogenic potential for development of oral cancer
Areca Nut Chewing Habitbull Areca nut is the seed of areca palm
bull Widely grown- Asia India Bangladesh Japan
bull Believed to help fatigue
bull Highest period of risk for first use is between 5 and 12 Farrand et al 2001
74 4-16 age group in Karachi indulged in the habit (Shah et al 2002)
Dangers Oral sub mucous fibrosis
bull Risk of oral cancer 99 times( Wollina et al 2004 ) Foreign body aspiration Severe tooth wear -- sensitivity root fractures
Mandibular arch with generalized staining in the deciduous dentition
Prajapati D Nayak R Nayak UA Shah PJ Areca nut chewing habit in preschoolers Two rare case reports and literature review Int J Dent Health Concern 201511-5 (Permission given)
Mandibular arch with generalized staining in the deciduous dentition
Prajapati D Nayak R Nayak UA Shah PJ Areca nut chewing habit in preschoolers Two rare case reports and literature review Int J Dent Health Concern 201511-5 (Permission given)
Oral tobacco use and cigar smoking
bull High prevalence tobacco use in any form is reported among school going adolescents aged 13ndash15 years in India (Arora and Reddy 2005) Smoking Chutta is relatively popular may begin in childhood in India
bull Acts as a stimulant euphoric
bull May sleep with tobacco mixture in mouth
Harmful effects halitosis brown black staining gingival recession if wad is held against gingivaleucoplakia oral squamous cell carcinoma
Tobacco use in children
PRACTICES RELATED TO PUBERTY AND GROOMING
Tooth filing tooth sharpening
Practiced -Nigeria Niger-Delta area (Ukeghesonand Akadiri ) Democratic Republic of Congo Thailand Indonesia
bull Perception Historically -spiritual reasons Contemporary times - aesthetic reasons
bull In Nigeria maxillary midline diastema is regarded as a symbol of beauty (Arigbede and Adesuwa 2012
bull Teeth filed- because represent negative emotions eg anger jealousy (Balinese Indonesia)
30 respondents would not mind having artificially created diastema (Omotosho and Kadri (2010)
Practices
bull Done in adolescence - fashionable
bull Manually done Usually incisors
Harmful effects
bull pain during process
bull Tooth discolouration (teeth -non vital)
bull Infection -pus discharge lip swelling
Tooth filing
Peri-apical x-ray of lower central incisor
Lacquering and staining of teethPerformed in Vietnam Laos Thailand Indonesia and Philippines
Perception For cosmetic reasons
bull Main ingredient dye dark-brown solution of ferric acetate called kanemizu (iron filings in vinegar)
bull Coating the teeth with this liquid helped to prevent tooth decay and enamel decay
bull Practice has slowly declined
Traditional gingival tattooinglips bull Practiced in Africarsquos Sahel region Woddebe
Fulani tribe Senegal Ethiopia middle eastern countries
Perception Reason aesthetic appeal superstition
bull Practices Done when females reach puberty
bull Kanuri females Borno State Nigeria tattooing lip gingiva usually performed thorns of Balanites aegyptiaca (Bukar et al 2004 )
bull Pigments -Mixture charcoal and seeds of Acacia nilotica vartomentosa
Lip plug lip plate
bull The lip plate (lip plug or lip disc) form of body modification
bull Amazonian tribes young males traditionally -rite of passage indicate status and prestige
bull Mursi of Ethiopia girls age 13 to 18
bull At puberty mother cuts her lower lip
bull Held open by a wooden plug - inserted into thereby stretching the lip
bull At times -combined with removal of two or four lower anterior incisal teeth
Lip plug lip plate
TRADITIONAL DENTAL SERVICES
bull Perceptions
Cause of illness determines treatment taken Practices
bull Yoruba community patronize traditional dentists (Oke Bankole et al 2011) Edo state
bull Services rendered include worm extraction tooth extraction drug prescription and offering sacrifices to deities
bull Charges based on the worm count
Northern Nigeria called Serdia Toothache associated with dandruff
Cameroon traditional healers perform atraumatic tooth extraction Agbor et al (2011)
bull Leaves stems of Dichrocephala integrifolia
bull Tooth pulled out fingerssharp instrument
bull No pain Plant has anaesthetic properties
bull Dangers infection sepsis infection with hepatitis B Human Immunodeficiency Virus
bull Jewish Unlikely keep Friday appointment with the dentist for their children
bull Routine appointments on Fridays avoided (Scambler et al )
The traditional healer harvesting the medicinal plant in Cameroon
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J Ethnobiol Ethnomed 2011 715
Tooth extraction by a traditional dentist
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J EthnobiolEthnomed 2011 715
bull Health is a consequence of an individualrsquos lifestyle
bull Essential to Identify cultural factors that are harmful and those that are beneficial
bull As paediatric dentists we should discourage the unhealthy practices through rigorous health education and promote the adoption of healthy practices
bull Need for multicentric research on the cultural influence of the family and peers regarding oral health of children
bull Bankole OO Lawal FB Ibiyemi O (2017) Dispelling myths associated with natalneonatal teeth ldquoAdunnirdquo a health education video in a native Nigerian language Annals of Ibadan Postgraduate Medicine15(2)137-141
Thank you for listening
COMMON DENTAL DISEASES
Dental Caries
bull Early childhood caries is a significant public health problem caries affecting children globally
bull In recent years in developing countries like Sub-Saharan Africa the prevalence is predicted to increase
bull Early childhood caries is largely untreated in a study in South Africa reported a caries prevalence of 716 and these 675 were untreated (Mohammed and Barnes 2018 )
Dental caries Perceived cause of dental
caries
Community tribe
Worms (resembling
maggots)
Borom bop (master of the
head)
Lagatas
Smaller version of pubu
Worms -removed from
ears
Yoruba Nomadic Fulani
Chinese (Dong et al 2007)
Senegalese ( Diouf et al 2003)
Brazil
Papua New Guinea
Indian (Nagaraj et al2014)
Dental caries -Care remedies Dental care remedies Community tribe Effect
Hydrochloric acid (Wet cell
battery liquid)
Aluminum Phosphate
(Alum)
Tobacco snuff
Charcoal and salt
Gentian violet
Atare (Alligator Pepper)
Yoruba Brazil
Kenya (Mulu Maryanne)
Yoruba (Oke et al 2011)
Chemical burns
mucosal ulceration
Erosion
Tetracycline capsule (topical)
Paracetamol (topical)
Hausa Nomadic Fulani
Hausa
Greyish brown tooth
discolouration
Mucosal ulceration
Traditional concoction
Dental are remedies Dental care remedies Community
tribe
Effect
White wineVinegar Powdered alum musk and frankincense
Chinese (Dong et al 2007)
Herbs traditional medicine
Aborigines (Wong 2005)
Nettles
Hot sweet potato
Wads hot leaves ginger
Residue smoking pipe
White sap of shrub used
to kill maggots
Insecticide ointment
Papua New
Guinea
Predisposition to
oral cancer
Toxic
Dental care remedies Dental care remedies Community Effect
Cooked meat
salt alcohol grease
deodorant
Iran
fingernail polish remover
black tar
Garlic Warm coconut milk
Brazil Toxic
Kawakawa Māori(Pepper Tree
Leaves) chewed
Harakeke -Korari Flax
the gum used for toothache
Maori
GingivitisPeriodontal disease
Perceptions
bull Bleeding gums caused by
bull Child stores food in pouch of mouth and does not clean teeth
Remedies for gingival periodontal disease
Remedies Community tribe
Effect
Aluminium phosphate (Alum ) + Lapalapa sap (Jatropha curcas)Warm water and salt Tomato and alum+polystrene foam or cotton woolHydrogen peroxide
Yoruba
Antibiotics NomadiFulani
Resistant strains Hyper sensitivityreactions
Herbs
ORAL HABITS Kola nut chewing
Common West Central Africa Symbol of hospitality Contains caffeine tannin
bull Helps students keep awakewithstand fatigue
Practices
bull One-year prevalence student use was 291 Erinfolami et al (2011)
bull Majority started at age 14 years or below
bull Dangers -insomnia nausea tooth discolourationcarcinogenic potential for development of oral cancer
Areca Nut Chewing Habitbull Areca nut is the seed of areca palm
bull Widely grown- Asia India Bangladesh Japan
bull Believed to help fatigue
bull Highest period of risk for first use is between 5 and 12 Farrand et al 2001
74 4-16 age group in Karachi indulged in the habit (Shah et al 2002)
Dangers Oral sub mucous fibrosis
bull Risk of oral cancer 99 times( Wollina et al 2004 ) Foreign body aspiration Severe tooth wear -- sensitivity root fractures
Mandibular arch with generalized staining in the deciduous dentition
Prajapati D Nayak R Nayak UA Shah PJ Areca nut chewing habit in preschoolers Two rare case reports and literature review Int J Dent Health Concern 201511-5 (Permission given)
Mandibular arch with generalized staining in the deciduous dentition
Prajapati D Nayak R Nayak UA Shah PJ Areca nut chewing habit in preschoolers Two rare case reports and literature review Int J Dent Health Concern 201511-5 (Permission given)
Oral tobacco use and cigar smoking
bull High prevalence tobacco use in any form is reported among school going adolescents aged 13ndash15 years in India (Arora and Reddy 2005) Smoking Chutta is relatively popular may begin in childhood in India
bull Acts as a stimulant euphoric
bull May sleep with tobacco mixture in mouth
Harmful effects halitosis brown black staining gingival recession if wad is held against gingivaleucoplakia oral squamous cell carcinoma
Tobacco use in children
PRACTICES RELATED TO PUBERTY AND GROOMING
Tooth filing tooth sharpening
Practiced -Nigeria Niger-Delta area (Ukeghesonand Akadiri ) Democratic Republic of Congo Thailand Indonesia
bull Perception Historically -spiritual reasons Contemporary times - aesthetic reasons
bull In Nigeria maxillary midline diastema is regarded as a symbol of beauty (Arigbede and Adesuwa 2012
bull Teeth filed- because represent negative emotions eg anger jealousy (Balinese Indonesia)
30 respondents would not mind having artificially created diastema (Omotosho and Kadri (2010)
Practices
bull Done in adolescence - fashionable
bull Manually done Usually incisors
Harmful effects
bull pain during process
bull Tooth discolouration (teeth -non vital)
bull Infection -pus discharge lip swelling
Tooth filing
Peri-apical x-ray of lower central incisor
Lacquering and staining of teethPerformed in Vietnam Laos Thailand Indonesia and Philippines
Perception For cosmetic reasons
bull Main ingredient dye dark-brown solution of ferric acetate called kanemizu (iron filings in vinegar)
bull Coating the teeth with this liquid helped to prevent tooth decay and enamel decay
bull Practice has slowly declined
Traditional gingival tattooinglips bull Practiced in Africarsquos Sahel region Woddebe
Fulani tribe Senegal Ethiopia middle eastern countries
Perception Reason aesthetic appeal superstition
bull Practices Done when females reach puberty
bull Kanuri females Borno State Nigeria tattooing lip gingiva usually performed thorns of Balanites aegyptiaca (Bukar et al 2004 )
bull Pigments -Mixture charcoal and seeds of Acacia nilotica vartomentosa
Lip plug lip plate
bull The lip plate (lip plug or lip disc) form of body modification
bull Amazonian tribes young males traditionally -rite of passage indicate status and prestige
bull Mursi of Ethiopia girls age 13 to 18
bull At puberty mother cuts her lower lip
bull Held open by a wooden plug - inserted into thereby stretching the lip
bull At times -combined with removal of two or four lower anterior incisal teeth
Lip plug lip plate
TRADITIONAL DENTAL SERVICES
bull Perceptions
Cause of illness determines treatment taken Practices
bull Yoruba community patronize traditional dentists (Oke Bankole et al 2011) Edo state
bull Services rendered include worm extraction tooth extraction drug prescription and offering sacrifices to deities
bull Charges based on the worm count
Northern Nigeria called Serdia Toothache associated with dandruff
Cameroon traditional healers perform atraumatic tooth extraction Agbor et al (2011)
bull Leaves stems of Dichrocephala integrifolia
bull Tooth pulled out fingerssharp instrument
bull No pain Plant has anaesthetic properties
bull Dangers infection sepsis infection with hepatitis B Human Immunodeficiency Virus
bull Jewish Unlikely keep Friday appointment with the dentist for their children
bull Routine appointments on Fridays avoided (Scambler et al )
The traditional healer harvesting the medicinal plant in Cameroon
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J Ethnobiol Ethnomed 2011 715
Tooth extraction by a traditional dentist
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J EthnobiolEthnomed 2011 715
bull Health is a consequence of an individualrsquos lifestyle
bull Essential to Identify cultural factors that are harmful and those that are beneficial
bull As paediatric dentists we should discourage the unhealthy practices through rigorous health education and promote the adoption of healthy practices
bull Need for multicentric research on the cultural influence of the family and peers regarding oral health of children
bull Bankole OO Lawal FB Ibiyemi O (2017) Dispelling myths associated with natalneonatal teeth ldquoAdunnirdquo a health education video in a native Nigerian language Annals of Ibadan Postgraduate Medicine15(2)137-141
Thank you for listening
Dental caries Perceived cause of dental
caries
Community tribe
Worms (resembling
maggots)
Borom bop (master of the
head)
Lagatas
Smaller version of pubu
Worms -removed from
ears
Yoruba Nomadic Fulani
Chinese (Dong et al 2007)
Senegalese ( Diouf et al 2003)
Brazil
Papua New Guinea
Indian (Nagaraj et al2014)
Dental caries -Care remedies Dental care remedies Community tribe Effect
Hydrochloric acid (Wet cell
battery liquid)
Aluminum Phosphate
(Alum)
Tobacco snuff
Charcoal and salt
Gentian violet
Atare (Alligator Pepper)
Yoruba Brazil
Kenya (Mulu Maryanne)
Yoruba (Oke et al 2011)
Chemical burns
mucosal ulceration
Erosion
Tetracycline capsule (topical)
Paracetamol (topical)
Hausa Nomadic Fulani
Hausa
Greyish brown tooth
discolouration
Mucosal ulceration
Traditional concoction
Dental are remedies Dental care remedies Community
tribe
Effect
White wineVinegar Powdered alum musk and frankincense
Chinese (Dong et al 2007)
Herbs traditional medicine
Aborigines (Wong 2005)
Nettles
Hot sweet potato
Wads hot leaves ginger
Residue smoking pipe
White sap of shrub used
to kill maggots
Insecticide ointment
Papua New
Guinea
Predisposition to
oral cancer
Toxic
Dental care remedies Dental care remedies Community Effect
Cooked meat
salt alcohol grease
deodorant
Iran
fingernail polish remover
black tar
Garlic Warm coconut milk
Brazil Toxic
Kawakawa Māori(Pepper Tree
Leaves) chewed
Harakeke -Korari Flax
the gum used for toothache
Maori
GingivitisPeriodontal disease
Perceptions
bull Bleeding gums caused by
bull Child stores food in pouch of mouth and does not clean teeth
Remedies for gingival periodontal disease
Remedies Community tribe
Effect
Aluminium phosphate (Alum ) + Lapalapa sap (Jatropha curcas)Warm water and salt Tomato and alum+polystrene foam or cotton woolHydrogen peroxide
Yoruba
Antibiotics NomadiFulani
Resistant strains Hyper sensitivityreactions
Herbs
ORAL HABITS Kola nut chewing
Common West Central Africa Symbol of hospitality Contains caffeine tannin
bull Helps students keep awakewithstand fatigue
Practices
bull One-year prevalence student use was 291 Erinfolami et al (2011)
bull Majority started at age 14 years or below
bull Dangers -insomnia nausea tooth discolourationcarcinogenic potential for development of oral cancer
Areca Nut Chewing Habitbull Areca nut is the seed of areca palm
bull Widely grown- Asia India Bangladesh Japan
bull Believed to help fatigue
bull Highest period of risk for first use is between 5 and 12 Farrand et al 2001
74 4-16 age group in Karachi indulged in the habit (Shah et al 2002)
Dangers Oral sub mucous fibrosis
bull Risk of oral cancer 99 times( Wollina et al 2004 ) Foreign body aspiration Severe tooth wear -- sensitivity root fractures
Mandibular arch with generalized staining in the deciduous dentition
Prajapati D Nayak R Nayak UA Shah PJ Areca nut chewing habit in preschoolers Two rare case reports and literature review Int J Dent Health Concern 201511-5 (Permission given)
Mandibular arch with generalized staining in the deciduous dentition
Prajapati D Nayak R Nayak UA Shah PJ Areca nut chewing habit in preschoolers Two rare case reports and literature review Int J Dent Health Concern 201511-5 (Permission given)
Oral tobacco use and cigar smoking
bull High prevalence tobacco use in any form is reported among school going adolescents aged 13ndash15 years in India (Arora and Reddy 2005) Smoking Chutta is relatively popular may begin in childhood in India
bull Acts as a stimulant euphoric
bull May sleep with tobacco mixture in mouth
Harmful effects halitosis brown black staining gingival recession if wad is held against gingivaleucoplakia oral squamous cell carcinoma
Tobacco use in children
PRACTICES RELATED TO PUBERTY AND GROOMING
Tooth filing tooth sharpening
Practiced -Nigeria Niger-Delta area (Ukeghesonand Akadiri ) Democratic Republic of Congo Thailand Indonesia
bull Perception Historically -spiritual reasons Contemporary times - aesthetic reasons
bull In Nigeria maxillary midline diastema is regarded as a symbol of beauty (Arigbede and Adesuwa 2012
bull Teeth filed- because represent negative emotions eg anger jealousy (Balinese Indonesia)
30 respondents would not mind having artificially created diastema (Omotosho and Kadri (2010)
Practices
bull Done in adolescence - fashionable
bull Manually done Usually incisors
Harmful effects
bull pain during process
bull Tooth discolouration (teeth -non vital)
bull Infection -pus discharge lip swelling
Tooth filing
Peri-apical x-ray of lower central incisor
Lacquering and staining of teethPerformed in Vietnam Laos Thailand Indonesia and Philippines
Perception For cosmetic reasons
bull Main ingredient dye dark-brown solution of ferric acetate called kanemizu (iron filings in vinegar)
bull Coating the teeth with this liquid helped to prevent tooth decay and enamel decay
bull Practice has slowly declined
Traditional gingival tattooinglips bull Practiced in Africarsquos Sahel region Woddebe
Fulani tribe Senegal Ethiopia middle eastern countries
Perception Reason aesthetic appeal superstition
bull Practices Done when females reach puberty
bull Kanuri females Borno State Nigeria tattooing lip gingiva usually performed thorns of Balanites aegyptiaca (Bukar et al 2004 )
bull Pigments -Mixture charcoal and seeds of Acacia nilotica vartomentosa
Lip plug lip plate
bull The lip plate (lip plug or lip disc) form of body modification
bull Amazonian tribes young males traditionally -rite of passage indicate status and prestige
bull Mursi of Ethiopia girls age 13 to 18
bull At puberty mother cuts her lower lip
bull Held open by a wooden plug - inserted into thereby stretching the lip
bull At times -combined with removal of two or four lower anterior incisal teeth
Lip plug lip plate
TRADITIONAL DENTAL SERVICES
bull Perceptions
Cause of illness determines treatment taken Practices
bull Yoruba community patronize traditional dentists (Oke Bankole et al 2011) Edo state
bull Services rendered include worm extraction tooth extraction drug prescription and offering sacrifices to deities
bull Charges based on the worm count
Northern Nigeria called Serdia Toothache associated with dandruff
Cameroon traditional healers perform atraumatic tooth extraction Agbor et al (2011)
bull Leaves stems of Dichrocephala integrifolia
bull Tooth pulled out fingerssharp instrument
bull No pain Plant has anaesthetic properties
bull Dangers infection sepsis infection with hepatitis B Human Immunodeficiency Virus
bull Jewish Unlikely keep Friday appointment with the dentist for their children
bull Routine appointments on Fridays avoided (Scambler et al )
The traditional healer harvesting the medicinal plant in Cameroon
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J Ethnobiol Ethnomed 2011 715
Tooth extraction by a traditional dentist
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J EthnobiolEthnomed 2011 715
bull Health is a consequence of an individualrsquos lifestyle
bull Essential to Identify cultural factors that are harmful and those that are beneficial
bull As paediatric dentists we should discourage the unhealthy practices through rigorous health education and promote the adoption of healthy practices
bull Need for multicentric research on the cultural influence of the family and peers regarding oral health of children
bull Bankole OO Lawal FB Ibiyemi O (2017) Dispelling myths associated with natalneonatal teeth ldquoAdunnirdquo a health education video in a native Nigerian language Annals of Ibadan Postgraduate Medicine15(2)137-141
Thank you for listening
Dental caries -Care remedies Dental care remedies Community tribe Effect
Hydrochloric acid (Wet cell
battery liquid)
Aluminum Phosphate
(Alum)
Tobacco snuff
Charcoal and salt
Gentian violet
Atare (Alligator Pepper)
Yoruba Brazil
Kenya (Mulu Maryanne)
Yoruba (Oke et al 2011)
Chemical burns
mucosal ulceration
Erosion
Tetracycline capsule (topical)
Paracetamol (topical)
Hausa Nomadic Fulani
Hausa
Greyish brown tooth
discolouration
Mucosal ulceration
Traditional concoction
Dental are remedies Dental care remedies Community
tribe
Effect
White wineVinegar Powdered alum musk and frankincense
Chinese (Dong et al 2007)
Herbs traditional medicine
Aborigines (Wong 2005)
Nettles
Hot sweet potato
Wads hot leaves ginger
Residue smoking pipe
White sap of shrub used
to kill maggots
Insecticide ointment
Papua New
Guinea
Predisposition to
oral cancer
Toxic
Dental care remedies Dental care remedies Community Effect
Cooked meat
salt alcohol grease
deodorant
Iran
fingernail polish remover
black tar
Garlic Warm coconut milk
Brazil Toxic
Kawakawa Māori(Pepper Tree
Leaves) chewed
Harakeke -Korari Flax
the gum used for toothache
Maori
GingivitisPeriodontal disease
Perceptions
bull Bleeding gums caused by
bull Child stores food in pouch of mouth and does not clean teeth
Remedies for gingival periodontal disease
Remedies Community tribe
Effect
Aluminium phosphate (Alum ) + Lapalapa sap (Jatropha curcas)Warm water and salt Tomato and alum+polystrene foam or cotton woolHydrogen peroxide
Yoruba
Antibiotics NomadiFulani
Resistant strains Hyper sensitivityreactions
Herbs
ORAL HABITS Kola nut chewing
Common West Central Africa Symbol of hospitality Contains caffeine tannin
bull Helps students keep awakewithstand fatigue
Practices
bull One-year prevalence student use was 291 Erinfolami et al (2011)
bull Majority started at age 14 years or below
bull Dangers -insomnia nausea tooth discolourationcarcinogenic potential for development of oral cancer
Areca Nut Chewing Habitbull Areca nut is the seed of areca palm
bull Widely grown- Asia India Bangladesh Japan
bull Believed to help fatigue
bull Highest period of risk for first use is between 5 and 12 Farrand et al 2001
74 4-16 age group in Karachi indulged in the habit (Shah et al 2002)
Dangers Oral sub mucous fibrosis
bull Risk of oral cancer 99 times( Wollina et al 2004 ) Foreign body aspiration Severe tooth wear -- sensitivity root fractures
Mandibular arch with generalized staining in the deciduous dentition
Prajapati D Nayak R Nayak UA Shah PJ Areca nut chewing habit in preschoolers Two rare case reports and literature review Int J Dent Health Concern 201511-5 (Permission given)
Mandibular arch with generalized staining in the deciduous dentition
Prajapati D Nayak R Nayak UA Shah PJ Areca nut chewing habit in preschoolers Two rare case reports and literature review Int J Dent Health Concern 201511-5 (Permission given)
Oral tobacco use and cigar smoking
bull High prevalence tobacco use in any form is reported among school going adolescents aged 13ndash15 years in India (Arora and Reddy 2005) Smoking Chutta is relatively popular may begin in childhood in India
bull Acts as a stimulant euphoric
bull May sleep with tobacco mixture in mouth
Harmful effects halitosis brown black staining gingival recession if wad is held against gingivaleucoplakia oral squamous cell carcinoma
Tobacco use in children
PRACTICES RELATED TO PUBERTY AND GROOMING
Tooth filing tooth sharpening
Practiced -Nigeria Niger-Delta area (Ukeghesonand Akadiri ) Democratic Republic of Congo Thailand Indonesia
bull Perception Historically -spiritual reasons Contemporary times - aesthetic reasons
bull In Nigeria maxillary midline diastema is regarded as a symbol of beauty (Arigbede and Adesuwa 2012
bull Teeth filed- because represent negative emotions eg anger jealousy (Balinese Indonesia)
30 respondents would not mind having artificially created diastema (Omotosho and Kadri (2010)
Practices
bull Done in adolescence - fashionable
bull Manually done Usually incisors
Harmful effects
bull pain during process
bull Tooth discolouration (teeth -non vital)
bull Infection -pus discharge lip swelling
Tooth filing
Peri-apical x-ray of lower central incisor
Lacquering and staining of teethPerformed in Vietnam Laos Thailand Indonesia and Philippines
Perception For cosmetic reasons
bull Main ingredient dye dark-brown solution of ferric acetate called kanemizu (iron filings in vinegar)
bull Coating the teeth with this liquid helped to prevent tooth decay and enamel decay
bull Practice has slowly declined
Traditional gingival tattooinglips bull Practiced in Africarsquos Sahel region Woddebe
Fulani tribe Senegal Ethiopia middle eastern countries
Perception Reason aesthetic appeal superstition
bull Practices Done when females reach puberty
bull Kanuri females Borno State Nigeria tattooing lip gingiva usually performed thorns of Balanites aegyptiaca (Bukar et al 2004 )
bull Pigments -Mixture charcoal and seeds of Acacia nilotica vartomentosa
Lip plug lip plate
bull The lip plate (lip plug or lip disc) form of body modification
bull Amazonian tribes young males traditionally -rite of passage indicate status and prestige
bull Mursi of Ethiopia girls age 13 to 18
bull At puberty mother cuts her lower lip
bull Held open by a wooden plug - inserted into thereby stretching the lip
bull At times -combined with removal of two or four lower anterior incisal teeth
Lip plug lip plate
TRADITIONAL DENTAL SERVICES
bull Perceptions
Cause of illness determines treatment taken Practices
bull Yoruba community patronize traditional dentists (Oke Bankole et al 2011) Edo state
bull Services rendered include worm extraction tooth extraction drug prescription and offering sacrifices to deities
bull Charges based on the worm count
Northern Nigeria called Serdia Toothache associated with dandruff
Cameroon traditional healers perform atraumatic tooth extraction Agbor et al (2011)
bull Leaves stems of Dichrocephala integrifolia
bull Tooth pulled out fingerssharp instrument
bull No pain Plant has anaesthetic properties
bull Dangers infection sepsis infection with hepatitis B Human Immunodeficiency Virus
bull Jewish Unlikely keep Friday appointment with the dentist for their children
bull Routine appointments on Fridays avoided (Scambler et al )
The traditional healer harvesting the medicinal plant in Cameroon
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J Ethnobiol Ethnomed 2011 715
Tooth extraction by a traditional dentist
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J EthnobiolEthnomed 2011 715
bull Health is a consequence of an individualrsquos lifestyle
bull Essential to Identify cultural factors that are harmful and those that are beneficial
bull As paediatric dentists we should discourage the unhealthy practices through rigorous health education and promote the adoption of healthy practices
bull Need for multicentric research on the cultural influence of the family and peers regarding oral health of children
bull Bankole OO Lawal FB Ibiyemi O (2017) Dispelling myths associated with natalneonatal teeth ldquoAdunnirdquo a health education video in a native Nigerian language Annals of Ibadan Postgraduate Medicine15(2)137-141
Thank you for listening
Dental are remedies Dental care remedies Community
tribe
Effect
White wineVinegar Powdered alum musk and frankincense
Chinese (Dong et al 2007)
Herbs traditional medicine
Aborigines (Wong 2005)
Nettles
Hot sweet potato
Wads hot leaves ginger
Residue smoking pipe
White sap of shrub used
to kill maggots
Insecticide ointment
Papua New
Guinea
Predisposition to
oral cancer
Toxic
Dental care remedies Dental care remedies Community Effect
Cooked meat
salt alcohol grease
deodorant
Iran
fingernail polish remover
black tar
Garlic Warm coconut milk
Brazil Toxic
Kawakawa Māori(Pepper Tree
Leaves) chewed
Harakeke -Korari Flax
the gum used for toothache
Maori
GingivitisPeriodontal disease
Perceptions
bull Bleeding gums caused by
bull Child stores food in pouch of mouth and does not clean teeth
Remedies for gingival periodontal disease
Remedies Community tribe
Effect
Aluminium phosphate (Alum ) + Lapalapa sap (Jatropha curcas)Warm water and salt Tomato and alum+polystrene foam or cotton woolHydrogen peroxide
Yoruba
Antibiotics NomadiFulani
Resistant strains Hyper sensitivityreactions
Herbs
ORAL HABITS Kola nut chewing
Common West Central Africa Symbol of hospitality Contains caffeine tannin
bull Helps students keep awakewithstand fatigue
Practices
bull One-year prevalence student use was 291 Erinfolami et al (2011)
bull Majority started at age 14 years or below
bull Dangers -insomnia nausea tooth discolourationcarcinogenic potential for development of oral cancer
Areca Nut Chewing Habitbull Areca nut is the seed of areca palm
bull Widely grown- Asia India Bangladesh Japan
bull Believed to help fatigue
bull Highest period of risk for first use is between 5 and 12 Farrand et al 2001
74 4-16 age group in Karachi indulged in the habit (Shah et al 2002)
Dangers Oral sub mucous fibrosis
bull Risk of oral cancer 99 times( Wollina et al 2004 ) Foreign body aspiration Severe tooth wear -- sensitivity root fractures
Mandibular arch with generalized staining in the deciduous dentition
Prajapati D Nayak R Nayak UA Shah PJ Areca nut chewing habit in preschoolers Two rare case reports and literature review Int J Dent Health Concern 201511-5 (Permission given)
Mandibular arch with generalized staining in the deciduous dentition
Prajapati D Nayak R Nayak UA Shah PJ Areca nut chewing habit in preschoolers Two rare case reports and literature review Int J Dent Health Concern 201511-5 (Permission given)
Oral tobacco use and cigar smoking
bull High prevalence tobacco use in any form is reported among school going adolescents aged 13ndash15 years in India (Arora and Reddy 2005) Smoking Chutta is relatively popular may begin in childhood in India
bull Acts as a stimulant euphoric
bull May sleep with tobacco mixture in mouth
Harmful effects halitosis brown black staining gingival recession if wad is held against gingivaleucoplakia oral squamous cell carcinoma
Tobacco use in children
PRACTICES RELATED TO PUBERTY AND GROOMING
Tooth filing tooth sharpening
Practiced -Nigeria Niger-Delta area (Ukeghesonand Akadiri ) Democratic Republic of Congo Thailand Indonesia
bull Perception Historically -spiritual reasons Contemporary times - aesthetic reasons
bull In Nigeria maxillary midline diastema is regarded as a symbol of beauty (Arigbede and Adesuwa 2012
bull Teeth filed- because represent negative emotions eg anger jealousy (Balinese Indonesia)
30 respondents would not mind having artificially created diastema (Omotosho and Kadri (2010)
Practices
bull Done in adolescence - fashionable
bull Manually done Usually incisors
Harmful effects
bull pain during process
bull Tooth discolouration (teeth -non vital)
bull Infection -pus discharge lip swelling
Tooth filing
Peri-apical x-ray of lower central incisor
Lacquering and staining of teethPerformed in Vietnam Laos Thailand Indonesia and Philippines
Perception For cosmetic reasons
bull Main ingredient dye dark-brown solution of ferric acetate called kanemizu (iron filings in vinegar)
bull Coating the teeth with this liquid helped to prevent tooth decay and enamel decay
bull Practice has slowly declined
Traditional gingival tattooinglips bull Practiced in Africarsquos Sahel region Woddebe
Fulani tribe Senegal Ethiopia middle eastern countries
Perception Reason aesthetic appeal superstition
bull Practices Done when females reach puberty
bull Kanuri females Borno State Nigeria tattooing lip gingiva usually performed thorns of Balanites aegyptiaca (Bukar et al 2004 )
bull Pigments -Mixture charcoal and seeds of Acacia nilotica vartomentosa
Lip plug lip plate
bull The lip plate (lip plug or lip disc) form of body modification
bull Amazonian tribes young males traditionally -rite of passage indicate status and prestige
bull Mursi of Ethiopia girls age 13 to 18
bull At puberty mother cuts her lower lip
bull Held open by a wooden plug - inserted into thereby stretching the lip
bull At times -combined with removal of two or four lower anterior incisal teeth
Lip plug lip plate
TRADITIONAL DENTAL SERVICES
bull Perceptions
Cause of illness determines treatment taken Practices
bull Yoruba community patronize traditional dentists (Oke Bankole et al 2011) Edo state
bull Services rendered include worm extraction tooth extraction drug prescription and offering sacrifices to deities
bull Charges based on the worm count
Northern Nigeria called Serdia Toothache associated with dandruff
Cameroon traditional healers perform atraumatic tooth extraction Agbor et al (2011)
bull Leaves stems of Dichrocephala integrifolia
bull Tooth pulled out fingerssharp instrument
bull No pain Plant has anaesthetic properties
bull Dangers infection sepsis infection with hepatitis B Human Immunodeficiency Virus
bull Jewish Unlikely keep Friday appointment with the dentist for their children
bull Routine appointments on Fridays avoided (Scambler et al )
The traditional healer harvesting the medicinal plant in Cameroon
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J Ethnobiol Ethnomed 2011 715
Tooth extraction by a traditional dentist
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J EthnobiolEthnomed 2011 715
bull Health is a consequence of an individualrsquos lifestyle
bull Essential to Identify cultural factors that are harmful and those that are beneficial
bull As paediatric dentists we should discourage the unhealthy practices through rigorous health education and promote the adoption of healthy practices
bull Need for multicentric research on the cultural influence of the family and peers regarding oral health of children
bull Bankole OO Lawal FB Ibiyemi O (2017) Dispelling myths associated with natalneonatal teeth ldquoAdunnirdquo a health education video in a native Nigerian language Annals of Ibadan Postgraduate Medicine15(2)137-141
Thank you for listening
Dental care remedies Dental care remedies Community Effect
Cooked meat
salt alcohol grease
deodorant
Iran
fingernail polish remover
black tar
Garlic Warm coconut milk
Brazil Toxic
Kawakawa Māori(Pepper Tree
Leaves) chewed
Harakeke -Korari Flax
the gum used for toothache
Maori
GingivitisPeriodontal disease
Perceptions
bull Bleeding gums caused by
bull Child stores food in pouch of mouth and does not clean teeth
Remedies for gingival periodontal disease
Remedies Community tribe
Effect
Aluminium phosphate (Alum ) + Lapalapa sap (Jatropha curcas)Warm water and salt Tomato and alum+polystrene foam or cotton woolHydrogen peroxide
Yoruba
Antibiotics NomadiFulani
Resistant strains Hyper sensitivityreactions
Herbs
ORAL HABITS Kola nut chewing
Common West Central Africa Symbol of hospitality Contains caffeine tannin
bull Helps students keep awakewithstand fatigue
Practices
bull One-year prevalence student use was 291 Erinfolami et al (2011)
bull Majority started at age 14 years or below
bull Dangers -insomnia nausea tooth discolourationcarcinogenic potential for development of oral cancer
Areca Nut Chewing Habitbull Areca nut is the seed of areca palm
bull Widely grown- Asia India Bangladesh Japan
bull Believed to help fatigue
bull Highest period of risk for first use is between 5 and 12 Farrand et al 2001
74 4-16 age group in Karachi indulged in the habit (Shah et al 2002)
Dangers Oral sub mucous fibrosis
bull Risk of oral cancer 99 times( Wollina et al 2004 ) Foreign body aspiration Severe tooth wear -- sensitivity root fractures
Mandibular arch with generalized staining in the deciduous dentition
Prajapati D Nayak R Nayak UA Shah PJ Areca nut chewing habit in preschoolers Two rare case reports and literature review Int J Dent Health Concern 201511-5 (Permission given)
Mandibular arch with generalized staining in the deciduous dentition
Prajapati D Nayak R Nayak UA Shah PJ Areca nut chewing habit in preschoolers Two rare case reports and literature review Int J Dent Health Concern 201511-5 (Permission given)
Oral tobacco use and cigar smoking
bull High prevalence tobacco use in any form is reported among school going adolescents aged 13ndash15 years in India (Arora and Reddy 2005) Smoking Chutta is relatively popular may begin in childhood in India
bull Acts as a stimulant euphoric
bull May sleep with tobacco mixture in mouth
Harmful effects halitosis brown black staining gingival recession if wad is held against gingivaleucoplakia oral squamous cell carcinoma
Tobacco use in children
PRACTICES RELATED TO PUBERTY AND GROOMING
Tooth filing tooth sharpening
Practiced -Nigeria Niger-Delta area (Ukeghesonand Akadiri ) Democratic Republic of Congo Thailand Indonesia
bull Perception Historically -spiritual reasons Contemporary times - aesthetic reasons
bull In Nigeria maxillary midline diastema is regarded as a symbol of beauty (Arigbede and Adesuwa 2012
bull Teeth filed- because represent negative emotions eg anger jealousy (Balinese Indonesia)
30 respondents would not mind having artificially created diastema (Omotosho and Kadri (2010)
Practices
bull Done in adolescence - fashionable
bull Manually done Usually incisors
Harmful effects
bull pain during process
bull Tooth discolouration (teeth -non vital)
bull Infection -pus discharge lip swelling
Tooth filing
Peri-apical x-ray of lower central incisor
Lacquering and staining of teethPerformed in Vietnam Laos Thailand Indonesia and Philippines
Perception For cosmetic reasons
bull Main ingredient dye dark-brown solution of ferric acetate called kanemizu (iron filings in vinegar)
bull Coating the teeth with this liquid helped to prevent tooth decay and enamel decay
bull Practice has slowly declined
Traditional gingival tattooinglips bull Practiced in Africarsquos Sahel region Woddebe
Fulani tribe Senegal Ethiopia middle eastern countries
Perception Reason aesthetic appeal superstition
bull Practices Done when females reach puberty
bull Kanuri females Borno State Nigeria tattooing lip gingiva usually performed thorns of Balanites aegyptiaca (Bukar et al 2004 )
bull Pigments -Mixture charcoal and seeds of Acacia nilotica vartomentosa
Lip plug lip plate
bull The lip plate (lip plug or lip disc) form of body modification
bull Amazonian tribes young males traditionally -rite of passage indicate status and prestige
bull Mursi of Ethiopia girls age 13 to 18
bull At puberty mother cuts her lower lip
bull Held open by a wooden plug - inserted into thereby stretching the lip
bull At times -combined with removal of two or four lower anterior incisal teeth
Lip plug lip plate
TRADITIONAL DENTAL SERVICES
bull Perceptions
Cause of illness determines treatment taken Practices
bull Yoruba community patronize traditional dentists (Oke Bankole et al 2011) Edo state
bull Services rendered include worm extraction tooth extraction drug prescription and offering sacrifices to deities
bull Charges based on the worm count
Northern Nigeria called Serdia Toothache associated with dandruff
Cameroon traditional healers perform atraumatic tooth extraction Agbor et al (2011)
bull Leaves stems of Dichrocephala integrifolia
bull Tooth pulled out fingerssharp instrument
bull No pain Plant has anaesthetic properties
bull Dangers infection sepsis infection with hepatitis B Human Immunodeficiency Virus
bull Jewish Unlikely keep Friday appointment with the dentist for their children
bull Routine appointments on Fridays avoided (Scambler et al )
The traditional healer harvesting the medicinal plant in Cameroon
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J Ethnobiol Ethnomed 2011 715
Tooth extraction by a traditional dentist
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J EthnobiolEthnomed 2011 715
bull Health is a consequence of an individualrsquos lifestyle
bull Essential to Identify cultural factors that are harmful and those that are beneficial
bull As paediatric dentists we should discourage the unhealthy practices through rigorous health education and promote the adoption of healthy practices
bull Need for multicentric research on the cultural influence of the family and peers regarding oral health of children
bull Bankole OO Lawal FB Ibiyemi O (2017) Dispelling myths associated with natalneonatal teeth ldquoAdunnirdquo a health education video in a native Nigerian language Annals of Ibadan Postgraduate Medicine15(2)137-141
Thank you for listening
GingivitisPeriodontal disease
Perceptions
bull Bleeding gums caused by
bull Child stores food in pouch of mouth and does not clean teeth
Remedies for gingival periodontal disease
Remedies Community tribe
Effect
Aluminium phosphate (Alum ) + Lapalapa sap (Jatropha curcas)Warm water and salt Tomato and alum+polystrene foam or cotton woolHydrogen peroxide
Yoruba
Antibiotics NomadiFulani
Resistant strains Hyper sensitivityreactions
Herbs
ORAL HABITS Kola nut chewing
Common West Central Africa Symbol of hospitality Contains caffeine tannin
bull Helps students keep awakewithstand fatigue
Practices
bull One-year prevalence student use was 291 Erinfolami et al (2011)
bull Majority started at age 14 years or below
bull Dangers -insomnia nausea tooth discolourationcarcinogenic potential for development of oral cancer
Areca Nut Chewing Habitbull Areca nut is the seed of areca palm
bull Widely grown- Asia India Bangladesh Japan
bull Believed to help fatigue
bull Highest period of risk for first use is between 5 and 12 Farrand et al 2001
74 4-16 age group in Karachi indulged in the habit (Shah et al 2002)
Dangers Oral sub mucous fibrosis
bull Risk of oral cancer 99 times( Wollina et al 2004 ) Foreign body aspiration Severe tooth wear -- sensitivity root fractures
Mandibular arch with generalized staining in the deciduous dentition
Prajapati D Nayak R Nayak UA Shah PJ Areca nut chewing habit in preschoolers Two rare case reports and literature review Int J Dent Health Concern 201511-5 (Permission given)
Mandibular arch with generalized staining in the deciduous dentition
Prajapati D Nayak R Nayak UA Shah PJ Areca nut chewing habit in preschoolers Two rare case reports and literature review Int J Dent Health Concern 201511-5 (Permission given)
Oral tobacco use and cigar smoking
bull High prevalence tobacco use in any form is reported among school going adolescents aged 13ndash15 years in India (Arora and Reddy 2005) Smoking Chutta is relatively popular may begin in childhood in India
bull Acts as a stimulant euphoric
bull May sleep with tobacco mixture in mouth
Harmful effects halitosis brown black staining gingival recession if wad is held against gingivaleucoplakia oral squamous cell carcinoma
Tobacco use in children
PRACTICES RELATED TO PUBERTY AND GROOMING
Tooth filing tooth sharpening
Practiced -Nigeria Niger-Delta area (Ukeghesonand Akadiri ) Democratic Republic of Congo Thailand Indonesia
bull Perception Historically -spiritual reasons Contemporary times - aesthetic reasons
bull In Nigeria maxillary midline diastema is regarded as a symbol of beauty (Arigbede and Adesuwa 2012
bull Teeth filed- because represent negative emotions eg anger jealousy (Balinese Indonesia)
30 respondents would not mind having artificially created diastema (Omotosho and Kadri (2010)
Practices
bull Done in adolescence - fashionable
bull Manually done Usually incisors
Harmful effects
bull pain during process
bull Tooth discolouration (teeth -non vital)
bull Infection -pus discharge lip swelling
Tooth filing
Peri-apical x-ray of lower central incisor
Lacquering and staining of teethPerformed in Vietnam Laos Thailand Indonesia and Philippines
Perception For cosmetic reasons
bull Main ingredient dye dark-brown solution of ferric acetate called kanemizu (iron filings in vinegar)
bull Coating the teeth with this liquid helped to prevent tooth decay and enamel decay
bull Practice has slowly declined
Traditional gingival tattooinglips bull Practiced in Africarsquos Sahel region Woddebe
Fulani tribe Senegal Ethiopia middle eastern countries
Perception Reason aesthetic appeal superstition
bull Practices Done when females reach puberty
bull Kanuri females Borno State Nigeria tattooing lip gingiva usually performed thorns of Balanites aegyptiaca (Bukar et al 2004 )
bull Pigments -Mixture charcoal and seeds of Acacia nilotica vartomentosa
Lip plug lip plate
bull The lip plate (lip plug or lip disc) form of body modification
bull Amazonian tribes young males traditionally -rite of passage indicate status and prestige
bull Mursi of Ethiopia girls age 13 to 18
bull At puberty mother cuts her lower lip
bull Held open by a wooden plug - inserted into thereby stretching the lip
bull At times -combined with removal of two or four lower anterior incisal teeth
Lip plug lip plate
TRADITIONAL DENTAL SERVICES
bull Perceptions
Cause of illness determines treatment taken Practices
bull Yoruba community patronize traditional dentists (Oke Bankole et al 2011) Edo state
bull Services rendered include worm extraction tooth extraction drug prescription and offering sacrifices to deities
bull Charges based on the worm count
Northern Nigeria called Serdia Toothache associated with dandruff
Cameroon traditional healers perform atraumatic tooth extraction Agbor et al (2011)
bull Leaves stems of Dichrocephala integrifolia
bull Tooth pulled out fingerssharp instrument
bull No pain Plant has anaesthetic properties
bull Dangers infection sepsis infection with hepatitis B Human Immunodeficiency Virus
bull Jewish Unlikely keep Friday appointment with the dentist for their children
bull Routine appointments on Fridays avoided (Scambler et al )
The traditional healer harvesting the medicinal plant in Cameroon
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J Ethnobiol Ethnomed 2011 715
Tooth extraction by a traditional dentist
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J EthnobiolEthnomed 2011 715
bull Health is a consequence of an individualrsquos lifestyle
bull Essential to Identify cultural factors that are harmful and those that are beneficial
bull As paediatric dentists we should discourage the unhealthy practices through rigorous health education and promote the adoption of healthy practices
bull Need for multicentric research on the cultural influence of the family and peers regarding oral health of children
bull Bankole OO Lawal FB Ibiyemi O (2017) Dispelling myths associated with natalneonatal teeth ldquoAdunnirdquo a health education video in a native Nigerian language Annals of Ibadan Postgraduate Medicine15(2)137-141
Thank you for listening
Remedies for gingival periodontal disease
Remedies Community tribe
Effect
Aluminium phosphate (Alum ) + Lapalapa sap (Jatropha curcas)Warm water and salt Tomato and alum+polystrene foam or cotton woolHydrogen peroxide
Yoruba
Antibiotics NomadiFulani
Resistant strains Hyper sensitivityreactions
Herbs
ORAL HABITS Kola nut chewing
Common West Central Africa Symbol of hospitality Contains caffeine tannin
bull Helps students keep awakewithstand fatigue
Practices
bull One-year prevalence student use was 291 Erinfolami et al (2011)
bull Majority started at age 14 years or below
bull Dangers -insomnia nausea tooth discolourationcarcinogenic potential for development of oral cancer
Areca Nut Chewing Habitbull Areca nut is the seed of areca palm
bull Widely grown- Asia India Bangladesh Japan
bull Believed to help fatigue
bull Highest period of risk for first use is between 5 and 12 Farrand et al 2001
74 4-16 age group in Karachi indulged in the habit (Shah et al 2002)
Dangers Oral sub mucous fibrosis
bull Risk of oral cancer 99 times( Wollina et al 2004 ) Foreign body aspiration Severe tooth wear -- sensitivity root fractures
Mandibular arch with generalized staining in the deciduous dentition
Prajapati D Nayak R Nayak UA Shah PJ Areca nut chewing habit in preschoolers Two rare case reports and literature review Int J Dent Health Concern 201511-5 (Permission given)
Mandibular arch with generalized staining in the deciduous dentition
Prajapati D Nayak R Nayak UA Shah PJ Areca nut chewing habit in preschoolers Two rare case reports and literature review Int J Dent Health Concern 201511-5 (Permission given)
Oral tobacco use and cigar smoking
bull High prevalence tobacco use in any form is reported among school going adolescents aged 13ndash15 years in India (Arora and Reddy 2005) Smoking Chutta is relatively popular may begin in childhood in India
bull Acts as a stimulant euphoric
bull May sleep with tobacco mixture in mouth
Harmful effects halitosis brown black staining gingival recession if wad is held against gingivaleucoplakia oral squamous cell carcinoma
Tobacco use in children
PRACTICES RELATED TO PUBERTY AND GROOMING
Tooth filing tooth sharpening
Practiced -Nigeria Niger-Delta area (Ukeghesonand Akadiri ) Democratic Republic of Congo Thailand Indonesia
bull Perception Historically -spiritual reasons Contemporary times - aesthetic reasons
bull In Nigeria maxillary midline diastema is regarded as a symbol of beauty (Arigbede and Adesuwa 2012
bull Teeth filed- because represent negative emotions eg anger jealousy (Balinese Indonesia)
30 respondents would not mind having artificially created diastema (Omotosho and Kadri (2010)
Practices
bull Done in adolescence - fashionable
bull Manually done Usually incisors
Harmful effects
bull pain during process
bull Tooth discolouration (teeth -non vital)
bull Infection -pus discharge lip swelling
Tooth filing
Peri-apical x-ray of lower central incisor
Lacquering and staining of teethPerformed in Vietnam Laos Thailand Indonesia and Philippines
Perception For cosmetic reasons
bull Main ingredient dye dark-brown solution of ferric acetate called kanemizu (iron filings in vinegar)
bull Coating the teeth with this liquid helped to prevent tooth decay and enamel decay
bull Practice has slowly declined
Traditional gingival tattooinglips bull Practiced in Africarsquos Sahel region Woddebe
Fulani tribe Senegal Ethiopia middle eastern countries
Perception Reason aesthetic appeal superstition
bull Practices Done when females reach puberty
bull Kanuri females Borno State Nigeria tattooing lip gingiva usually performed thorns of Balanites aegyptiaca (Bukar et al 2004 )
bull Pigments -Mixture charcoal and seeds of Acacia nilotica vartomentosa
Lip plug lip plate
bull The lip plate (lip plug or lip disc) form of body modification
bull Amazonian tribes young males traditionally -rite of passage indicate status and prestige
bull Mursi of Ethiopia girls age 13 to 18
bull At puberty mother cuts her lower lip
bull Held open by a wooden plug - inserted into thereby stretching the lip
bull At times -combined with removal of two or four lower anterior incisal teeth
Lip plug lip plate
TRADITIONAL DENTAL SERVICES
bull Perceptions
Cause of illness determines treatment taken Practices
bull Yoruba community patronize traditional dentists (Oke Bankole et al 2011) Edo state
bull Services rendered include worm extraction tooth extraction drug prescription and offering sacrifices to deities
bull Charges based on the worm count
Northern Nigeria called Serdia Toothache associated with dandruff
Cameroon traditional healers perform atraumatic tooth extraction Agbor et al (2011)
bull Leaves stems of Dichrocephala integrifolia
bull Tooth pulled out fingerssharp instrument
bull No pain Plant has anaesthetic properties
bull Dangers infection sepsis infection with hepatitis B Human Immunodeficiency Virus
bull Jewish Unlikely keep Friday appointment with the dentist for their children
bull Routine appointments on Fridays avoided (Scambler et al )
The traditional healer harvesting the medicinal plant in Cameroon
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J Ethnobiol Ethnomed 2011 715
Tooth extraction by a traditional dentist
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J EthnobiolEthnomed 2011 715
bull Health is a consequence of an individualrsquos lifestyle
bull Essential to Identify cultural factors that are harmful and those that are beneficial
bull As paediatric dentists we should discourage the unhealthy practices through rigorous health education and promote the adoption of healthy practices
bull Need for multicentric research on the cultural influence of the family and peers regarding oral health of children
bull Bankole OO Lawal FB Ibiyemi O (2017) Dispelling myths associated with natalneonatal teeth ldquoAdunnirdquo a health education video in a native Nigerian language Annals of Ibadan Postgraduate Medicine15(2)137-141
Thank you for listening
ORAL HABITS Kola nut chewing
Common West Central Africa Symbol of hospitality Contains caffeine tannin
bull Helps students keep awakewithstand fatigue
Practices
bull One-year prevalence student use was 291 Erinfolami et al (2011)
bull Majority started at age 14 years or below
bull Dangers -insomnia nausea tooth discolourationcarcinogenic potential for development of oral cancer
Areca Nut Chewing Habitbull Areca nut is the seed of areca palm
bull Widely grown- Asia India Bangladesh Japan
bull Believed to help fatigue
bull Highest period of risk for first use is between 5 and 12 Farrand et al 2001
74 4-16 age group in Karachi indulged in the habit (Shah et al 2002)
Dangers Oral sub mucous fibrosis
bull Risk of oral cancer 99 times( Wollina et al 2004 ) Foreign body aspiration Severe tooth wear -- sensitivity root fractures
Mandibular arch with generalized staining in the deciduous dentition
Prajapati D Nayak R Nayak UA Shah PJ Areca nut chewing habit in preschoolers Two rare case reports and literature review Int J Dent Health Concern 201511-5 (Permission given)
Mandibular arch with generalized staining in the deciduous dentition
Prajapati D Nayak R Nayak UA Shah PJ Areca nut chewing habit in preschoolers Two rare case reports and literature review Int J Dent Health Concern 201511-5 (Permission given)
Oral tobacco use and cigar smoking
bull High prevalence tobacco use in any form is reported among school going adolescents aged 13ndash15 years in India (Arora and Reddy 2005) Smoking Chutta is relatively popular may begin in childhood in India
bull Acts as a stimulant euphoric
bull May sleep with tobacco mixture in mouth
Harmful effects halitosis brown black staining gingival recession if wad is held against gingivaleucoplakia oral squamous cell carcinoma
Tobacco use in children
PRACTICES RELATED TO PUBERTY AND GROOMING
Tooth filing tooth sharpening
Practiced -Nigeria Niger-Delta area (Ukeghesonand Akadiri ) Democratic Republic of Congo Thailand Indonesia
bull Perception Historically -spiritual reasons Contemporary times - aesthetic reasons
bull In Nigeria maxillary midline diastema is regarded as a symbol of beauty (Arigbede and Adesuwa 2012
bull Teeth filed- because represent negative emotions eg anger jealousy (Balinese Indonesia)
30 respondents would not mind having artificially created diastema (Omotosho and Kadri (2010)
Practices
bull Done in adolescence - fashionable
bull Manually done Usually incisors
Harmful effects
bull pain during process
bull Tooth discolouration (teeth -non vital)
bull Infection -pus discharge lip swelling
Tooth filing
Peri-apical x-ray of lower central incisor
Lacquering and staining of teethPerformed in Vietnam Laos Thailand Indonesia and Philippines
Perception For cosmetic reasons
bull Main ingredient dye dark-brown solution of ferric acetate called kanemizu (iron filings in vinegar)
bull Coating the teeth with this liquid helped to prevent tooth decay and enamel decay
bull Practice has slowly declined
Traditional gingival tattooinglips bull Practiced in Africarsquos Sahel region Woddebe
Fulani tribe Senegal Ethiopia middle eastern countries
Perception Reason aesthetic appeal superstition
bull Practices Done when females reach puberty
bull Kanuri females Borno State Nigeria tattooing lip gingiva usually performed thorns of Balanites aegyptiaca (Bukar et al 2004 )
bull Pigments -Mixture charcoal and seeds of Acacia nilotica vartomentosa
Lip plug lip plate
bull The lip plate (lip plug or lip disc) form of body modification
bull Amazonian tribes young males traditionally -rite of passage indicate status and prestige
bull Mursi of Ethiopia girls age 13 to 18
bull At puberty mother cuts her lower lip
bull Held open by a wooden plug - inserted into thereby stretching the lip
bull At times -combined with removal of two or four lower anterior incisal teeth
Lip plug lip plate
TRADITIONAL DENTAL SERVICES
bull Perceptions
Cause of illness determines treatment taken Practices
bull Yoruba community patronize traditional dentists (Oke Bankole et al 2011) Edo state
bull Services rendered include worm extraction tooth extraction drug prescription and offering sacrifices to deities
bull Charges based on the worm count
Northern Nigeria called Serdia Toothache associated with dandruff
Cameroon traditional healers perform atraumatic tooth extraction Agbor et al (2011)
bull Leaves stems of Dichrocephala integrifolia
bull Tooth pulled out fingerssharp instrument
bull No pain Plant has anaesthetic properties
bull Dangers infection sepsis infection with hepatitis B Human Immunodeficiency Virus
bull Jewish Unlikely keep Friday appointment with the dentist for their children
bull Routine appointments on Fridays avoided (Scambler et al )
The traditional healer harvesting the medicinal plant in Cameroon
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J Ethnobiol Ethnomed 2011 715
Tooth extraction by a traditional dentist
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J EthnobiolEthnomed 2011 715
bull Health is a consequence of an individualrsquos lifestyle
bull Essential to Identify cultural factors that are harmful and those that are beneficial
bull As paediatric dentists we should discourage the unhealthy practices through rigorous health education and promote the adoption of healthy practices
bull Need for multicentric research on the cultural influence of the family and peers regarding oral health of children
bull Bankole OO Lawal FB Ibiyemi O (2017) Dispelling myths associated with natalneonatal teeth ldquoAdunnirdquo a health education video in a native Nigerian language Annals of Ibadan Postgraduate Medicine15(2)137-141
Thank you for listening
Areca Nut Chewing Habitbull Areca nut is the seed of areca palm
bull Widely grown- Asia India Bangladesh Japan
bull Believed to help fatigue
bull Highest period of risk for first use is between 5 and 12 Farrand et al 2001
74 4-16 age group in Karachi indulged in the habit (Shah et al 2002)
Dangers Oral sub mucous fibrosis
bull Risk of oral cancer 99 times( Wollina et al 2004 ) Foreign body aspiration Severe tooth wear -- sensitivity root fractures
Mandibular arch with generalized staining in the deciduous dentition
Prajapati D Nayak R Nayak UA Shah PJ Areca nut chewing habit in preschoolers Two rare case reports and literature review Int J Dent Health Concern 201511-5 (Permission given)
Mandibular arch with generalized staining in the deciduous dentition
Prajapati D Nayak R Nayak UA Shah PJ Areca nut chewing habit in preschoolers Two rare case reports and literature review Int J Dent Health Concern 201511-5 (Permission given)
Oral tobacco use and cigar smoking
bull High prevalence tobacco use in any form is reported among school going adolescents aged 13ndash15 years in India (Arora and Reddy 2005) Smoking Chutta is relatively popular may begin in childhood in India
bull Acts as a stimulant euphoric
bull May sleep with tobacco mixture in mouth
Harmful effects halitosis brown black staining gingival recession if wad is held against gingivaleucoplakia oral squamous cell carcinoma
Tobacco use in children
PRACTICES RELATED TO PUBERTY AND GROOMING
Tooth filing tooth sharpening
Practiced -Nigeria Niger-Delta area (Ukeghesonand Akadiri ) Democratic Republic of Congo Thailand Indonesia
bull Perception Historically -spiritual reasons Contemporary times - aesthetic reasons
bull In Nigeria maxillary midline diastema is regarded as a symbol of beauty (Arigbede and Adesuwa 2012
bull Teeth filed- because represent negative emotions eg anger jealousy (Balinese Indonesia)
30 respondents would not mind having artificially created diastema (Omotosho and Kadri (2010)
Practices
bull Done in adolescence - fashionable
bull Manually done Usually incisors
Harmful effects
bull pain during process
bull Tooth discolouration (teeth -non vital)
bull Infection -pus discharge lip swelling
Tooth filing
Peri-apical x-ray of lower central incisor
Lacquering and staining of teethPerformed in Vietnam Laos Thailand Indonesia and Philippines
Perception For cosmetic reasons
bull Main ingredient dye dark-brown solution of ferric acetate called kanemizu (iron filings in vinegar)
bull Coating the teeth with this liquid helped to prevent tooth decay and enamel decay
bull Practice has slowly declined
Traditional gingival tattooinglips bull Practiced in Africarsquos Sahel region Woddebe
Fulani tribe Senegal Ethiopia middle eastern countries
Perception Reason aesthetic appeal superstition
bull Practices Done when females reach puberty
bull Kanuri females Borno State Nigeria tattooing lip gingiva usually performed thorns of Balanites aegyptiaca (Bukar et al 2004 )
bull Pigments -Mixture charcoal and seeds of Acacia nilotica vartomentosa
Lip plug lip plate
bull The lip plate (lip plug or lip disc) form of body modification
bull Amazonian tribes young males traditionally -rite of passage indicate status and prestige
bull Mursi of Ethiopia girls age 13 to 18
bull At puberty mother cuts her lower lip
bull Held open by a wooden plug - inserted into thereby stretching the lip
bull At times -combined with removal of two or four lower anterior incisal teeth
Lip plug lip plate
TRADITIONAL DENTAL SERVICES
bull Perceptions
Cause of illness determines treatment taken Practices
bull Yoruba community patronize traditional dentists (Oke Bankole et al 2011) Edo state
bull Services rendered include worm extraction tooth extraction drug prescription and offering sacrifices to deities
bull Charges based on the worm count
Northern Nigeria called Serdia Toothache associated with dandruff
Cameroon traditional healers perform atraumatic tooth extraction Agbor et al (2011)
bull Leaves stems of Dichrocephala integrifolia
bull Tooth pulled out fingerssharp instrument
bull No pain Plant has anaesthetic properties
bull Dangers infection sepsis infection with hepatitis B Human Immunodeficiency Virus
bull Jewish Unlikely keep Friday appointment with the dentist for their children
bull Routine appointments on Fridays avoided (Scambler et al )
The traditional healer harvesting the medicinal plant in Cameroon
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J Ethnobiol Ethnomed 2011 715
Tooth extraction by a traditional dentist
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J EthnobiolEthnomed 2011 715
bull Health is a consequence of an individualrsquos lifestyle
bull Essential to Identify cultural factors that are harmful and those that are beneficial
bull As paediatric dentists we should discourage the unhealthy practices through rigorous health education and promote the adoption of healthy practices
bull Need for multicentric research on the cultural influence of the family and peers regarding oral health of children
bull Bankole OO Lawal FB Ibiyemi O (2017) Dispelling myths associated with natalneonatal teeth ldquoAdunnirdquo a health education video in a native Nigerian language Annals of Ibadan Postgraduate Medicine15(2)137-141
Thank you for listening
Mandibular arch with generalized staining in the deciduous dentition
Prajapati D Nayak R Nayak UA Shah PJ Areca nut chewing habit in preschoolers Two rare case reports and literature review Int J Dent Health Concern 201511-5 (Permission given)
Mandibular arch with generalized staining in the deciduous dentition
Prajapati D Nayak R Nayak UA Shah PJ Areca nut chewing habit in preschoolers Two rare case reports and literature review Int J Dent Health Concern 201511-5 (Permission given)
Oral tobacco use and cigar smoking
bull High prevalence tobacco use in any form is reported among school going adolescents aged 13ndash15 years in India (Arora and Reddy 2005) Smoking Chutta is relatively popular may begin in childhood in India
bull Acts as a stimulant euphoric
bull May sleep with tobacco mixture in mouth
Harmful effects halitosis brown black staining gingival recession if wad is held against gingivaleucoplakia oral squamous cell carcinoma
Tobacco use in children
PRACTICES RELATED TO PUBERTY AND GROOMING
Tooth filing tooth sharpening
Practiced -Nigeria Niger-Delta area (Ukeghesonand Akadiri ) Democratic Republic of Congo Thailand Indonesia
bull Perception Historically -spiritual reasons Contemporary times - aesthetic reasons
bull In Nigeria maxillary midline diastema is regarded as a symbol of beauty (Arigbede and Adesuwa 2012
bull Teeth filed- because represent negative emotions eg anger jealousy (Balinese Indonesia)
30 respondents would not mind having artificially created diastema (Omotosho and Kadri (2010)
Practices
bull Done in adolescence - fashionable
bull Manually done Usually incisors
Harmful effects
bull pain during process
bull Tooth discolouration (teeth -non vital)
bull Infection -pus discharge lip swelling
Tooth filing
Peri-apical x-ray of lower central incisor
Lacquering and staining of teethPerformed in Vietnam Laos Thailand Indonesia and Philippines
Perception For cosmetic reasons
bull Main ingredient dye dark-brown solution of ferric acetate called kanemizu (iron filings in vinegar)
bull Coating the teeth with this liquid helped to prevent tooth decay and enamel decay
bull Practice has slowly declined
Traditional gingival tattooinglips bull Practiced in Africarsquos Sahel region Woddebe
Fulani tribe Senegal Ethiopia middle eastern countries
Perception Reason aesthetic appeal superstition
bull Practices Done when females reach puberty
bull Kanuri females Borno State Nigeria tattooing lip gingiva usually performed thorns of Balanites aegyptiaca (Bukar et al 2004 )
bull Pigments -Mixture charcoal and seeds of Acacia nilotica vartomentosa
Lip plug lip plate
bull The lip plate (lip plug or lip disc) form of body modification
bull Amazonian tribes young males traditionally -rite of passage indicate status and prestige
bull Mursi of Ethiopia girls age 13 to 18
bull At puberty mother cuts her lower lip
bull Held open by a wooden plug - inserted into thereby stretching the lip
bull At times -combined with removal of two or four lower anterior incisal teeth
Lip plug lip plate
TRADITIONAL DENTAL SERVICES
bull Perceptions
Cause of illness determines treatment taken Practices
bull Yoruba community patronize traditional dentists (Oke Bankole et al 2011) Edo state
bull Services rendered include worm extraction tooth extraction drug prescription and offering sacrifices to deities
bull Charges based on the worm count
Northern Nigeria called Serdia Toothache associated with dandruff
Cameroon traditional healers perform atraumatic tooth extraction Agbor et al (2011)
bull Leaves stems of Dichrocephala integrifolia
bull Tooth pulled out fingerssharp instrument
bull No pain Plant has anaesthetic properties
bull Dangers infection sepsis infection with hepatitis B Human Immunodeficiency Virus
bull Jewish Unlikely keep Friday appointment with the dentist for their children
bull Routine appointments on Fridays avoided (Scambler et al )
The traditional healer harvesting the medicinal plant in Cameroon
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J Ethnobiol Ethnomed 2011 715
Tooth extraction by a traditional dentist
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J EthnobiolEthnomed 2011 715
bull Health is a consequence of an individualrsquos lifestyle
bull Essential to Identify cultural factors that are harmful and those that are beneficial
bull As paediatric dentists we should discourage the unhealthy practices through rigorous health education and promote the adoption of healthy practices
bull Need for multicentric research on the cultural influence of the family and peers regarding oral health of children
bull Bankole OO Lawal FB Ibiyemi O (2017) Dispelling myths associated with natalneonatal teeth ldquoAdunnirdquo a health education video in a native Nigerian language Annals of Ibadan Postgraduate Medicine15(2)137-141
Thank you for listening
Mandibular arch with generalized staining in the deciduous dentition
Prajapati D Nayak R Nayak UA Shah PJ Areca nut chewing habit in preschoolers Two rare case reports and literature review Int J Dent Health Concern 201511-5 (Permission given)
Oral tobacco use and cigar smoking
bull High prevalence tobacco use in any form is reported among school going adolescents aged 13ndash15 years in India (Arora and Reddy 2005) Smoking Chutta is relatively popular may begin in childhood in India
bull Acts as a stimulant euphoric
bull May sleep with tobacco mixture in mouth
Harmful effects halitosis brown black staining gingival recession if wad is held against gingivaleucoplakia oral squamous cell carcinoma
Tobacco use in children
PRACTICES RELATED TO PUBERTY AND GROOMING
Tooth filing tooth sharpening
Practiced -Nigeria Niger-Delta area (Ukeghesonand Akadiri ) Democratic Republic of Congo Thailand Indonesia
bull Perception Historically -spiritual reasons Contemporary times - aesthetic reasons
bull In Nigeria maxillary midline diastema is regarded as a symbol of beauty (Arigbede and Adesuwa 2012
bull Teeth filed- because represent negative emotions eg anger jealousy (Balinese Indonesia)
30 respondents would not mind having artificially created diastema (Omotosho and Kadri (2010)
Practices
bull Done in adolescence - fashionable
bull Manually done Usually incisors
Harmful effects
bull pain during process
bull Tooth discolouration (teeth -non vital)
bull Infection -pus discharge lip swelling
Tooth filing
Peri-apical x-ray of lower central incisor
Lacquering and staining of teethPerformed in Vietnam Laos Thailand Indonesia and Philippines
Perception For cosmetic reasons
bull Main ingredient dye dark-brown solution of ferric acetate called kanemizu (iron filings in vinegar)
bull Coating the teeth with this liquid helped to prevent tooth decay and enamel decay
bull Practice has slowly declined
Traditional gingival tattooinglips bull Practiced in Africarsquos Sahel region Woddebe
Fulani tribe Senegal Ethiopia middle eastern countries
Perception Reason aesthetic appeal superstition
bull Practices Done when females reach puberty
bull Kanuri females Borno State Nigeria tattooing lip gingiva usually performed thorns of Balanites aegyptiaca (Bukar et al 2004 )
bull Pigments -Mixture charcoal and seeds of Acacia nilotica vartomentosa
Lip plug lip plate
bull The lip plate (lip plug or lip disc) form of body modification
bull Amazonian tribes young males traditionally -rite of passage indicate status and prestige
bull Mursi of Ethiopia girls age 13 to 18
bull At puberty mother cuts her lower lip
bull Held open by a wooden plug - inserted into thereby stretching the lip
bull At times -combined with removal of two or four lower anterior incisal teeth
Lip plug lip plate
TRADITIONAL DENTAL SERVICES
bull Perceptions
Cause of illness determines treatment taken Practices
bull Yoruba community patronize traditional dentists (Oke Bankole et al 2011) Edo state
bull Services rendered include worm extraction tooth extraction drug prescription and offering sacrifices to deities
bull Charges based on the worm count
Northern Nigeria called Serdia Toothache associated with dandruff
Cameroon traditional healers perform atraumatic tooth extraction Agbor et al (2011)
bull Leaves stems of Dichrocephala integrifolia
bull Tooth pulled out fingerssharp instrument
bull No pain Plant has anaesthetic properties
bull Dangers infection sepsis infection with hepatitis B Human Immunodeficiency Virus
bull Jewish Unlikely keep Friday appointment with the dentist for their children
bull Routine appointments on Fridays avoided (Scambler et al )
The traditional healer harvesting the medicinal plant in Cameroon
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J Ethnobiol Ethnomed 2011 715
Tooth extraction by a traditional dentist
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J EthnobiolEthnomed 2011 715
bull Health is a consequence of an individualrsquos lifestyle
bull Essential to Identify cultural factors that are harmful and those that are beneficial
bull As paediatric dentists we should discourage the unhealthy practices through rigorous health education and promote the adoption of healthy practices
bull Need for multicentric research on the cultural influence of the family and peers regarding oral health of children
bull Bankole OO Lawal FB Ibiyemi O (2017) Dispelling myths associated with natalneonatal teeth ldquoAdunnirdquo a health education video in a native Nigerian language Annals of Ibadan Postgraduate Medicine15(2)137-141
Thank you for listening
Oral tobacco use and cigar smoking
bull High prevalence tobacco use in any form is reported among school going adolescents aged 13ndash15 years in India (Arora and Reddy 2005) Smoking Chutta is relatively popular may begin in childhood in India
bull Acts as a stimulant euphoric
bull May sleep with tobacco mixture in mouth
Harmful effects halitosis brown black staining gingival recession if wad is held against gingivaleucoplakia oral squamous cell carcinoma
Tobacco use in children
PRACTICES RELATED TO PUBERTY AND GROOMING
Tooth filing tooth sharpening
Practiced -Nigeria Niger-Delta area (Ukeghesonand Akadiri ) Democratic Republic of Congo Thailand Indonesia
bull Perception Historically -spiritual reasons Contemporary times - aesthetic reasons
bull In Nigeria maxillary midline diastema is regarded as a symbol of beauty (Arigbede and Adesuwa 2012
bull Teeth filed- because represent negative emotions eg anger jealousy (Balinese Indonesia)
30 respondents would not mind having artificially created diastema (Omotosho and Kadri (2010)
Practices
bull Done in adolescence - fashionable
bull Manually done Usually incisors
Harmful effects
bull pain during process
bull Tooth discolouration (teeth -non vital)
bull Infection -pus discharge lip swelling
Tooth filing
Peri-apical x-ray of lower central incisor
Lacquering and staining of teethPerformed in Vietnam Laos Thailand Indonesia and Philippines
Perception For cosmetic reasons
bull Main ingredient dye dark-brown solution of ferric acetate called kanemizu (iron filings in vinegar)
bull Coating the teeth with this liquid helped to prevent tooth decay and enamel decay
bull Practice has slowly declined
Traditional gingival tattooinglips bull Practiced in Africarsquos Sahel region Woddebe
Fulani tribe Senegal Ethiopia middle eastern countries
Perception Reason aesthetic appeal superstition
bull Practices Done when females reach puberty
bull Kanuri females Borno State Nigeria tattooing lip gingiva usually performed thorns of Balanites aegyptiaca (Bukar et al 2004 )
bull Pigments -Mixture charcoal and seeds of Acacia nilotica vartomentosa
Lip plug lip plate
bull The lip plate (lip plug or lip disc) form of body modification
bull Amazonian tribes young males traditionally -rite of passage indicate status and prestige
bull Mursi of Ethiopia girls age 13 to 18
bull At puberty mother cuts her lower lip
bull Held open by a wooden plug - inserted into thereby stretching the lip
bull At times -combined with removal of two or four lower anterior incisal teeth
Lip plug lip plate
TRADITIONAL DENTAL SERVICES
bull Perceptions
Cause of illness determines treatment taken Practices
bull Yoruba community patronize traditional dentists (Oke Bankole et al 2011) Edo state
bull Services rendered include worm extraction tooth extraction drug prescription and offering sacrifices to deities
bull Charges based on the worm count
Northern Nigeria called Serdia Toothache associated with dandruff
Cameroon traditional healers perform atraumatic tooth extraction Agbor et al (2011)
bull Leaves stems of Dichrocephala integrifolia
bull Tooth pulled out fingerssharp instrument
bull No pain Plant has anaesthetic properties
bull Dangers infection sepsis infection with hepatitis B Human Immunodeficiency Virus
bull Jewish Unlikely keep Friday appointment with the dentist for their children
bull Routine appointments on Fridays avoided (Scambler et al )
The traditional healer harvesting the medicinal plant in Cameroon
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J Ethnobiol Ethnomed 2011 715
Tooth extraction by a traditional dentist
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J EthnobiolEthnomed 2011 715
bull Health is a consequence of an individualrsquos lifestyle
bull Essential to Identify cultural factors that are harmful and those that are beneficial
bull As paediatric dentists we should discourage the unhealthy practices through rigorous health education and promote the adoption of healthy practices
bull Need for multicentric research on the cultural influence of the family and peers regarding oral health of children
bull Bankole OO Lawal FB Ibiyemi O (2017) Dispelling myths associated with natalneonatal teeth ldquoAdunnirdquo a health education video in a native Nigerian language Annals of Ibadan Postgraduate Medicine15(2)137-141
Thank you for listening
Tobacco use in children
PRACTICES RELATED TO PUBERTY AND GROOMING
Tooth filing tooth sharpening
Practiced -Nigeria Niger-Delta area (Ukeghesonand Akadiri ) Democratic Republic of Congo Thailand Indonesia
bull Perception Historically -spiritual reasons Contemporary times - aesthetic reasons
bull In Nigeria maxillary midline diastema is regarded as a symbol of beauty (Arigbede and Adesuwa 2012
bull Teeth filed- because represent negative emotions eg anger jealousy (Balinese Indonesia)
30 respondents would not mind having artificially created diastema (Omotosho and Kadri (2010)
Practices
bull Done in adolescence - fashionable
bull Manually done Usually incisors
Harmful effects
bull pain during process
bull Tooth discolouration (teeth -non vital)
bull Infection -pus discharge lip swelling
Tooth filing
Peri-apical x-ray of lower central incisor
Lacquering and staining of teethPerformed in Vietnam Laos Thailand Indonesia and Philippines
Perception For cosmetic reasons
bull Main ingredient dye dark-brown solution of ferric acetate called kanemizu (iron filings in vinegar)
bull Coating the teeth with this liquid helped to prevent tooth decay and enamel decay
bull Practice has slowly declined
Traditional gingival tattooinglips bull Practiced in Africarsquos Sahel region Woddebe
Fulani tribe Senegal Ethiopia middle eastern countries
Perception Reason aesthetic appeal superstition
bull Practices Done when females reach puberty
bull Kanuri females Borno State Nigeria tattooing lip gingiva usually performed thorns of Balanites aegyptiaca (Bukar et al 2004 )
bull Pigments -Mixture charcoal and seeds of Acacia nilotica vartomentosa
Lip plug lip plate
bull The lip plate (lip plug or lip disc) form of body modification
bull Amazonian tribes young males traditionally -rite of passage indicate status and prestige
bull Mursi of Ethiopia girls age 13 to 18
bull At puberty mother cuts her lower lip
bull Held open by a wooden plug - inserted into thereby stretching the lip
bull At times -combined with removal of two or four lower anterior incisal teeth
Lip plug lip plate
TRADITIONAL DENTAL SERVICES
bull Perceptions
Cause of illness determines treatment taken Practices
bull Yoruba community patronize traditional dentists (Oke Bankole et al 2011) Edo state
bull Services rendered include worm extraction tooth extraction drug prescription and offering sacrifices to deities
bull Charges based on the worm count
Northern Nigeria called Serdia Toothache associated with dandruff
Cameroon traditional healers perform atraumatic tooth extraction Agbor et al (2011)
bull Leaves stems of Dichrocephala integrifolia
bull Tooth pulled out fingerssharp instrument
bull No pain Plant has anaesthetic properties
bull Dangers infection sepsis infection with hepatitis B Human Immunodeficiency Virus
bull Jewish Unlikely keep Friday appointment with the dentist for their children
bull Routine appointments on Fridays avoided (Scambler et al )
The traditional healer harvesting the medicinal plant in Cameroon
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J Ethnobiol Ethnomed 2011 715
Tooth extraction by a traditional dentist
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J EthnobiolEthnomed 2011 715
bull Health is a consequence of an individualrsquos lifestyle
bull Essential to Identify cultural factors that are harmful and those that are beneficial
bull As paediatric dentists we should discourage the unhealthy practices through rigorous health education and promote the adoption of healthy practices
bull Need for multicentric research on the cultural influence of the family and peers regarding oral health of children
bull Bankole OO Lawal FB Ibiyemi O (2017) Dispelling myths associated with natalneonatal teeth ldquoAdunnirdquo a health education video in a native Nigerian language Annals of Ibadan Postgraduate Medicine15(2)137-141
Thank you for listening
PRACTICES RELATED TO PUBERTY AND GROOMING
Tooth filing tooth sharpening
Practiced -Nigeria Niger-Delta area (Ukeghesonand Akadiri ) Democratic Republic of Congo Thailand Indonesia
bull Perception Historically -spiritual reasons Contemporary times - aesthetic reasons
bull In Nigeria maxillary midline diastema is regarded as a symbol of beauty (Arigbede and Adesuwa 2012
bull Teeth filed- because represent negative emotions eg anger jealousy (Balinese Indonesia)
30 respondents would not mind having artificially created diastema (Omotosho and Kadri (2010)
Practices
bull Done in adolescence - fashionable
bull Manually done Usually incisors
Harmful effects
bull pain during process
bull Tooth discolouration (teeth -non vital)
bull Infection -pus discharge lip swelling
Tooth filing
Peri-apical x-ray of lower central incisor
Lacquering and staining of teethPerformed in Vietnam Laos Thailand Indonesia and Philippines
Perception For cosmetic reasons
bull Main ingredient dye dark-brown solution of ferric acetate called kanemizu (iron filings in vinegar)
bull Coating the teeth with this liquid helped to prevent tooth decay and enamel decay
bull Practice has slowly declined
Traditional gingival tattooinglips bull Practiced in Africarsquos Sahel region Woddebe
Fulani tribe Senegal Ethiopia middle eastern countries
Perception Reason aesthetic appeal superstition
bull Practices Done when females reach puberty
bull Kanuri females Borno State Nigeria tattooing lip gingiva usually performed thorns of Balanites aegyptiaca (Bukar et al 2004 )
bull Pigments -Mixture charcoal and seeds of Acacia nilotica vartomentosa
Lip plug lip plate
bull The lip plate (lip plug or lip disc) form of body modification
bull Amazonian tribes young males traditionally -rite of passage indicate status and prestige
bull Mursi of Ethiopia girls age 13 to 18
bull At puberty mother cuts her lower lip
bull Held open by a wooden plug - inserted into thereby stretching the lip
bull At times -combined with removal of two or four lower anterior incisal teeth
Lip plug lip plate
TRADITIONAL DENTAL SERVICES
bull Perceptions
Cause of illness determines treatment taken Practices
bull Yoruba community patronize traditional dentists (Oke Bankole et al 2011) Edo state
bull Services rendered include worm extraction tooth extraction drug prescription and offering sacrifices to deities
bull Charges based on the worm count
Northern Nigeria called Serdia Toothache associated with dandruff
Cameroon traditional healers perform atraumatic tooth extraction Agbor et al (2011)
bull Leaves stems of Dichrocephala integrifolia
bull Tooth pulled out fingerssharp instrument
bull No pain Plant has anaesthetic properties
bull Dangers infection sepsis infection with hepatitis B Human Immunodeficiency Virus
bull Jewish Unlikely keep Friday appointment with the dentist for their children
bull Routine appointments on Fridays avoided (Scambler et al )
The traditional healer harvesting the medicinal plant in Cameroon
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J Ethnobiol Ethnomed 2011 715
Tooth extraction by a traditional dentist
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J EthnobiolEthnomed 2011 715
bull Health is a consequence of an individualrsquos lifestyle
bull Essential to Identify cultural factors that are harmful and those that are beneficial
bull As paediatric dentists we should discourage the unhealthy practices through rigorous health education and promote the adoption of healthy practices
bull Need for multicentric research on the cultural influence of the family and peers regarding oral health of children
bull Bankole OO Lawal FB Ibiyemi O (2017) Dispelling myths associated with natalneonatal teeth ldquoAdunnirdquo a health education video in a native Nigerian language Annals of Ibadan Postgraduate Medicine15(2)137-141
Thank you for listening
30 respondents would not mind having artificially created diastema (Omotosho and Kadri (2010)
Practices
bull Done in adolescence - fashionable
bull Manually done Usually incisors
Harmful effects
bull pain during process
bull Tooth discolouration (teeth -non vital)
bull Infection -pus discharge lip swelling
Tooth filing
Peri-apical x-ray of lower central incisor
Lacquering and staining of teethPerformed in Vietnam Laos Thailand Indonesia and Philippines
Perception For cosmetic reasons
bull Main ingredient dye dark-brown solution of ferric acetate called kanemizu (iron filings in vinegar)
bull Coating the teeth with this liquid helped to prevent tooth decay and enamel decay
bull Practice has slowly declined
Traditional gingival tattooinglips bull Practiced in Africarsquos Sahel region Woddebe
Fulani tribe Senegal Ethiopia middle eastern countries
Perception Reason aesthetic appeal superstition
bull Practices Done when females reach puberty
bull Kanuri females Borno State Nigeria tattooing lip gingiva usually performed thorns of Balanites aegyptiaca (Bukar et al 2004 )
bull Pigments -Mixture charcoal and seeds of Acacia nilotica vartomentosa
Lip plug lip plate
bull The lip plate (lip plug or lip disc) form of body modification
bull Amazonian tribes young males traditionally -rite of passage indicate status and prestige
bull Mursi of Ethiopia girls age 13 to 18
bull At puberty mother cuts her lower lip
bull Held open by a wooden plug - inserted into thereby stretching the lip
bull At times -combined with removal of two or four lower anterior incisal teeth
Lip plug lip plate
TRADITIONAL DENTAL SERVICES
bull Perceptions
Cause of illness determines treatment taken Practices
bull Yoruba community patronize traditional dentists (Oke Bankole et al 2011) Edo state
bull Services rendered include worm extraction tooth extraction drug prescription and offering sacrifices to deities
bull Charges based on the worm count
Northern Nigeria called Serdia Toothache associated with dandruff
Cameroon traditional healers perform atraumatic tooth extraction Agbor et al (2011)
bull Leaves stems of Dichrocephala integrifolia
bull Tooth pulled out fingerssharp instrument
bull No pain Plant has anaesthetic properties
bull Dangers infection sepsis infection with hepatitis B Human Immunodeficiency Virus
bull Jewish Unlikely keep Friday appointment with the dentist for their children
bull Routine appointments on Fridays avoided (Scambler et al )
The traditional healer harvesting the medicinal plant in Cameroon
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J Ethnobiol Ethnomed 2011 715
Tooth extraction by a traditional dentist
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J EthnobiolEthnomed 2011 715
bull Health is a consequence of an individualrsquos lifestyle
bull Essential to Identify cultural factors that are harmful and those that are beneficial
bull As paediatric dentists we should discourage the unhealthy practices through rigorous health education and promote the adoption of healthy practices
bull Need for multicentric research on the cultural influence of the family and peers regarding oral health of children
bull Bankole OO Lawal FB Ibiyemi O (2017) Dispelling myths associated with natalneonatal teeth ldquoAdunnirdquo a health education video in a native Nigerian language Annals of Ibadan Postgraduate Medicine15(2)137-141
Thank you for listening
Tooth filing
Peri-apical x-ray of lower central incisor
Lacquering and staining of teethPerformed in Vietnam Laos Thailand Indonesia and Philippines
Perception For cosmetic reasons
bull Main ingredient dye dark-brown solution of ferric acetate called kanemizu (iron filings in vinegar)
bull Coating the teeth with this liquid helped to prevent tooth decay and enamel decay
bull Practice has slowly declined
Traditional gingival tattooinglips bull Practiced in Africarsquos Sahel region Woddebe
Fulani tribe Senegal Ethiopia middle eastern countries
Perception Reason aesthetic appeal superstition
bull Practices Done when females reach puberty
bull Kanuri females Borno State Nigeria tattooing lip gingiva usually performed thorns of Balanites aegyptiaca (Bukar et al 2004 )
bull Pigments -Mixture charcoal and seeds of Acacia nilotica vartomentosa
Lip plug lip plate
bull The lip plate (lip plug or lip disc) form of body modification
bull Amazonian tribes young males traditionally -rite of passage indicate status and prestige
bull Mursi of Ethiopia girls age 13 to 18
bull At puberty mother cuts her lower lip
bull Held open by a wooden plug - inserted into thereby stretching the lip
bull At times -combined with removal of two or four lower anterior incisal teeth
Lip plug lip plate
TRADITIONAL DENTAL SERVICES
bull Perceptions
Cause of illness determines treatment taken Practices
bull Yoruba community patronize traditional dentists (Oke Bankole et al 2011) Edo state
bull Services rendered include worm extraction tooth extraction drug prescription and offering sacrifices to deities
bull Charges based on the worm count
Northern Nigeria called Serdia Toothache associated with dandruff
Cameroon traditional healers perform atraumatic tooth extraction Agbor et al (2011)
bull Leaves stems of Dichrocephala integrifolia
bull Tooth pulled out fingerssharp instrument
bull No pain Plant has anaesthetic properties
bull Dangers infection sepsis infection with hepatitis B Human Immunodeficiency Virus
bull Jewish Unlikely keep Friday appointment with the dentist for their children
bull Routine appointments on Fridays avoided (Scambler et al )
The traditional healer harvesting the medicinal plant in Cameroon
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J Ethnobiol Ethnomed 2011 715
Tooth extraction by a traditional dentist
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J EthnobiolEthnomed 2011 715
bull Health is a consequence of an individualrsquos lifestyle
bull Essential to Identify cultural factors that are harmful and those that are beneficial
bull As paediatric dentists we should discourage the unhealthy practices through rigorous health education and promote the adoption of healthy practices
bull Need for multicentric research on the cultural influence of the family and peers regarding oral health of children
bull Bankole OO Lawal FB Ibiyemi O (2017) Dispelling myths associated with natalneonatal teeth ldquoAdunnirdquo a health education video in a native Nigerian language Annals of Ibadan Postgraduate Medicine15(2)137-141
Thank you for listening
Peri-apical x-ray of lower central incisor
Lacquering and staining of teethPerformed in Vietnam Laos Thailand Indonesia and Philippines
Perception For cosmetic reasons
bull Main ingredient dye dark-brown solution of ferric acetate called kanemizu (iron filings in vinegar)
bull Coating the teeth with this liquid helped to prevent tooth decay and enamel decay
bull Practice has slowly declined
Traditional gingival tattooinglips bull Practiced in Africarsquos Sahel region Woddebe
Fulani tribe Senegal Ethiopia middle eastern countries
Perception Reason aesthetic appeal superstition
bull Practices Done when females reach puberty
bull Kanuri females Borno State Nigeria tattooing lip gingiva usually performed thorns of Balanites aegyptiaca (Bukar et al 2004 )
bull Pigments -Mixture charcoal and seeds of Acacia nilotica vartomentosa
Lip plug lip plate
bull The lip plate (lip plug or lip disc) form of body modification
bull Amazonian tribes young males traditionally -rite of passage indicate status and prestige
bull Mursi of Ethiopia girls age 13 to 18
bull At puberty mother cuts her lower lip
bull Held open by a wooden plug - inserted into thereby stretching the lip
bull At times -combined with removal of two or four lower anterior incisal teeth
Lip plug lip plate
TRADITIONAL DENTAL SERVICES
bull Perceptions
Cause of illness determines treatment taken Practices
bull Yoruba community patronize traditional dentists (Oke Bankole et al 2011) Edo state
bull Services rendered include worm extraction tooth extraction drug prescription and offering sacrifices to deities
bull Charges based on the worm count
Northern Nigeria called Serdia Toothache associated with dandruff
Cameroon traditional healers perform atraumatic tooth extraction Agbor et al (2011)
bull Leaves stems of Dichrocephala integrifolia
bull Tooth pulled out fingerssharp instrument
bull No pain Plant has anaesthetic properties
bull Dangers infection sepsis infection with hepatitis B Human Immunodeficiency Virus
bull Jewish Unlikely keep Friday appointment with the dentist for their children
bull Routine appointments on Fridays avoided (Scambler et al )
The traditional healer harvesting the medicinal plant in Cameroon
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J Ethnobiol Ethnomed 2011 715
Tooth extraction by a traditional dentist
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J EthnobiolEthnomed 2011 715
bull Health is a consequence of an individualrsquos lifestyle
bull Essential to Identify cultural factors that are harmful and those that are beneficial
bull As paediatric dentists we should discourage the unhealthy practices through rigorous health education and promote the adoption of healthy practices
bull Need for multicentric research on the cultural influence of the family and peers regarding oral health of children
bull Bankole OO Lawal FB Ibiyemi O (2017) Dispelling myths associated with natalneonatal teeth ldquoAdunnirdquo a health education video in a native Nigerian language Annals of Ibadan Postgraduate Medicine15(2)137-141
Thank you for listening
Lacquering and staining of teethPerformed in Vietnam Laos Thailand Indonesia and Philippines
Perception For cosmetic reasons
bull Main ingredient dye dark-brown solution of ferric acetate called kanemizu (iron filings in vinegar)
bull Coating the teeth with this liquid helped to prevent tooth decay and enamel decay
bull Practice has slowly declined
Traditional gingival tattooinglips bull Practiced in Africarsquos Sahel region Woddebe
Fulani tribe Senegal Ethiopia middle eastern countries
Perception Reason aesthetic appeal superstition
bull Practices Done when females reach puberty
bull Kanuri females Borno State Nigeria tattooing lip gingiva usually performed thorns of Balanites aegyptiaca (Bukar et al 2004 )
bull Pigments -Mixture charcoal and seeds of Acacia nilotica vartomentosa
Lip plug lip plate
bull The lip plate (lip plug or lip disc) form of body modification
bull Amazonian tribes young males traditionally -rite of passage indicate status and prestige
bull Mursi of Ethiopia girls age 13 to 18
bull At puberty mother cuts her lower lip
bull Held open by a wooden plug - inserted into thereby stretching the lip
bull At times -combined with removal of two or four lower anterior incisal teeth
Lip plug lip plate
TRADITIONAL DENTAL SERVICES
bull Perceptions
Cause of illness determines treatment taken Practices
bull Yoruba community patronize traditional dentists (Oke Bankole et al 2011) Edo state
bull Services rendered include worm extraction tooth extraction drug prescription and offering sacrifices to deities
bull Charges based on the worm count
Northern Nigeria called Serdia Toothache associated with dandruff
Cameroon traditional healers perform atraumatic tooth extraction Agbor et al (2011)
bull Leaves stems of Dichrocephala integrifolia
bull Tooth pulled out fingerssharp instrument
bull No pain Plant has anaesthetic properties
bull Dangers infection sepsis infection with hepatitis B Human Immunodeficiency Virus
bull Jewish Unlikely keep Friday appointment with the dentist for their children
bull Routine appointments on Fridays avoided (Scambler et al )
The traditional healer harvesting the medicinal plant in Cameroon
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J Ethnobiol Ethnomed 2011 715
Tooth extraction by a traditional dentist
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J EthnobiolEthnomed 2011 715
bull Health is a consequence of an individualrsquos lifestyle
bull Essential to Identify cultural factors that are harmful and those that are beneficial
bull As paediatric dentists we should discourage the unhealthy practices through rigorous health education and promote the adoption of healthy practices
bull Need for multicentric research on the cultural influence of the family and peers regarding oral health of children
bull Bankole OO Lawal FB Ibiyemi O (2017) Dispelling myths associated with natalneonatal teeth ldquoAdunnirdquo a health education video in a native Nigerian language Annals of Ibadan Postgraduate Medicine15(2)137-141
Thank you for listening
Traditional gingival tattooinglips bull Practiced in Africarsquos Sahel region Woddebe
Fulani tribe Senegal Ethiopia middle eastern countries
Perception Reason aesthetic appeal superstition
bull Practices Done when females reach puberty
bull Kanuri females Borno State Nigeria tattooing lip gingiva usually performed thorns of Balanites aegyptiaca (Bukar et al 2004 )
bull Pigments -Mixture charcoal and seeds of Acacia nilotica vartomentosa
Lip plug lip plate
bull The lip plate (lip plug or lip disc) form of body modification
bull Amazonian tribes young males traditionally -rite of passage indicate status and prestige
bull Mursi of Ethiopia girls age 13 to 18
bull At puberty mother cuts her lower lip
bull Held open by a wooden plug - inserted into thereby stretching the lip
bull At times -combined with removal of two or four lower anterior incisal teeth
Lip plug lip plate
TRADITIONAL DENTAL SERVICES
bull Perceptions
Cause of illness determines treatment taken Practices
bull Yoruba community patronize traditional dentists (Oke Bankole et al 2011) Edo state
bull Services rendered include worm extraction tooth extraction drug prescription and offering sacrifices to deities
bull Charges based on the worm count
Northern Nigeria called Serdia Toothache associated with dandruff
Cameroon traditional healers perform atraumatic tooth extraction Agbor et al (2011)
bull Leaves stems of Dichrocephala integrifolia
bull Tooth pulled out fingerssharp instrument
bull No pain Plant has anaesthetic properties
bull Dangers infection sepsis infection with hepatitis B Human Immunodeficiency Virus
bull Jewish Unlikely keep Friday appointment with the dentist for their children
bull Routine appointments on Fridays avoided (Scambler et al )
The traditional healer harvesting the medicinal plant in Cameroon
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J Ethnobiol Ethnomed 2011 715
Tooth extraction by a traditional dentist
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J EthnobiolEthnomed 2011 715
bull Health is a consequence of an individualrsquos lifestyle
bull Essential to Identify cultural factors that are harmful and those that are beneficial
bull As paediatric dentists we should discourage the unhealthy practices through rigorous health education and promote the adoption of healthy practices
bull Need for multicentric research on the cultural influence of the family and peers regarding oral health of children
bull Bankole OO Lawal FB Ibiyemi O (2017) Dispelling myths associated with natalneonatal teeth ldquoAdunnirdquo a health education video in a native Nigerian language Annals of Ibadan Postgraduate Medicine15(2)137-141
Thank you for listening
Lip plug lip plate
bull The lip plate (lip plug or lip disc) form of body modification
bull Amazonian tribes young males traditionally -rite of passage indicate status and prestige
bull Mursi of Ethiopia girls age 13 to 18
bull At puberty mother cuts her lower lip
bull Held open by a wooden plug - inserted into thereby stretching the lip
bull At times -combined with removal of two or four lower anterior incisal teeth
Lip plug lip plate
TRADITIONAL DENTAL SERVICES
bull Perceptions
Cause of illness determines treatment taken Practices
bull Yoruba community patronize traditional dentists (Oke Bankole et al 2011) Edo state
bull Services rendered include worm extraction tooth extraction drug prescription and offering sacrifices to deities
bull Charges based on the worm count
Northern Nigeria called Serdia Toothache associated with dandruff
Cameroon traditional healers perform atraumatic tooth extraction Agbor et al (2011)
bull Leaves stems of Dichrocephala integrifolia
bull Tooth pulled out fingerssharp instrument
bull No pain Plant has anaesthetic properties
bull Dangers infection sepsis infection with hepatitis B Human Immunodeficiency Virus
bull Jewish Unlikely keep Friday appointment with the dentist for their children
bull Routine appointments on Fridays avoided (Scambler et al )
The traditional healer harvesting the medicinal plant in Cameroon
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J Ethnobiol Ethnomed 2011 715
Tooth extraction by a traditional dentist
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J EthnobiolEthnomed 2011 715
bull Health is a consequence of an individualrsquos lifestyle
bull Essential to Identify cultural factors that are harmful and those that are beneficial
bull As paediatric dentists we should discourage the unhealthy practices through rigorous health education and promote the adoption of healthy practices
bull Need for multicentric research on the cultural influence of the family and peers regarding oral health of children
bull Bankole OO Lawal FB Ibiyemi O (2017) Dispelling myths associated with natalneonatal teeth ldquoAdunnirdquo a health education video in a native Nigerian language Annals of Ibadan Postgraduate Medicine15(2)137-141
Thank you for listening
Lip plug lip plate
TRADITIONAL DENTAL SERVICES
bull Perceptions
Cause of illness determines treatment taken Practices
bull Yoruba community patronize traditional dentists (Oke Bankole et al 2011) Edo state
bull Services rendered include worm extraction tooth extraction drug prescription and offering sacrifices to deities
bull Charges based on the worm count
Northern Nigeria called Serdia Toothache associated with dandruff
Cameroon traditional healers perform atraumatic tooth extraction Agbor et al (2011)
bull Leaves stems of Dichrocephala integrifolia
bull Tooth pulled out fingerssharp instrument
bull No pain Plant has anaesthetic properties
bull Dangers infection sepsis infection with hepatitis B Human Immunodeficiency Virus
bull Jewish Unlikely keep Friday appointment with the dentist for their children
bull Routine appointments on Fridays avoided (Scambler et al )
The traditional healer harvesting the medicinal plant in Cameroon
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J Ethnobiol Ethnomed 2011 715
Tooth extraction by a traditional dentist
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J EthnobiolEthnomed 2011 715
bull Health is a consequence of an individualrsquos lifestyle
bull Essential to Identify cultural factors that are harmful and those that are beneficial
bull As paediatric dentists we should discourage the unhealthy practices through rigorous health education and promote the adoption of healthy practices
bull Need for multicentric research on the cultural influence of the family and peers regarding oral health of children
bull Bankole OO Lawal FB Ibiyemi O (2017) Dispelling myths associated with natalneonatal teeth ldquoAdunnirdquo a health education video in a native Nigerian language Annals of Ibadan Postgraduate Medicine15(2)137-141
Thank you for listening
TRADITIONAL DENTAL SERVICES
bull Perceptions
Cause of illness determines treatment taken Practices
bull Yoruba community patronize traditional dentists (Oke Bankole et al 2011) Edo state
bull Services rendered include worm extraction tooth extraction drug prescription and offering sacrifices to deities
bull Charges based on the worm count
Northern Nigeria called Serdia Toothache associated with dandruff
Cameroon traditional healers perform atraumatic tooth extraction Agbor et al (2011)
bull Leaves stems of Dichrocephala integrifolia
bull Tooth pulled out fingerssharp instrument
bull No pain Plant has anaesthetic properties
bull Dangers infection sepsis infection with hepatitis B Human Immunodeficiency Virus
bull Jewish Unlikely keep Friday appointment with the dentist for their children
bull Routine appointments on Fridays avoided (Scambler et al )
The traditional healer harvesting the medicinal plant in Cameroon
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J Ethnobiol Ethnomed 2011 715
Tooth extraction by a traditional dentist
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J EthnobiolEthnomed 2011 715
bull Health is a consequence of an individualrsquos lifestyle
bull Essential to Identify cultural factors that are harmful and those that are beneficial
bull As paediatric dentists we should discourage the unhealthy practices through rigorous health education and promote the adoption of healthy practices
bull Need for multicentric research on the cultural influence of the family and peers regarding oral health of children
bull Bankole OO Lawal FB Ibiyemi O (2017) Dispelling myths associated with natalneonatal teeth ldquoAdunnirdquo a health education video in a native Nigerian language Annals of Ibadan Postgraduate Medicine15(2)137-141
Thank you for listening
Cameroon traditional healers perform atraumatic tooth extraction Agbor et al (2011)
bull Leaves stems of Dichrocephala integrifolia
bull Tooth pulled out fingerssharp instrument
bull No pain Plant has anaesthetic properties
bull Dangers infection sepsis infection with hepatitis B Human Immunodeficiency Virus
bull Jewish Unlikely keep Friday appointment with the dentist for their children
bull Routine appointments on Fridays avoided (Scambler et al )
The traditional healer harvesting the medicinal plant in Cameroon
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J Ethnobiol Ethnomed 2011 715
Tooth extraction by a traditional dentist
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J EthnobiolEthnomed 2011 715
bull Health is a consequence of an individualrsquos lifestyle
bull Essential to Identify cultural factors that are harmful and those that are beneficial
bull As paediatric dentists we should discourage the unhealthy practices through rigorous health education and promote the adoption of healthy practices
bull Need for multicentric research on the cultural influence of the family and peers regarding oral health of children
bull Bankole OO Lawal FB Ibiyemi O (2017) Dispelling myths associated with natalneonatal teeth ldquoAdunnirdquo a health education video in a native Nigerian language Annals of Ibadan Postgraduate Medicine15(2)137-141
Thank you for listening
The traditional healer harvesting the medicinal plant in Cameroon
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J Ethnobiol Ethnomed 2011 715
Tooth extraction by a traditional dentist
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J EthnobiolEthnomed 2011 715
bull Health is a consequence of an individualrsquos lifestyle
bull Essential to Identify cultural factors that are harmful and those that are beneficial
bull As paediatric dentists we should discourage the unhealthy practices through rigorous health education and promote the adoption of healthy practices
bull Need for multicentric research on the cultural influence of the family and peers regarding oral health of children
bull Bankole OO Lawal FB Ibiyemi O (2017) Dispelling myths associated with natalneonatal teeth ldquoAdunnirdquo a health education video in a native Nigerian language Annals of Ibadan Postgraduate Medicine15(2)137-141
Thank you for listening
Tooth extraction by a traditional dentist
Agbor AM Naidoo S Mbia AM The role of traditional healers in tooth extractions in Lekie Division Cameroon J EthnobiolEthnomed 2011 715
bull Health is a consequence of an individualrsquos lifestyle
bull Essential to Identify cultural factors that are harmful and those that are beneficial
bull As paediatric dentists we should discourage the unhealthy practices through rigorous health education and promote the adoption of healthy practices
bull Need for multicentric research on the cultural influence of the family and peers regarding oral health of children
bull Bankole OO Lawal FB Ibiyemi O (2017) Dispelling myths associated with natalneonatal teeth ldquoAdunnirdquo a health education video in a native Nigerian language Annals of Ibadan Postgraduate Medicine15(2)137-141
Thank you for listening
bull Health is a consequence of an individualrsquos lifestyle
bull Essential to Identify cultural factors that are harmful and those that are beneficial
bull As paediatric dentists we should discourage the unhealthy practices through rigorous health education and promote the adoption of healthy practices
bull Need for multicentric research on the cultural influence of the family and peers regarding oral health of children
bull Bankole OO Lawal FB Ibiyemi O (2017) Dispelling myths associated with natalneonatal teeth ldquoAdunnirdquo a health education video in a native Nigerian language Annals of Ibadan Postgraduate Medicine15(2)137-141
Thank you for listening
bull Bankole OO Lawal FB Ibiyemi O (2017) Dispelling myths associated with natalneonatal teeth ldquoAdunnirdquo a health education video in a native Nigerian language Annals of Ibadan Postgraduate Medicine15(2)137-141
Thank you for listening
Thank you for listening