title: Extirpation of the primary canine tooth follicles: a form of infant oral mutilation.
abstract: BACKGROUND
  Ebinyo is a form of infant oral mutilation (IOM), widely practiced in rural areas of eastern Africa, in which traditional healers and other village elders extirpate the primary canine tooth follicles of infants by using crude, often unsterilized, instruments or utensils. Traditional folklore suggests that the underlying tooth follicles, thought to resemble worms, are the cause of high temperature, vomiting, loss of appetite and diarrhea in infants. In addition to the serious and potentially fatal immediate postsurgical complications, many of those who undergo this practice exhibit characteristic long-term adverse dentoalveolar effects. Children in these families also may be at greater risk of undergoing other mutilation rituals because of their cultural background.
  
  
  METHODS
  We report on the clinical and radiographic findings in five siblings who apparently were subjected to IOM as infants before immigrating to the United States.
  
  
  CONCLUSIONS
  Although the practice of IOM is believed to be exceedingly rare in developed countries, it is important that dentists and allied dental personnel who treat refugees from areas of the world in which IOM is endemic be aware of the social factors behind this practice as well as be able to recognize its dental and psychological sequelae.
authors.affiliation: Department of Periodontics and Oral Medicine, Division of Oral Pathology, Medicine and Radiology, University of Michigan School of Dentistry, 1011 N. University Ave., Office 2029E, Ann Arbor, Michigan 48109-1078, USA. paulce@umich.edu
authors.forename: Paul C
authors.initials: PC
authors.lastname: Edwards
authors.forename: Nicholas
authors.initials: N
authors.lastname: Levering
authors.forename: Erin
authors.initials: E
authors.lastname: Wetzel
authors.forename: Tarnjit
authors.initials: T
authors.lastname: Saini
mesh_terms: D016301:Alveolar Bone Loss / Q000209:etiology; D046289:Body Modification, Non-Therapeutic / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D003481:Cuspid / Q000002:abnormalities / Q000601:surgery*; D003795:Dental Sac / Q000601:surgery*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008519:Medicine, Traditional; D012036:Refugees; D013397:Sudan / Q000208:ethnology; D014094:Tooth, Deciduous / Q000002:abnormalities / Q000601:surgery*