University of Tennessee, Knoxville TRACE: Tennessee Research and Creative Exchange
Masters Theses Graduate School
5-1998
A Biocultural Analysis of Intentional Dental Modifications
Derek Christiaan Benedix University of Tennessee - Knoxville
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Recommended Citation Benedix, Derek Christiaan, "A Biocultural Analysis of Intentional Dental Modifications. " Master's Thesis, University of Tennessee, 1998. https://trace.tennessee.edu/utk_gradthes/3240
This Thesis is brought to you for free and open access by the Graduate School at TRACE: Tennessee Research and Creative Exchange. It has been accepted for inclusion in Masters Theses by an authorized administrator of TRACE: Tennessee Research and Creative Exchange. For more information, please contact [email protected]. To the Graduate Council:
I am submitting herewith a thesis written by Derek Christiaan Benedix entitled "A Biocultural Analysis of Intentional Dental Modifications." I have examined the final electronic copy of this thesis for form and content and recommend that it be accepted in partial fulfillment of the requirements for the degree of Master of Arts, with a major in Anthropology.
Michael H. Logan, Major Professor
We have read this thesis and recommend its acceptance:
Murray K. Marks, Walter E. Klippel
Accepted for the Council: Carolyn R. Hodges
Vice Provost and Dean of the Graduate School
(Original signatures are on file with official studentecor r ds.) To the Graduate Council:
I am submitting herewith a thesis written by Derek Christiaan Benedix entitled "A Biocultural Analysis of Intentional Dental Modifications." I have examined the final copy of this thesis for form and content and recommend that it be accepted in partial fulfillment of the requirements for the degree of Master of Arts, with a major in Anthropology.
We have read this thesis and recommend its ace
Accepted for the Council:
Associate Vice Chancellor and Dean of The Graduate School A Biocultural Analysis of Intentional Dental Modifications
A Thesis Presented for the Master of Arts Degree The University of Tennessee, Knoxville
Derek Christiaan Benedix May 1998 •
Copyright© Derek Christiaan Benedix, 1998
All rights reserved
11 Dedication
As a mentor and friend, Dr. Murray K. Marks has taught me to
"appreciate the variation" in everything. I cannot thank him enough for all the opportunities he has given to me throughout the past four years. It is with utmost respect and admiration that I dedicate this thesis to him.
111 Acknowledgments
I would like to acknowledge many people who helped me complete all the requirements for my Master's degree. First and foremost, I want to thank the members of my committee: Dr. Michael H. Logan, for sharing his knowledge and insight with me while helping formulate many of the ideas this thesis draws upon; Dr. Murray K. Marks, for being a great advisor, teacher, mentor, and friend; and Dr. Walter E. Klippel, for teaching me above and beyond the world of zooarchaeology.
I would also like to thank two people who helped steer me in the direction of anthropology: Jim Woods and Bill West of the Herrett Center for Arts and Sciences and the College of Southern Idaho, respectively. I also appreciate the help given to me by Dr. Guillermo Mata Amado and
Brisa Escalona. Additionally, I thank Dr. Michael Keene and Stephanie
Gibbs for editing many preliminary drafts of this thesis. Thanks to all my colleagues and friends throughout the years (you know who you are).
To my sisters, Gretchen and Meghan, I extend a great deal of thanks.
You helped me cope through both good and bad. Because of you I am a better person.
Additionally I acknowledge my mother and father, Miss Vicki and
The Rev. I would not be the person I am today without all the love and kindness you showered upon me throughout my life. Thank you for teaching and guiding me.
lV And last, but not least, I would like to thank Mary, my wife, for helping me get through this academic period. You have been the source of great inspiration and have consoled me through thick and thin.
v Abstract
When we consider how painful dental drilling is now in spite of the advances of science with respect to anesthesia and modern instruments, we cannot help but think how much those people must have suffered from the filing and dental preparations which were performed. (Fastlicht 1948:319)
Human teeth provide an excellent source of information about an individual's past. Because of this, scientists study the range of characteristics manifested in teeth. One such characteristic is dental modification. Modification of the human dentition has a long and varied history in numerous cultures (see Milner and Larsen 1991). This study explores the practice and theorizes on the purposes of dental modifications from a biocultural viewpoint. There are three relevant questions to this endeavor: What, if any, are the consequences accompanying the alteration of teeth? What are the biosocial benefits associated with modified dentitions? Is this custom a maladaptive trait? A definition of dental art is presented along with an historical overview of this practice. This thesis also provides a review of relevant literature on dental modification. The effects of dental alterations on the oral complex are then discussed, including their hygienic, morphological, and histological impacts. Lastly, a theoretical discussion is offered on the reasons why some cultures engaged in this practice, and why some contemporary societies still do. New areas of research on this subject are also advanced.
VL Table of Contents
Chapter Page
1 Introduction: A brief overview of dental anthropology...... 1 What is the history of the study of teeth?...... 1 Why are teeth studied and what can be learned?...... 2 Bioculturalism in anthropology...... 2 What is intentional dental modification?...... 4 Effects of dental modifications on the oral complex...... 7
2 Oral histology and dental anatomy...... 16 Terms and tissues...... 16
3 Pathologies in modified teeth...... 21 The intentional filing, inlaying, and/or ablation (evulsion) of teeth increases the likelihood of pathology to the orofacial com.plex...... 21 Pathological reactions of orofacial complex in response to
intentional dental modifications ...... 22 Evidence of orofacial pathology directly associated with intentional dental modifications ...... 23
� . . 4 Discussion...... 28
Why do dental modifications occur? ...... 28 Who possesses altered teeth? ...... 29 Reasons for dental modification...... 30 Methods of modification...... 35 Distribution of intentionally modified teeth...... 37 Temporal and spatial dimensions...... 37 Maladaptive traits...... 39 What is maladaptive?...... 39 What is the power of conformity?...... 44 Theoretical implications ...... 47
5 Conclusions and summary...... 50
Bibliography...... 54
Vim...... 66
vii List of Figures
Figure Page
1.1 The oral complex...... 6
1.2 Diagram of longitudinal section of enamel, dentine, pulp, and cementum...... 10
1.3 Thin section of tooth showing dentine in its three forms:
primary (A), secondary (C), and tertiary (B) ...... 11
1.4 Mineral inlays on labial side of anterior maxillary teeth...... 13
1.5 Mineral inlay on maxillary canine...... 14
2.1 Diagram of tertiary dentine forming to protect pulp ...... 20
. 3.1 Periapical abscessing on maxillary alveolar bone above right central incisor and left central and lateral incisors...... 24
4.1 Tribal identification patterns in intentional tooth mod�fications of African groups...... 33
4.2 Detail of fresco showing apparent tooth filing...... 46
Vlll Chapter 1
Introduction: A brief overview of Dental Anthropology
What is the history of the study of teeth?
The study of human teeth has an important scholarly history in biological anthropology. Because teeth are comprised of the hardest substance in the human body and are not as susceptible to decay as the non-mineralized elements of the human body, they hold the best evidence for reconstructing demography, health, and biological/phylogenetic relationships of past human communities (see
Hillson 1996). Put simply, dental anthropology is the study of both past and present human behaviors from evidence revealed in teeth. Dental anthropologists are interested in many anatomical and biological aspects of the human orofacial complex. Many themes help dental anthropologists understand the characteristics observed in archaeological and contemporary populations. These themes range from studying prehistoric and modern odontometric variation to examining the processes that occur with dental embryology and development, histology, eruption, occlusion, wear, and pathology (for review see Hillson 1996;
Jordan and Abrams 1992; Kelley and Larsen 1991).
1 Why are teeth studied and what can be learned?
Why study teeth? Dental anthropology provides answers to research questions concerning morphology, odontometrics (the dimensions of teeth), evolution, genetics, forensic odontology, dental and oral pathology and health, tooth use and abuse, and cultural and behavioral practices. From a behavioral viewpoint, "oral cultural practices can leave their imprint on the dentition" as the teeth are used in functions beyond normal food mastication Gordan and Abrams 1992:290).
In some cases, the teeth have been used as tools, such as vice-like grips to hold pins, pipes, sinew, etc. This type of habitual activity can leave a characteristic mark on the teeth that aids the dental anthropologist in the reconstruction of past lifestyles. By studying the dentitions of individuals within different cultures, dental anthropologists can interpret general and specific cultural behaviors. In the present study, intentional dental modification is examined from a biocultural perspective to glean information from archaeological and contemporary populations that embraced (or still do, in some cases) this interesting, if little understood, cultural behavior.
Bioculturalism in Anthropology
The purpose of this study is to examine intentional dental modifications from a biocultural perspective. To better understand this endeavor, a discussion of biocultural anthropology is provided. The discipline of anthropology studies humans and their biology and behavior. Humans are the only animals with a complex set of learned
2 behaviors referred to as culture (Crooks 1996). Many anthropologists
utilize a biocultural approach when studying the behavior of humans.
Bioculturalism is the study of human behaviors using both biological and
cultural data. It attempts to build an understanding between these aspects
with respect to evolution. It also seeks to find answers regarding why
cultural behaviors are important for different populations and how those
behaviors affect, in both positive and negative ways, the people engaging
in them.
A concept fundamental to bioculturalism is that of adaptation (see
Carneiro 1968; Irons 1996). Anthropologists have used the term
adaptation to identify the behaviors that exist in groups. During its
history, anthropology has been criticized by some for over using the term
adaptation (Gould and Lewontin 1979). Today, anthropologists realize that
in fact some behaviors are not adaptive, but rather maladaptive. The
behaviors within cultures elicit some purpose, but "many traits and behaviors exist at functional cost" (Crooks 1996:131).
With a reexamination of culture and biology, scientists are now beginning to observe the underlying function of maladaptive behaviors.
It is understood that "traits and behaviors may ... have survival value for
the individual or population ... and therefore are adaptive in the
Darwinian sense" (Crooks 1996:131). I hypothesize that intentional dental
modifications are adaptive in the Darwinian sense, but may be regarded as
maladaptive because of the possible risk to the orofacial complex.
Much is written on intentional dental modifications especially from
a descriptive stance. However, there is a paucity of studies in the literature
3 that examine such dental modifications from a biocultural standpoint (see
Logan and Qirko 1996; Mata 1994). Logan and Qirko (1996) mention numerous maladaptive behaviors spanning the entire globe. Amongst their list of maladaptive behaviors affecting diet, health care, status, parenting, religion, and ethnicity are many specific behaviors that populations engage in as part of their cultural repertoire. While the list is extensive and well organized, it is too long to reproduce here, but some mention of specific behaviors is warranted. For example, foot binding of Chinese girls, the use of corsets during the Victorian era, trephination of the cranium among certain ancient Mesoamerican groups, silicon implants among North American women, tanning of the skin among different populations, and intentional dental modifications among the Aztec are a few of the examples of maladaptive behaviors cited (Logan and
Qirko 1996). These examples show cultural behaviors and traits that are perhaps harmful to the individual partaking in them. This thesis will focus on intentional dental modifications as a potentially deleterious trait, but one, when viewed from a Darwinian perspective, that may have conferred a reproductive advantage.
What is Intentional Dental Modification? The study of dental modification has interested anthropologists for many years, but how and why did this practice ever start? Perhaps there will never be a clear answer, but such modification is a result of various cultural practices, including artificially shaping the teeth, decorating labial surfaces with inlays, deliberate removal (ablation), and using them as non-
4 masticatory tools. Additionally, other factors such as attrition, abrasion,
tooth fractures, antemortem tooth loss, surgery, and pathological
conditions all characterize dental variation seen in the oral complexes of
individuals from different populations. The phenotypic differences in
modified teeth reflect a wide range of cultural practices and help
anthropologists in the process of reconstructing and understanding human behaviors of the past (Milner and Larsen 1991). Ortner and
Putschar (1985) state that there are two kinds of intentional dental modifications that involve fracture of the dentition, one is ablation of specific teeth, and the other is mutilation of the dentition, usually involving the labial, or lip, surface of the anterior teeth (i.e., incisors and canines). (See Figure 1.1). Mutilation occurs when the teeth are ablated, filed, or drilled and inlayed with carved materials.
Linne (1940) and Romero (1970) state that, judging from
archaeological evidence, there were three distinct trends in the types of dental alterations practiced in aboriginal Mesoamerica. The first and earliest of these involved filing, which then progressed into filing and inlaying. The last trend consisted of filing the teeth, but with no inlays of stone or coral. In Africa, the types of dental mutilation are limited to
ablation and filing (see van Reenen 1978a, 1978b, 1986). Fastlicht (1976) believes that dental mutilation is a misnomer because it is presumed that modifying the teeth was meant to beautify, not mutilate. As such, the terms "intentional tooth modification" or "intentional dental modification" will be used throughout the rest of this thesis when
discussing this cultural practice.
5 • = Anterior teeth
Figure 1.1 The oral complex. Modified fromBath-Balough and Fehrenbach (1997).
6 There are numerous cross-cultural examples and descriptions of intentional dental modifications. Despite an abundance of cases, the origins of intentional dental modification are difficult to trace. Perhaps tooth modification derived from early attempts to maintain oral health
(Fastlicht 1976). Historical accounts in Mesoamerica after the Spanish
Conquest of the Aztec in 1521 are helpful in understanding the practice of early dental modification in this culture area (see de la Cruz 1940, Sahagt1n
1950-1969). Among these accounts is the Badianus Manuscript written by de la Cruz in 1552. This report is important because it was completed 31 years after the fall of Tenochtitlan, the Aztec capital. It contains ethnohistorical information regarding 251 plants used by the Aztec for medicinal purposes. Of particular importance, one chapter of the manuscript deals with oral health and the treatments prescribed for many oral and perioral ailments including halitosis, dental pathology, and oral hygiene. Some of these botanical remedies may have been used to treat the side effects resulting from intentional dental modifications.
Effects of dental modifications on the oral complex Barring accidents or intentional ablation, the heterodontic dentition of Homo sapiens sapiens is composed of 32 teeth with 8 incisors, 4 canines,
8 premolars and 12 molars. The teeth are just one part of a complex system in the oral cavity and have diverse functions. The most basic is mastication, or the chewing of substances. Mastication involves the processing of food, which aids in digestion. Another function is paramasticatory, where the teeth are used as agents not related to
7 processing food. There are studies of the use of teeth as non-masticatory agents (see Blakely and Beck 1984; Gould 1968; Gould, et al. 1971; Molnar
1972; Merbs 1968, 1983). Teeth become tools with specific "signature" marks reflecting their use. These signature marks differ from the normal wear patterns associated with food mastication. For example, Blakely and
Beck (1984) describe symmetrical notches in anterior teeth of crania from archaeological sites in Tennessee. This alteration was most likely caused by the individuals using their teeth as gripping tools in the processing of sinew. Gould (1968) and Gould, et al. (1971) provide an interesting case of
Australian aborigines using their teeth to flake stone tools. Merbs (1968,
1983) describes anterior tooth loss in Arctic populations, where the effects of activity-induced pathology, not ritual ablation, resulted in the loss of teeth.
Because the anterior teeth are visible to individuals while conversing, dental hygiene may have originated first from an aesthetic desire, not one pertaining to health. In fact, Scott and Turner (1997) state that the mouth is a "social organ" that commands the viewer's attention.
The appearance of the teeth, then, becomes culturally important, as in the case of intentionally modifying the anterior dentition. However, while modification may provide some aesthetic benefit it may also cause harm.
That is, if the masticatory apparatus is compromised by accidental or intentional modification, severe complications may result. To better understand the deleterious effects of dental modifications on the oral health of individuals a basic summary of odontology becomes necessary.
8 At a simplified macroscopic level, the teeth are composed of
enamel, dentine, pulp, and cementum (See Figure 1.2). The enamel,
dentine, and pulp of the tooth are of particular importance when examining the effects of dental modifications because these tissues are most readily altered and susceptible to responding. Enamel covers the entire anatomical crown of the tooth, providing protection. Given its high mineral content, it is the hardest tissue in the human body. Dentine constitutes the entire body and bulk of the tooth. It is found under the crown and in all of the root. There are three types of dentine: primary, secondary, and tertiary (See Figure 1.3). Primary dentine is laid down during dentinogenesis, i.e., the formation of dentine. Secondary dentine is produced during the lifetime of the individual and acts as a maintenance mechanism. Tertiary dentine forms in response to irritation from trauma or disease of the tooth (Avery 1992; Jordan and Abrams 1992).
Pulp is the living constituent of the tooth, containing nerves, blood vessels, and lymphatic tissue. The pulp functions in a number of ways to protect, supply nutrition, and repair itself in the tooth (Ten Cate 1994).
Trauma to the dentition is not uncommon and the teeth respond accordingly to injury, as well as to the harmful effects of bacterial introduction. In the case of intentional modification, enamel and dentine are compromised and the pulp can be exposed or liberated. In such instances, tertiary dentine is produced and laid down to protect the pulp chamber and curb the effects of subsequent pathology such as caries or abscess. Tertiary dentine is the result of pulpal stimulation and forms at the site of odontoblastic activity, or where dentine forms. Damage to a
9 Dentinoenamel junction (DEJ)
Cementoenamel junction (CEJ)
._---Cementum
Figure 1.2 Diagram of longitudinal section of enamel, dentine, pulp, and cementum.
10 Figure 1.3 Thin section of tooth showing dentine in its three forms: primary {A), secondary (C), and tertiary (B). From Berkovitz, et.al. 1992.
11 tooth may take several forms, including attrition, caries, abrasion, and fracture. Restorative procedures such as amalgams or fillings, and mineral inlays in culturally modified teeth, could also be placed into this category (See Figure 1.4 and 1.5). Secondary dentine is continually produced throughout life. However, pathologies cause changes in the dentine (Bhaskar 1991; Moss-Salentijn and Hendricks-Klyvert 1990).
These changes may come in the form of dead tracts, sclerosis, and reparative dentine. These changes, known as dentinal repair, are the tooth's attempt to save itself from infection, abscessing, and subsequent removal from the oral cavity.
Severe consequences may occur to the dentition after a traumatic episode. Ortner and Putschar (1985) state that accidental or deliberate trauma to the dentition will likely leave permanent signatures.
Therefore, the mere fact that the change in tooth morphology is intentional does not save the individual from negative, possibly life threatening, consequences. In most cases the crown (enamel and dentine) is damaged and, in rarer cases, the root is damaged. Researchers warn that exposure of the dentinal tubules increases the risk for infection of the pulp, which may then lead to periapical abscess (Mata 1994; Ortner and
Putschar 1985). The present study proposes that intentionally modifying the teeth increases the threat of pathology. Studies have confirmed that dental modifications do not occur without pain (Fastlicht 1976; van
Reenen 1978a, 1978b). In fact, pre-Columbian Mesoamericans undoubtedly used plant-based anesthetic agents, such as the prickly pear cactus (Opuntia sp.) to dull the pain resulting from modification (Hernandez 1959; see also
12 13 14 de la Cruz 1940; Fastlicht 1976). Elsewhere, when anesthetic agents are not used during modification procedures, pain is an inevitable outcome. If it persists, normal mastication may be compromised (see van Reenen 1978a,
1978b).
15 Chapter 2
Oral Histology and. Dental Anatomy
Terms and Tissues The terms utilized in this study concerning oral histology and dental anatomy are presented at a simplified level. For those interested, advanced sources on oral histology and dental anatomy exist (see Avery
1992; Bath-Balogh and Fehrenbach 1997; Bhaskar 1991; Jordan and Abrams
1992; Moss-Salentijn and Hendricks-Klyvert 1990; Ten Cate 1994). Dental embryology is characterized by many intricate stages and a brief discussion of oral development is necessary to explain tissue response to the areas affected by dental modifications. Dental anatomy encompasses a number of complex stages that includes growth and development, histology, mineralization, and emergence. Intentional dental modification primarily affects two tissues, the enamel and the dentine. In addition, it may adversely affect a third tissue, the pulp. In order to better understand the mechanisms at work, brief outlines of the cellular stages of enamel and dentine are addressed. Because teeth erupt in different sequences, the timing of these events are highly variable. Enamel and dentine growth for the first deciduous teeth occurs very early, beginning around the seventh week of embryonic life
(Moss-Salentijn and Hendricks-Klyvert 1990).
16 The formation and development of enamel at the cellular level is called amelogenesis. It is first characterized by the primary production of a thin layer found at the dentinoenamel junction (DEJ). This is the first layer that mineralizes, allowing Tomes processes to attach. The differentiated cells that make enamel are called ameloblasts. The ameloblasts begin production and secrete an organic matrix comprised of amelogin and enamelin seeded with hydroxyapatite crystals that mineralize into keyhole-shaped prisms. Hydroxyapatite is one of the main inorganic compounds found in enamel. As the ameloblasts migrate outward, mapping out the crown outline of the tooth, mineralization occurs immediately behind the ameloblastic cells. During amelogenesis, daily incremental growth is observable in cross striations. Larger incremental growth lines, or Striae of Retzius, are circaseptan events.
When these growth lines continue outward and terminate on the tooth surface, they are demarcated as perikymata. The ameloblasts only travel as far as communicated by cells during their production of enamel. The result is that in the finished product, various enamel thickness is seen, characterized by individual stresses and strains. Near cusp tips the prisms bend at differing angles, producing what is called gnarled enamel to help dissipate occlusal masticatory forces. Similarly, the formation and development of dentine at the cellular level is called dentinogenesis. Dentine forms the bulk of the tooth. The process begins when a biochemical message from the inner enamel epithelium (the pre-ameloblast) is sent from the enamel organ across the
DEJ to the dental papilla informing those mesenchymal cells to initiate
17 dentine production. Amelogenesis begins when 4J.Lm of dentine have been deposited at the DEJ. The cells that give rise to dentine are called odontoblasts, and they begin by laying down a thin layer of matrix called pre-dentine, which eventually mineralizes into dentine. This layer of dentine adjacent to the DEJ is known as mantle dentine. Odontoblasts produce dentine and move inward toward the pulp in their production.
Odontoblasts are housed in dentinal tubules. The odontoblasts work by secreting pre-dentine and then moving inward toward what will become the pulp in the finished crown. Pre-dentine mineralizes into dentine and follows in a front immediately behind the active odontoblasts. There are three types of dentine: primary, secondary, and tertiary. Primary dentine is laid down during dentinogenesis for original crown formation.
Secondary dentine is produced at a reduced rate during the lifetime of an individual as a result of normal aging. Tertiary, sometimes called reparative dentine, is produced and utilized during a traumatic episode to the tooth. The tooth will attempt to protect itself from the effects of traumatic episodes like caries or fractures. Dentine is different from enamel in that it continually remodels itself throughout life in response to the stresses placed upon it. A third tissue byproduct of dental growth is the pulp. It is the living constituent of the tooth and acts accordingly to protect and defend itself.
The pulp is filled with different and numerous tissues including blood, lymph, and nerves. When a tooth is altered in a traumatic way, (e.g., carious lesion, fracture, intentional filing or drilling), and the dentinal wall has been invaded, the pulp will act to save the life of the tooth by
18 causing tertiary dentine to form attempting to seal off the affected area (See
Figure 2.1). In some cases this succeeds. In other cases it does not, thereby causing an inflammatory response and affecting the tooth and perioral complex, in a severe manner.
The cellular level of tooth growth and development is the primary stage in a tooth's life. With maturation, the teeth do not remodel as other living tissues, such as bone, do. That is, teeth will not act to repair themselves in response to the stresses placed upon them. In this sense, the teeth will permanently reflect the use wear signature markings they accumulate through the life of the tooth. As mentioned above, a mature tooth's innervation is supplied through the pulp. The enamel and the dentine are not connected vascularly and do not transmit pain. By intentionally modifying the teeth, individuals significantly increase harm to the masticatory apparatus if there is exposure of the pulp.
When enamel and dentine are compromised and pulp is exposed, the physiological response of the surrounding soft tissues manifests itself as pain. If bacteria is introduced this will likely lead to infection, decay, and loss of alveolar bone and teeth. The potential pathological responses to modified teeth are described in greater detail in the next chapter.
19 Preparation -formlay
Tertiary dentine formingto protect pulp
Figure 2.1 Diagram of tertiary dentine forming to protect pulp.
20 Chapter 3
Pathologies in Modified Teeth
The intentional filing, inlaying, and/or ablation (evulsion) of teeth increases the likelihood of pathologyto the orofacial complex.
Aside from the specific function of such dental treatments within the sociocultural values ... one must consider the pain suffered during the treatment as well as the health complications that might have resulted from havingsuch work done (Mata 1994:257).
Although there are some who have declared there is no real health risk from dental modification (Milner and Larsen 1991), others disagree or at least make mention of pathologies directly related to intentionally altering the teeth for cultural reasons (see Fastlicht 1976; Mata 1993, 1994;
Romero 1958). It is well known that trauma to the dental arcades increases the risk of pathology, which in tum may compromise the overall health of an individual (Ortner and Putschar 1985). Some researchers describe intentional dental modification as a form of trauma (Merbs 1989; Schwartz
1995; White 1991). Mata (1994) reports that evidence of perioral pathology was detected in a large number of archaeological specimens he examined.
Even though the teeth are being modified in ways to conform to cultural standards, the problem with artificially modifying the dentition lies directly in the risk placed to the health of the individual participating in the procedure. The intentional filing, inlaying and ablation of teeth greatly increases the likelihood of pathology to the orofacial complex.
21 This chapter begins by discussing the effects of trauma via intentional dental modification to the human orofacial complex. It then explores the instances found in the literature where perioral pathology, i.e., abscess and alveolar resorption, is noted by the researcher. Many researchers disregard the fact that pain, health complications, and even death may result from such procedures. I contend that there are many examples of oral pathology directly related to intentional dental modification. These examples must be considered when attempting to understand why intentional dental modifications occur along such a wide historical and cross-cultural continuum.
Pathological reactions of orofacial complex in response to
intentional dental modifications
The pathological reactions after a traumatic episode has occurred to the teeth are numerous and are reflected in the dentition and surrounding orofacial structures. Mata (1994) explores the effects of postoperative recovery and pain to the oral complex associated with intentional dental modification. Mata's research examines dental treatments that occurred in pre-Columbian Mexico. He contends that the treatments employed to perform the operation of intentional dental modifications were potentially harmful and, in some cases, even fatal. He states that preparing a circular hole on the labial side of a tooth for an inlay produced a tremendous amount of heat, which in tum, caused excruciating pain. In some cases the damage was reversible and the pain would dissipate a few days after the operation. In other cases, the damage suffered by the tooth
22 was irreversible, resulting in a swelling of the periapical tissues. Bacterial infection could set in causing abscessing of the tooth and resorption of the surrounding alveolar bone (See Figure 3.1). Side effects of infection include loss of the modified tooth, loss of adjacent teeth, infection of perioral musculature, and even death to the individual due to severe bacterial infection.
Mata's description shows that intentional dental modification is not without its risks to the perioral complex. It is interesting to note that many of the researchers who describe the risk of orofacial pathology are dentists.
Evidence of orofacial pathology directly associated with
intentional dental modifications
Most researchers agree that while dental modifications were no doubt the work of skilled craftsmen, the modifications probably did not originate as a therapeutic procedure (Fastlicht 1976; Mata 1994, 1996;
Romero 1958; Rubin de la Borbolla 1940). As previously mentioned, pathological conditions such as caries and periapical abscesses may result from oral infections if the teeth are traumatized when filed or prepared for inlays. If the dentition is accidentally damaged and the masticatory apparatus is hindered, serious consequences can result as well.
The literature is rife with examples of dental pathology directly related to the intentional modification of the teeth. The following case studies demonstrate there is significant risk associated with intentional dental modification. For instance, Van Rippen (1917:870) says that "the
23 Figure 3.1 Periapical abscessing on maxillary alveolar bone above right central incisor and left central and lateral incisors.
24 procedure must have caused considerable pain." Rittershofer (1937:132) describes dental specimens from the Philippines and notes that "many of the pulps were exposed during ... (the) operation," increasing the risk of necrosis to the tooth and surrounding alveolar bone. Alexanderson (1940) describes the risk of pathology to the dental pulp and the intense pain associated with the preparation of teeth for modification. Rubin de la
Borbolla (1940) finds that some archaeological specimens possessed incomplete inlay operations and hypothesizes that the procedure had to be halted due to intense pain, or, perhaps, the death of the individual.
Additionally, Rubin de la Borbolla (1940:356) mentions that in several other maxillae and mandibles he examined, "alveolar infections and tooth decay were the inevitable results of imperfect drillings made by inexpert hands." Fastlicht (1948:319) provides evidence that filing and inlaying the teeth "produced disorders such as the degeneration of the pulp and .. . periapical alveolar abscess." In other examples he notes teeth filed to such a degree as to inhibit mastication due to sensitivity caused by damage to the innervated pulp. Further, he describes the risk of periapical abscesses and dental caries. In short, "some defective mutilations cause pathologic processes and the functional loss of the teeth" (Fastlicht
1948:323).
Romero (1958:232) states that numerous archaeological specimens show "evident traces of alveolar abscesses which demonstrate that filing as well as inlay on certain occasions was not successfully accomplished." He supports this statement in later research: "The association of dental mutilation with alveolar abscesses in certain other cases demonstrates ...
25 the mutilation damaged the pulp chamber of the teeth, doubtless causing pain and making mastication difficult" (Romero 1970:55). Goose (1963) notes that by examining radiographs of modified teeth he found evidence in some cases that such filing operations lead to necrosis of the pulp with related periapical pathology. Stewart and Groome's (1968) research also ' shows clear evidence of periapical infection, i.e., infection occurring around the apex of the tooth root, associated with intentional dental modification in an individual from Grenada, West Indies.
Davies (1972) notes abscessing in the roots of inlaid teeth from
Borneo. He concludes: "There were more caries in filed teeth than in unfiled teeth"_ (Davies 1972:96). Moreover, Fastlicht (1976:47) reiterates a finding drawn from his earlier research: "Lesions with abscesses observed in some of the maxillae are the result of injury to the dental pulp, and of damage caused by faulty techniques in which the pulp cavity was penetrated during preparation of the tooth." Carter, et al. (1987) state that in some cases, a lack of knowledge of dental anatomy caused operators to expose the pulp of some individuals after inlaying the teeth with minerals. Both Pindborg (1969) and Weiss (1992) report trauma to the permanent canines, such as malformation and agenesis, after the deciduous canines have been forcibly extracted. Miller and Taube (1993) conclude that intentionally modifying the teeth, as in the case of inlays, could cause severe pain, even death. Mata (1993) describes a pathological lesion associated with pulpal infection on a tooth and correlates it with an operative procedure to produce a hole to receive an inlay. In other research, he notes that improper drilling procedures will produce intense
26 pain. Such modification may also lead to infections of teeth, bone, and
mouth (Mata 1996). One important area of consideration is the alveolar bone that makes up the jaws and holds the teeth. Infections as a result of traumatic episodes to the oral complex may likely cause further damage in the form of alveolar bone loss or resorption. There have been many studies on overall health and alveolar bone loss associated with periodontal disease
(see Clarke and Hirsch 1991; Hildebolt and Molnar 1991). This is one area that future studies in intentional dental modifications need to address. In conclusion, many examples of pain and perioral pathology directly related to intentional dental modifications exist. These examples all lend credence to the primary theme of this chapter. For whatever reasons individuals modify their teeth, the choice to artificially shape the teeth is clearly risk-laden.
27 Chapter 4
Discussion
Whydo dental modifications occur?
Individuals in many cultures are not content with the natural morphology of their teeth but feel a cultural or idiosyncratic urge to produce an artificial morphology more in line with their value system (Scott and Turner 1997:xiv).
Numerous reasons have been advanced in an attempt to explain why the custom of intentional dental modification is found in a wide variety of historical and cultural settings. Many authors point out that intentionally altering the teeth affords specific privileges to those possessing modified dentitions. For example, the literature exhibits a wealth of differing theories on why people today or in the past would modify their teeth. These theories pertain to animal imitation (Carter, et al. 1987; Comas 1960), beautification and cosmetic adornment (Whittlesey
1935), cadaveric, or post-mortem, adornment (Dembo and Imbelloni 1938;
Hamy 1882), diplomatic and political markings (Mata 1996), ethnic markers and tribal identification (Rojo 1909; van Reenen 1978a, 1978b,
1986), expressions of mourning (Comas 1960), initiation and rites of passage (Krogman and Iscan 1986), medical purposes (Davies 1972; Goose
1963), religious practices (Mata 1996), sexual attraction (Thomas 1916), and markings of social status (Fastlicht 1976).
28 Who possesses altered teeth?
Researchers have recorded dental modifications in both males and females. Moreover, evidence points to young adults as the prime candidates for intentionally modified teeth (Carter, et al. 1987; Romero
1970; Stewart 1941). Interestingly, Havill, et al. (1997:90) state that while both males and females possessed dental modifications, "it appears to be more common among one sex or the other in different time periods."
The practice of intentional dental modification is found most often in stratified societies, although there are examples of nomadic groups such as the !Kung who intentionally alter the morphology of their teeth for social benefits (See !Kung example in Maladaptive Traits section below). The practice of intentionally altering the dentition is not usually observed in most egalitarian or hunting and gathering societies perhaps due to the reliance on the teeth as tools. Dental modification in these cases is, most likely, unintentional (see Gould 1968; Gould, et al. 1971; Merbs 1968, 1983).
In studies on living individuals in Africa, dental modifications occurring in young adults have been associated with the transition ceremonies from childhood to puberty (Goose 1963; van Reenen 1978a,
1978b). There may be a bias in the archaeological record because natural tooth wear (attrition) in older individuals might erase evidence of intentional modification on teeth (Milner and Larsen 1991). That is, through the natural process of tooth wear consistent with a gritty diet, individuals who possess dental modifications as young adults may actually wear the modification away. Thus as time passes, when an archaeologist examines a skull of antiquity, the teeth, if present, may not
29 reveal intentional modification even though those teeth may have been modified.
There are few examples of children with altered deciduous dentitions. Three reasons may account for this. First, the primary teeth are relatively more fragile than their permanent counterparts. Second, the rapid exfoliation, or loss, of the primary teeth seems to make them less likely to be chosen for intentional modification. Third, Romero (1958) suggests that adults in pre-Columbian Mesoamerica did not allow their children to undergo intentional dental modification because of the risks involved. Interestingly though, adults were either oblivious to, or chose to ignore, these risks when modifying their own teeth.
Reasons for dental modification
The reasons for modifying the teeth are numerous. Early researchers working in Mesoamerica thought that the very nature of the dental operation itself indicated a postmortem practice because modifications in live individuals would not be feasible due to the pain, as well as the skill and time required for such alterati�(Dembo and Imbelloni 1938, Hamy 1882). In fact, Fastlicht (1948) states that these researchers believed modified teeth represented cadaveric adornment.
These accounts can be rejected, however. Fastlicht (1976), for example, states that in post-conquest Mesoamerica there are historical data showing that indigenous peoples had words for filing the teeth of living individuals. There are additional sources of information that support the claim that dental modifications were performed on the living, not the
30 deceased (see Fastlicht 1948, 1976; Goose 1963; Rittershofer 1937; Romero
1958, 1970; Rubin de la Borbolla 1940; Stewart and Groome 1968; van
Reenen 1978a, 1978b). Researchers point out that dental modifications were performed on live individuals because dentinal repair often occurs.
Most evidence comes from radiographs taken of maxillae and mandibles confirming the existence of dental pathologies resulting from intentional modifications. In some instances, periapical abscesses resulted when the dental pulp was damaged. Finally, recent ethnographic studies have documented the occurrence of such practices among contemporary peoples in southern African countries (Bachmayer 1982; van Reenen
1978a, 1978b, 1986). These accounts establish that modifications of the dentition typically occur antemortem.
Blakely and Beck (1984) correctly observe that intentionally modified teeth are/were meant to be seen by other individuals. Most researchers report that cultural groups believe dental modifications serve an aesthetic, beautifying purpose (Blakely and Beck 1984; Fastlicht 1948,
1976; Goose 1963; Milner and Larsen 1991; Pindborg 1969; Rittershofer 1937;
Romero 1958, 1970; Rubin de la Borbolla 1940, Whittlesey 1935). For instance, among the peoples of Borneo, DuBois (1944:84) states that modified teeth are "considered definitely attractive." Goose (1963:91) reports that an intentional change to the dentition "makes men look more warlike." Another example deals with the use of modified teeth to attract the opposite sex (Thomas 1916). Whittlesey (1935) comments on the observations of Bishop Diego de Landa in 16th century Mexico. According
31 to Landa, Yucatec women decorated their bodies and teeth to appear brave and fearless (Whittlesey 1935).
Some researchers have argued that dental modifications function as an ethnic marker (Bachmayer 1982; Entwistle 1946; Fastlicht 1976; Handler
1994; Marshall 1946; van Reenen 1978a, 1978b, 1986; Wilson 1946). For instance, Bachmayer's (1982) and van Reenen's (1978a, 1978b, 1986) research on Africans in Namibia is quite revealing in this respect. They conclude that filing and ablation of the teeth in particular ways served as an identification of tribal membership. Interestingly, members of one cultural group would inspect the patterns of dental modification in a visitor to establish, or re-affirm, ethnic or tribal identity (van Reenen
1978a, 1986). Van Reenen (1978b) also discovered that different tribes sharing a similar geographical area possessed group-specific patterns of dental modifications (See Figure 4.1). There are instances where an individual may exhibit combinations of different styles in dental art. This may have resulted from intergroup diffusion or perhaps marriage into a different tribe (van Reenen 1978b). Fastlicht discusses Rojo's (1909) argument that dental modifications served as ethnic markers among ancient Mesoamericans. He lists Rojo's (1909) classification of different cultural groups according to the type of modification practiced, as well as the kind of material used for inlays. The Tarascans of Michoacan filed a slash onto the incisal edge of the tooth; the Totonacans from Veracruz put two cuts into the free edge of the anterior teeth; the Zapotecs used pyrite inlays; the Mayans in Chiapas used jadeite inlays (Fastlicht 1976).
32 African Groups Typical style Va riations in style
Sambyu (Xf)Cli) (Xf)Cli) CJJJ\1\fJ (}JrxJJ\) a w (fi)Cli) (fi)Cli) w Herero (JJ CQ lJJ aOJ ())00\f) (J)00\f) Cokwe 000000 (}0(7\U) CffJJlllb a � (X[)Ch) mDCJro CJJDCJro Wanyemba CJJJ\1\fJ CJJJ\JJJ QOOOOQ a (]Jrxf\JJb c
Figure 4.1 Tribal identification patterns in intentional tooth modifications of African groups. Modified from Bachlnayer (1982) and van Reenen (1986). Because differential patterns or styles of tooth modifications are observed in several Mesoamerican archaeological populations, some researchers believe dental modifications, aside from being ethnic markers, are indicative of status or rank (Fastlicht 1948, 1976). Fastlicht (1976) gives an example of intracultural patterning in dental modification among residents of Palenque, a Classic Period (AD 300-900) Mayan ceremonial center in Chiapas, Mexico. Pacal, one of the kings of this Mayan center, was buried in a temple at Palenque. While Pacal's teeth were filed, some of his attendants, presumably of lower status, possessed beautiful dental inlays in their dentitions. Similar findings are reported by Milner and
Larsen (1991) for the Mississippian period Indians (AD 1000-1400) in the southeastern United States. The authors also state that differential styles of dental filings are indicative of variability in social status. A third example comes from Stuart's (1997) recent archaeological study of Copan, an ancient Mayan city in Honduras. Stuart (1997:75) speculates that two anterior teeth from an adult male possessing jade inlays "emphasized that he was a highly esteemed person."
Not all researchers agree, however, that intentional tooth modifications represent status markers. Romero (1958, 1970) believes that there is no relationship between intentionally modified teeth and status.
He bases this on his studies of numerous burials assigned to all classes of society. Mata (1996) notes that intentionally modified teeth have been found in both royal and common burials. This suggests that modification of the teeth was very widespread. The questions of whether this practice
34 was indicative of status differentials must go unanswered until more
research on intra-cultural stylistic differences is done.
Other reasons given for the intentional alteration of the dentition
pertain to rites of passage. Researchers have reported on cultural groups
that permanently alter the appearance of the dentition to mark the
transition between childhood to adulthood (Bachmayer 1982; Goose 1963;
van Reenen 1978a, 1978b, 1986). Goose (1963) reports that among the Ibo of
Nigeria, women were not permitted to bear children until their teeth were
filed. He also reports that some groups in South Africa require
modification of the dentition to produce a lisp because "language cannot
be spoken properly unless ... [the] ...front teeth are knocked out" (Goose
1963:91).
Methods of modification
There have been a variety of techniques developed to produce dental modifications. Because there are many different types of dental
modifications, a variety of tool kits exist for the operative procedure
(Romero 1958, 1970; see also Fastlicht 1948, 1976; Rittershofer 1937; Rubin de la Borbolla 1940; Saville 1913). Modifications include both filing and inlaying the teeth with "plugs" of certain minerals. In other regions, filing and ablation of teeth were present while inlaying was not practiced
(Bachmayer 1982; Goose 1963; van Reenen 1978a, 1978b).
For dental filing, Fastlicht (1976) and van Rippen (1917) report that
among ancient Mesoamericans, stones were the preferred tool.
Specifically, filing tools made from obsidian allow the person performing
the modification to cut the incisal, distal, and mesial margins of the teeth
35 to alter their natural morphology. Van Reenen (1978a, 1978b) notes that in filing the teeth among South West Africans, the tools used for the operation included an ax head, a knife, a file, or any combination of the three. Ablation of the teeth required that the teeth be loosened from their alveoli (sockets) using tools similar to those used for filing. Once loosened, the teeth were removed manually and the alveoli cauterized by inserting a heated stick in the wound (van Reenen 1978a). Inlaying required greater skill as the individual performing the procedure was required to drill small holes into the labial surface of the tooth, ideally without piercing the pulp chamber. The holes would then be plugged with sized mineral encrustations. Fastlicht (1976) and Whittlesey (1935) report that Mesoamericans used iron pyrite, hematite, jadeite, jade, turquoise, quartz, serpentine, rock crystal, Mother-of-Pearl, and cinnabar for this procedure, while Rittershofer (1937) and Rubin de la Borbolla
(1940) note that gold was the preferred mineral for inlays in the
Philippines and Ecuador.
The techniques used to produce the holes for inlays likely included a bow drill with a hollow tubular bit, not unlike those used to make trephinations in the skull (Fastlicht 1976, Romero 1970). The tubular drill bit was made of jade, copper, or bird bone, and powdered quartz or fine sand was probably used as an abrasive (Fastlicht 1976; Romero 1970). Some researchers have begun preliminary replicative studies on dental inlaying in Guatemala using middle range research methods on donated teeth
(Mata 1994, 1996; Woods 1996). The techniques for these studies involve the utilization of both replica bow and pump drills with hollow bird bone
36 and copper bits. The labial surface of the tooth is covered with bee's wax, and a small area is scratched to expose the enamel. A drop of acid derived from plant extracts is used to start an indentation on the enamel. This indentation acts as a guide for the rotating drill.
These studies are promising because they give insight into the procedures for dental modifications. Whatever technique is applied, when the dentition of a person is modified, the risk to the life of the tooth, and perhaps the individual, is increased.
Distribution of intentionally modified teeth Temporal and Spatial Dimensions
Intentional dental modification has enjoyed a diverse history.
There are accounts of many societies in many countries engaging in this interesting cultural behavior. Dental modification is a trait that enjoys wide geographic range and significant temporal depth. From the temporal perspective, Alexanderson (1940) states that intentional dental modification began with the ancient Egyptians. In Mesoamerica filing and inlaying the dentition occurred for roughly 3000 years, ending with
European contact (Fastlicht 1976; Romero 1958, 1970). In Africa, intentional filing and ablation of teeth are still widely practiced
(Bachmayer 1982; Briedenhann and van Reenen 1985; van Reenen 1986).
While this trait does not enjoy great antiquity (i.e., it is not present during the Paleolithic), it has persisted in certain stratified societies for over 3000 years. The question that arises, of course, is why does this behavior
37 continue to be practiced if it proves to be deleterious to individual health?
Possible answers to this question are discussed in greater detail below.
Geographically, culturally induced modification of the dentition is found throughout the world. There are both archaeological and contemporary examples from Africa: Namibia (Bachmayer 1982;
Briedenhann and van Reenen 1985; van Reenen 1978a, 1978b), Nigeria
(Goose 1963), Sierra Leone (Thomas 1916), South Africa (De Jager 1965),
Sudan (Davies 1972), Tanzania (Weiss 1992), Uganda (Pindborg 1969),
Eastern Africa (Singer 1953), and Western Africa (Entwistle 1946; Marshall
1946; Wilson 1946); Asia: Borneo (Davies 1972; Du Bois 1944; Gomes 1911),
India (Kennedy et al., 1981), the Malay Archipelago (Davies 1972), Mariana
Islands (Ikehara-Quebral and Douglas 1997), Philippines (Rittershofer
1937), and Thailand (Frank 1926); Australia (Davies 1972; Spencer and
Gillen 1899); North America: Colorado (White et al. 1997), Illinois
(Holder and Stewart 1958); New York (Handler 1994), Tennessee (Blakely and Beck 1984), and the We st Indies (Stewart and Groome 1968);
Mesoamerica: Belize (Havill et al. 1997); Costa Rica (Weinberger 1948),
Ecuador (Saville 1913; van Rippen 1917; Weinberger 1948), Guatemala
(Lopez Olivares 1997; Mata 1993, 1994, 1996), Mexico (Alexanderson 1940;
Fastlicht 1948, 1976; Hamy 1882; Rojo 1909; Romero 1958, 1970; Rubin de la
Borbolla 1940; van Rippen 1917; Weinberger 1948; Whittlesey 1935); and
South America: Argentina (Weinberger 1948), Bolivia (Weinberger 1948),
Brazil (Weinberger 1948), and Chile (Weinberger 1948).
As is seen by the above listings, intentional alteration of tooth morphology is very widespread. Additionally, this practice has a long
38 history occurring in many cultures. Given the risks associated with this custom, the question that arises is why has this trait enjoyed such significant temporal depth and geographic range?
Maladaptive Traits
What is maladaptive?
"Sometimes pain, mutilation, and even death are acceptable risks in the pursuit of perfection" (MacFarquhar 1997:68). Even with such risks, intentional dental modification has enjoyed a long history. In order to understand why people continue to modify their teeth it is necessary to examine the ultimate benefits possibly gained by having altered dentition.
In their1996 study, Logan and Qirko present a perspective on maladaptive traits and the power of cultural conformity. They begin by discussing that many human behaviors have traditionally been erroneously analyzed as being adaptive (Logan and Qirko 1996). In the past, certain cultural behaviors, however bizarre they may seem, have been written off as functional for the group engaging in them. For example, Tindale (1974) discusses the damaging, though "adaptive", consequences of rites of passage involving circumcision and subincision among males in aboriginal Australia. He views these rites as a latent means through which population growth was reduced due to enhanced male infertility and mortality. His claim can certainly be challenged.
MacFarquhar (1997) discusses cosmetic surgery -- in this case, face lifts -- concluding that:
The fact is that there are still many retrogressive arguments circulating against cosmetic surgery, despite its new prevalence: it's unnatural; it's
39 violence ...to allow yourself to be sliced up andmutilated for the sake of beauty, is a sign of pitiful mental imbalance (MacFarquhar 1997:68).
If this is being said for plastic surgery, perhaps dental modification is a sign
of mental imbalance as well, but only when viewed from an etic, not ernie, perspective. Why then is intentional tooth modification so widespread along a temporal and spatial continuum? There must be a reason why people continued to expose their dentitions to such operative procedures.
What benefits come from having modified teeth? Perhaps this is a culturally induced trait pertaining to beauty. The ultimate ideal for how teeth should appear varies from one culture to another (Scott and Turner
1997). Researchers report that modified teeth are used to attract the opposite sex (Carter, et al. 1987; Coffin 1911; Thomas 1916; Scott and Turner
1997). For instance, Scott and Turner (1997) report that an informal poll among a college population showed that the appearance of the teeth played a significant role in assessments of sexual attractiveness. They stated that 94% of those students asked "felt teeth were an important element of physical attraction" (Scott and Turner 1997:xiv).
Modification of the human body, whether through permanent or temporary changes, has a long history. From a Darwinian standpoint, to be genetically successful is to pass one's genes from one generation to the next. In other words, to meet, mate, and procreate. If people can increase the likelihood that their genes will be passed by adorning themselves to be more noticeable by the opposite sex, then particular fo rms of somatic art become more understandable, and this certainly includes the custom of altering the dentition. Here, social and reproductive rewards may overshadow any risks, whether known or unknown. Selection and the
40 differential fitness of given traits is always environmentally dependent. If an environment changes, so, too, will the process of natural selection.
An interesting case in point is provided by Weiner (1994), who summarizes research done on the Galapagos Islands over the past 25 years.
The research was carried out on finches suggesting that natural selection has served as a major architect of avian morphology and behavior. That is, one bird may be more likely to mate with another bird that possesses a particular trait. Initially, this trait may prove advantageous to the surviving offspring, but with subsequent generations it may become harmful. An example that illustrates this point comes from Weiner's
(1994) report on El Nino of 1982-83. El Nino is the environmental change seen worldwide that is caused by an increase in ocean temperature, which in turn produces major fluctuations in global weather patterns. During
1982-1983, El Nino caused a tremendous increase in the flora in the
Galapagos, and specific finches capitalized on the change. Mate selection at that point reflected those specific traits helpful to gathering the plethora of food. When El Nino ended, the result was many finches suited for individualized types of food (which were more plentiful and available during El Nino) died out. Those finches that did survive were better suited for adapting to the more harsh and less plentiful environment.
Thus their traits were selected for in the subsequent mating season. This example shows how mate preferences among finches can be affected by periods of environmental change. Such fluctuating preferences can affect their ability to be reproductively successful.
Cultural environments also change. As Denby (1997:56) points out,
41 not only is natural selection the center of biology but it explains more of consciousness andmorality than most people realize. For our choices and character, our desires and deeds may be the result of long-ago accidents and adaptive mechanisms, which improved chances of reproductive success in a given environment, and then got passed along in genes, afternumberless generations, to you and me, where they function in a new environment, sometimes successfully, sometimes not.
Obviously, the trait of dental modification is not passed from one generation to another via biological mechanisms. However, Dawkins
(1986) uses the term 'meme' to suggest that a custom or idea can be passed from generation to generation in a pattern similar or analogous to genetic inheritance. Thus, behaviors can be replicated by cultural inheritance.
There is no doubt there is risk to the oral complex when the teeth are intentionally modified. However, perhaps there is a greater reward, one that outweighs the risk of altering the morphology of the teeth.
While the risk may be present for the individual, the population as a whole may actually flourish. In fact, some have argued that cultural maladaptive behaviors are maintained within populations (Logan and
Qirko 1996). With this in mind, a clearer understanding of human behavior is achieved using Darwinian evolutionary theory. Different behaviors seen in groups "carry differential rewards with respect to fitness" (Logan and Qirko 1996:615). Fitness manifests itself in reproductive success. In this light, Logan and Qirko (1996) present many examples that do not fit the explanation offered by Darwinian evolutionary theory. This leads them to ponder "the persistence of behaviors which appear to reduce individual somatic and reproductive
success" (Logan and Qirko 1996:615). Woven among the many examples they describe is tooth alteration, specifically the inlaying of teeth occurring among ancient Mesoamericans.
42 Logan and Qirko's (1996) study of maladaptive traits provides a possible answer for the persistence of such customs : individual benefits may outnumber individual risks. For example, Chagnon (1988) demonstrates that among Yanomamo males, status and rank are dependent on warfare. High status and prestigious rank are earned by those males who have killed someone in battle. These males (Unokai) enjoy greater access to mates and elevated fertility than non-Unokai males. An increasing number of other researchers have documented a similar correlation, one long ago predicted by Irons (1979), between
"cultural success and reproductive success." The cultural behaviors rewarded reproductively vary considerably from one society to another.
The behaviors affecting differential fitness include hunting skill (Kaplan and Hill 1985), land ownership (Voland 1990), political power (Betzig
1986), assimilation into a foreign culture (Cronk 1989; Logan and Qirko
1990), and many others. And if deleterious or maladaptive customs become valued culturally, might they also persist because of the social, even biological, rewards they could convey?
It is proposed in the present case that individuals with modified dentitions who reside in stratified societies may enjoy enhanced accessibility to potential mates. From a Darwinian evolutionary perspective, passing genes into the next generation is fundamental.
Perhaps for certain groups, especially those that practice polygyny, modifying the teeth may be socially advantageous, thus allowing certain individuals a better chance of securing a mate or mates through enhanced status and associated personal adornment. Although this correlation
43 cannot be established in most archaeological contexts, it can be explored by ethnographers.
However, there are clear risks to individual health when dental modification is practiced. Fastlicht (1976) states that the inlaying of semiprecious minerals into healthy teeth demonstrates that pre
Columbian Mexicans either had limited knowledge of dental anatomy or chose to ignore it. The cultural environment may have played a big role in dental modifications: "prestige or presentability may have ...surpassed comfort or health as justification for these inlays" (Fastlicht 1976:13). De
Jager (1965) mentions that maxillary incisors in a !Kung San population were absent due to carious lesions brought on by filing the teeth. In an example of ablation of the primary canines in children, Pindborg (1969) notes that the crude fashion used to remove the teeth increased the chances for malformation or agenesis of the permanent canines.
From the information reviewed above, it becomes clear that intentional dental modifications are deleterious to individual health.
Therefore, regardless of the reasons people engage in this practice, the choice to modify the dentition carried definite risks to the oral complex.
The next section examines why this practice occurred.
Whatis the power of conformity?
Cultural conformity and diffusion may play big roles in the practice of dental modification. But, if there is pain and risk to the perioral complex when teeth are modified, why does this practice continue?
According to Logan and Qirko (1996), humans tend to conform to the
44 opinions and practices of the majority. The need to conform is viewed by some as a deeply imbedded psychological design mechanism whereby humans recognize and adopt behaviors and practices from those around them even when those behaviors may be deleterious or harmful (see
Symons 1987). When viewed in this light, intentionally modifying the dentition may be an act of social conformity.
Dental modification has been widespread within most groups where it is practiced, implying that it is an accepted human behavior. For example, van Reenen (1986) and Bachmayer (1982) both found that tooth modification was a highly visible avenue through which nomadic peoples established beneficial ties and developed good diplomacy with their more sedentary neighbors. During the lean months of winter when food is scarce, nomadic groups such as the !Kung San would stay in and around more sedentary groups where food was more plentiful. In an effort to make sure they would be welcome, the !Kung San would intentionally file and ablate their teeth in the same tribal pattern as their sedentary hosts.
This way, the !Kung San could come back year after year to reap the benefits from their neighbors (see van Reenen 1986).
Fastlicht (1976) discusses a fragment from an ancient Mesoamerican fresco representing "Earthly Paradise." It depicts two figures, one apparently using a stone to file the teeth of the other (See Figure 4.2). Due to the shee! number of different societies that practiced dental modification, this custom may represent an example of cultUral conformity.. Logan and Qirko (1996:625) assert that "conformity ... carried important social and, ultimately, biological rewards." If this holds true for
45 ...... 0
CJo0
46 intentional dental modifications, the rewards from society may outweigh the potentially damaging physical effects befalling the individual.
Theoretical Implications
According to Logan and Qirko (1996:622),
natural selection has likely favored conformity as a primary means through which individuals compete socially for biological rewards: access to mates and increased reproductive success.
Intentional dental modification becomes understandable when viewed through the lens of Darwinian theory. Perhaps by highlighting the rewards o_f such behaviors, we may better understand why risky, potentially maladaptive behaviors, persist. The need and ability to conform to one's social group is a powerful motivation for members of any society to adopt given practices. The number of people in our country today who engage in body piercing, tattooing, and cosmetic surgery is surprisingly large. But, are these cultural fads, or do they help people feel as if they belong to a specific group? MacFarquhar (1997:68) states that
"cosmetic surgery, in fact, is becoming an art form." Some modem people are willing to change their bodies to the point of surgically altering them to fit specific cultural ideals.
Many different reasons have been advanced by researchers for the presence of intentional dental modifications. "People engrave, color, and even intentionally pull out (evulse) teeth for cosmetic purposes" (White
1991:355). Understanding a culture's notion of what comprises beauty. may be a daunting task. For most mainstream Americans, the piercing, scarring, mutilating, and other body altering practices that exist among outlying sub-cultures are usually not regarded as beautiful. Additionally,
47 most people today would probably not find the intentionally modified crania of prehispanic Mesoamericans, South Americans, and peoples of the Pacific northwest coast to be appealing (see Brothwell 1981; Ortner and
Putschar 1985; Romero 1970). Another example is the contemporary fad among many African-Americans of using ornamental gold crowns placed on the anterior teeth (see Carter et al. 1987). This custom is so popular there are some cases where edentulous (i.e., possessing no teeth) individuals have decorative gold crowns placed on their dentures (Logan
1998). Logan and Qirko (1996:626) admit that the "means to valued ends may be viewed as deviant by members of differing social units." While the behaviors are perhaps not socially acceptable by all, the end result for individuals engaging in these behaviors is considered attractive and is desired. From this perspective, the power of cultural conformity is observable. Cultural conformity requires only that individuals adopt behaviors and traits from their surrounding group (see Flinn and
Alexander 1982). Conformity "does carry potential rewards, even when chosen means and ends are risk-laden and denounced by other segments of society" (Logan and Qirko 1996:626).
Conforming to specific behaviors varies greatly across cultural boundaries. Such variation is easily seen in the examples cited above.
Not all people find tattoos appealing, but, more importantly, some people do. Likewise, the practice of artificially altering the shape of the skull is not embraced by many peoples, but this custom still found a way to exist in certain cultures. Finally, the act of capping the anterior teeth with gold crowns, which is a sign of pride and wealth among some African-
48 Americans, is not pleasing to most others. These behaviors vary across ethnic borders. As mentioned above, some researchers contend that intentional dental modifications are used by groups to maintain tribal identity and group cohesion (Bachmayer 1982; Entwistle 1946; Fastlicht
1976; Marshall 1946; van Reenen 1978a, 1978b, 1986; Wilson 1946). For example, among African groups studied by Bachmayer (1982) and van
Reenen (1986), the patterns of intentionally modified teeth are group specific (see Figure 4.1). By artificially altering the morphology of the dentition in a particular way, certain groups can identify friend from foe with a flash of a smile.
Furthermore, there is evidence that some forms of dental modification may be therapeutic. For instance, Davies (1972) and Goose
(1963) note that the ablation of selected incisors allows individuals suffering from tetanus induced lockjaw to be fed. Pindborg (1969) and
Weiss (1992) report that the ablation of the primary canines in infants is believed to be efficacious among groups such as the Bakiga, Acholi,
Batoros, and Bugisus of Uganda and the Hay a of Tanzania. It is believed that these teeth are associated with disease, so they are removed to maintain health. While intentional modification of the dentition may at times serve beneficial purposes, in the vast majority of cases this practice is performed for social reasons, despite the pain and disease it clearly invites.
49 Chapter 5
Conclusions and Summary
Humans in a variety of different time periods and cultural settings have engaged in purposeful alteration of the teeth. Intentional dental modification manifests itself in different forms: ablation of specific teeth, the filing of teeth, and the drilling and inlaying of the labial surface of teeth. Such dental modifications were meant to be seen and most often involved the anterior dentition in either or both of the dental arcades.
The instruments used, as well as the individuals who specialized in this art, are highly variable. In light of the fact that some researchers (see
Milner and Larsen 1991) only fleetingly touch on the harmful effects of this practice, it is clear that dental modification elevated one's risk of infection, notably in the form of caries and periapical abscesses.
Intentionally altering the teeth may be a maladaptive trait that, interestingly, has persisted over time, a continuity owing most likely to the power of cultural conformity.
Numerous authors have identified a variety of reasons for why such modifications occur. Everything from cosmetic enhancement, ritualistic initiation, and tribal identification to early dental practices have been discussed. Whatever the reasons for this practice, dental modification is a traumatic episode to the orofacial complex and there is significant potential risk when the dentition is intentionally altered
50 (Merbs 1989; Schwartz 1995; White 1991). However, the custom of purposefully modifying the teeth enjoys such wide geographic range and historical depth that the practice must have carried some type of benefit. The benefit gained was first social, then perhaps biological (notably greater access to mates). While risk to oral health is certainly present, the benefits of having artificially modified teeth outweighed that risk. From a Darwinian perspective, perhaps the continuity of this trait allowed people in given cultures to enjoy a greater chance of passing on one's genes. Most research on intentionally modified teeth is concerned with typological aspects surrounding this interesting cultural behavior. However, the question that remains is how did this practice of decorating the teeth begin? Further, why has it enjoyed such widespread acceptance? Perhaps these questions will remain unanswered. From a statistical standpoint, however, a potential answer might be, given enough time, the odds are in favor that humans will eventually embrace the idea of altering the appearance of their dentition. Afterall, there are only a limited number of ways that the body can be permanently modified. And if, through a conformity mechanism, a society adopts and deems important this particular form of somatic art, explanations for how and why the trait of dental modification arose and persisted for thousands of years may become clear. This thesis has explored intentional dental modifications from a biocultural perspective advancing an exploratory interpretation about the social, and perhaps even biological, benefits associated with dental art. The literature on dental modifications has been examined in an attempt to
51 find patterns in pathological conditions to the orofacial complex of individuals engaging in this practice. Based on the review of the literature, such patterns certainly exist. These patterns open up many new research possibilities and further study in this area is certainly warranted.
Future studies of intentional dental modifications should implement new research strategies. For example, one area that should be explored is the inspection, both at the macroscopic and radiographic levels, of skeletal populations that possess dental modifications. The information gleaned would provide statistical correlations between the presence of dental modifications and poor oral health. This information would be useful for better understanding why people would continue to intentionally alter their teeth despite the health risks.
Additionally, research in cross-cultural comparisons of archaeological populations that engaged in dental modification versus populations that did not will likely show significant variations in orofacial health. This research design should look at the skeletal remains of individuals of the same age and compare their dental health. The information from such a design could shed light on the underlying risks to the orofacial complex in the individuals with modified dentitions versus those with non-modified dentitions.
A third research avenue is analyzing living populations who continue to engage in this practice. Radiographic examinations of the modified dentitions compared with healthy dentitions would be useful to find correlations linking the trait of dental alteration with the presence of infection, alveolar bone loss, caries, and other oral ' pathologies. The age of
52 individuals in test and control groups would be controlled, thus clarifying the impact of dental modification on the oral complex. Further, ethnographic inquiries on how and why some people choose to undergo the change in their dentitions would be helpful in understanding the reasons behind choosing to modify the teeth. Also, the participants can explain the sensations felt during and after the operation. Ethnographic accounts may also shed additional light on intentional dental modifications as an ethnic or status marker. More research on intra cultural stylistic differences is required to better understand if this practice is indicative of status differentials.
Another research area to examine concerns the techniques and tools used to modify teeth. One important point is the comparison of the hollow tubular drills used to make the holes for inlays. As mentioned in the previous chapter, there is a similarity in the techniques used to make the holes on the labial surface of the teeth and trephination holes found in skulls (see also Fastlicht 1976). Additional research is needed to find if covariance between inlays and trephinations exists.
Hopefully the research lines identified above will be pursued. With additional data, it may be possible to explain more fully why the trait of intentionally modifying the teeth enjoyed such temporal depth and geographic range. This phenomenon certainly represents a significant question, particularly because the types of dental alterations reviewed in this thesis caused pronounced pain and deteriorating oral health.
53 BIBLIOGRAPHY
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65 Vita
Derek C. Benedix was born February 20, 1970 in Baguio City, Luzon,
Republic of the Philippines. During early childhood, he and his family moved quite often traveling from the Philippines to California to Idaho.
In Idaho, the family abandonded its love for nomadic life and became somewhat sedentary. Derek attended 5th grade through high school in rural southern Idaho. He graduated from Filer High School in May of
1988 and in the Fall of 1988 he began his undergraduate career at the
University of California Santa Cruz. After graduating, Derek found himself in a bit of a pickle so decided to move back in with his parents and save some cash dollars (Yay for Derek, Boo for his parents). After 11 months, Derek decided to return schoot whereupon packing his borrowed
Honda CRX to the hilt, he left Idaho on a warm August day and made the three day trek across the good ol' USA to the University of Tennessee,
Knoxville. He graduated in May of 1998 with a Master's degree in
Anthropology.
66