Ethnobotanical tattooing of the gingiva: literature review and report of a case.
BACKGROUND
Traditional gingival tattooing, practiced in Ethiopia and occasionally in other African and Middle Eastern nations, is performed for esthetic appeal or superstition, and it occasionally may be used as a homeopathic remedy for dental diseases. The authors provide a literature review and case report of this oral custom.


METHODS
A 54-year-old woman from Ethiopia reported that she had undergone tattooing of the maxillary gingiva six years previously for analgesic management of undisclosed oral disease. The gingiva was pierced with a needle, tipped with lantern soot and resin from the plant Datura stramonium (an herb that possesses potent anticholinergic tropane alkaloids and has demonstrated in vitro antimicrobial activity). However, the patient admitted that this procedure had provided no reduction in the pain. Clinical examination was significant for a pronounced blue pigmentation of the maxillary gingiva, generalized mild periodontitis and several carious lesions.


CONCLUSIONS
Practitioners should ascertain whether gingival tattooing had been performed when patients manifest unusual oral pigmentation and be aware of its use in folk medicine for various oral conditions.
Department of Diagnostic Sciences and Pathology, Baltimore College of Dental Surgery, Dental School, University of Maryland, Baltimore, 650 W. Baltimore St., Baltimore, MD 21201-1586, USA. oralpath5@comcast.net
John K
JK
Brooks
Mark A
MA
Reynolds
D032302:Datura; D005002:Ethiopia / Q000208:ethnology; D019448:Ethnobotany; D005260:Female; D005881:Gingiva; D005882:Gingival Diseases / Q000188:drug therapy; D006801:Humans; D008437:Maxilla; D008519:Medicine, Traditional; D008875:Middle Aged; D008517:Phytotherapy / Q000379:methods*; D028321:Plant Preparations / Q000627:therapeutic use*; D018514:Plant Structures; D012116:Resins, Plant / Q000627:therapeutic use*; D013653:Tattooing
D028321:Plant Preparations; D012116:Resins, Plant