'Killer' canines: the morbidity and mortality of ebino in northern Uganda

Abstract

SummaryIn northern Uganda, unerupted primary canine teeth are commonly extracted because they are believed to cause diarrhoea, vomiting, and fever. This practice, known as ebino, is performed under very crude conditions often using unclean tools. To evaluate the morbidity and mortality of complications related to ebino, we retrospectively analysed discharge records from the paediatric ward of Lacor Hospital, Gulu. In the period 1992-98, ebino-related complications, mainly sepsis and anaemia, were among the leading causes of admission (n ϭ 740) and hospital death (n ϭ 156, case fatality rate ϭ 21.1%, proportional mortality rate ϭ 3.3%). Discouraging the adoption of deeply rooted traditional practices that are potentially hazardous to health should be a public health priority in northern Uganda. This could be done by educating not only the general public, but also traditional healers and community and religious leaders, who could convey the knowledge to their people.keywords ebino, hospital, Africa correspondence Silvia Declich,

Erupted compound odontoma: case report of a 15-year-old Sudanese boy with a history of traditional dental mutilation

“…This custom has been described in the literature 19,20 amongst the peoples of the region of Africa where the patient spent the majority of his life. An incidence rate of traditional mutila tion by tooth extraction as high as 16% of children in northern Uganda, 22% amongst urban Sudanese and 100% in a southern Sudanese hospital was reported by Elinor et al 19 Iriso et al 21 recorded traditional tooth extraction complica tions as one of the leading causes for hospital admission, morbidity and death in the paediatric ward of a large refer considered a 'success' if the 'tooth worm' is removed along with the primary cus pid. The 'tooth worm' is the dental lamina of the permanent canine, before crown development.…”

A review of the role of African traditional medicine in the management of oral diseases

“…Removal of deciduous canine tooth buds among infants below 2 years has been reported in several studies to be common mainly amongst communities in East Africa. It is very common in the Eastern African region like Tanzania (Kikwilu and Hiza,1997; Kikwilu and Hiza ,1992), Ethiopia (68), Kenya (Mutai ,2010), Uganda (Acorsi et al , Iriso et al 2000. This practice, known as ebino in Northern Uganda ,the gauging of unerupted deciduous canine teeth occurs in approximately one in three children in some areas of Uganda.…”

“…The main reason for the practice revolves around the belief that tooth buds or 'maggots' are false teeth, nylon or worms are responsible for diarrhoea, vomiting, fever and growth retardation in children, amongst other illnesses (Mutai ,2010). Traditional healers use very crude conditions often using unclean tools (Iriso et al 2000) such as knitting needles, bicycle spokes, scissors or broken glass to extract the teeth. Post-ebino extraction complications included septicaemia, anaemia, difficulties in feeding and pain with some of the children requiring hospitalization (Jamieson, 2006).…”

“…Tooth bud extraction was always bilateral (Kikwilu and Hiza , Kikwilu and Hiza ,1992). Iriso et al, (2000) reported some complications of ebino " IOM" in the period 1992-98, ebino-related complications, mainly sepsis and anaemia, were among the leading causes of admission (n = 740) and hospital death (n = 156, case fatality rate = 21.1%, proportional mortality rate = 3.3%). They emphasized that discouraging the adoption of deeply rooted traditional practices that are potentially hazardous to health should be a public health priority in northern Uganda.…”

Dental Ritual Mutilations and Forensic Odontologist Practice: a Review of the Literature

“…The most common immediate risks include excessive bleeding, infections, osteomyelitis of the jaws, anemia, noma, tetanus, meningitis, aspiration bronchopneumonia, transmission of infectious diseases (including HIV and hepatitis) and death, often from sepsis (36)(37)(38)(39).…”