Peer-reviewed article
The Prevalence, Dental Complications, and Effects of Infant Oral Mutilation.
Spang D, Kemoli AM, de Soet HJJ, Ziesemer KA, Volgenant CMC ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This scoping review examined infant oral mutilation (IOM), a harmful practice primarily found in East Africa where teeth are intentionally removed from children aged 4-8 months. The review found prevalence rates ranging from 2% to 87% across Uganda, Ethiopia, Sudan, Kenya, and Tanzania. The practice causes serious immediate complications including infection, bleeding, and in some cases death, as well as long-term dental problems such as enamel damage and abnormal tooth eruption. The review identifies diarrhoea as the most common stated reason for the practice and highlights significant gaps in knowledge about its long-term effects.
Key points
- Prevalence of IOM varies by country: Uganda 2-30%, Ethiopia 12-86%, Sudan 10%, Kenya 61-87%, Tanzania 0-24%
- Most affected children are aged 4-8 months, with deciduous mandibular canines being the most commonly targeted teeth
- Immediate serious effects include infection, bleeding, anaemia, pneumonia, septicaemia, osteomyelitis, meningitis, tetanus, and blood-borne diseases, with some deaths reported
- Long-term dental complications include enamel hypoplasia, malformations, abnormal tooth eruption, occlusal discrepancies, and chronic infections
- Diarrhoea is cited as the most common motivating factor for the practice
Limitations
This scoping review synthesises existing literature but does not establish causation or detailed mechanisms of harm. The review identifies significant knowledge gaps regarding the long-term consequences of IOM and notes that prevalence data quality varies, limiting definitive estimates.
Abstract
Objective The aim of this scoping review on infant oral mutilation (IOM) was to study the prevalence, dental complications, and immediate and long-term effects of this practice, in addition to providing a systematic overview on existing knowledge and analysis of identified knowledge gaps on IOM. Methods Five electronic bibliographic databases (OVID/Medline, Embase.com, Clarivate Analytics/Web of Science Core Collection, SCOPUS, and Global Index Medicus) were searched for relevant studies. Data were entered in a bespoke data-charting form. The risk of bias was assessed by 2 independent reviewers. Results A total of 478 studies were identified from the search, out of which 42 studies were included in this review. Of the 42 studies, 19 were prevalence studies published between 1969 and 2019 which were additionally assessed for the risk of bias. We found the prevalence of IOM in Uganda was 2% to 30%; Ethiopia, 12% to 86%; Sudan, 10%; Kenya, 61% to 87%; and Tanzania 0% to 24%. Based on the prevalence studies, we observed that the most common factor motivating IOM was diarrhoea. The immediate effects of IOM were found to be infection, bleeding, anaemia, pneumonia, septicaemia, osteomyelitis, meningitis, tetanus, and blood-borne diseases, with some infants dying from these effects. Missing canines, enamel hypoplasia, malformations, abnormal eruption of permanent teeth, occlusal discrepancies, midline shift, chronic periapical infections, rotations, canine transposition, or odontomas were the long-term effects found in relation to IOM. Conclusions IOM is a practice with serious immediate and long-term consequences that is mainly performed in East Africa (or by people originated from this region) in children aged 4 to 8 months. Most frequently affected are the deciduous canines and mostly the mandibular teeth. It is important to create professional and public awareness of the procedure in low- and high-income countries. Furthermore, there is a need for more research on the prevalence of IOM in Africa and other areas of the world to determine the long-term consequences of the practice.