Traumatic effects of infant oral mutilation on odontogenesis: A case report.

Abstract

Infant oral mutilation (IOM), widely practiced in East Africa, involves gouging of unerupted teeth to allegedly cure childhood diseases. Non-sterile instruments are often used during IOM, causing immediate and long-term complications, including dental defects, infection, and death. This is a case report describing how IOM affected tooth development and oral health in a four-year-old Somali girl who, three years prior, underwent IOM of her primary mandibular canines. Two affected primary mandibular canines (denoted M* and R*) were extracted from the patient at age four because they were dysmorphic, nonfunctional, and at risk of further pathology. Tooth M* was moderately affected, with reduced root length and blunt root tip, though enamel and dentin thickness, densities, and tissue organization were within normal range by micro-computed tomography. Tooth R* was dramatically diminished in size and severely dysmorphic. By histology, dentinal tubules were within normal parameters in affected canines, and acellular cementum was thin but with undiminished mineral density and normal histological appearance. Permanent canines appeared unaffected in radiographs. This case demonstrates that IOM affected odontogenesis of primary canines, although formation of enamel, dentin and cementum proceeded despite the trauma. Further investigation of IOM and its effects on oral and systemic health can aid in advocacy efforts to eradicate this practice.