WHAT CAN BE DONE TO STOP IT ? HOW CAN I HELP ?

♦ Raise awareness of the practice among ♦ Help Dentaid in its mission to raise awareness governments, dental schools, health of the practice of IOM. Further copies of this professionals, teachers and charity workers in leaflet are available from Dentaid. and in countries in which immigrants settle. ♦ Action against ♦ Make a donation to enable Dentaid to develop Educate local Mothers’ Groups about the educational materials and programmes to dangers of IOM. Fathers should also be combat this practice. targeted because of their dominant role in family decisions. ♦ ♦ Inform Dentaid if you have seen evidence of Provide culturally appropriate educational this practice in any other countries. materials for use in these countries. Dentaid has produced a booklet and poster in partnership with Christian Relief for use A document giving a detailed in educating local groups about the myth of ebiino . overview of Infant Oral Mutilation may be read on the Dentaid website together with a Literature Analysis of current papers on the subject at www.dentaid.org/whatwedo/iommaterials

Infant

♦ Influence the traditional healers by encouraging their good practices whilst Oral discouraging IOM. Giles Lane, Landford Salisbury, Wiltshire ♦ Aim to prevent infant febrile diseases and SP5 2BG

diarrhoea by ensuring good hygiene , safe Mutilation Tel: 01794 324249 water supplies and good sanitation . For further information, contact [email protected]

♦ Encourage further research into the prevalence www.dentaid.org of IOM in these and other countries. Registered Charity No: 1075826 © Dentaid 2010 WHAT IS INFANT ORAL MUTILATION? WHERE IS IOM PRACTISED? WHO BELIEVES IN THE PRACTICE?

Infant Oral Mutilation (IOM) is the U.K. term Most reports are from African countries. applied to a traditional practice performed, usually ♦ The Traditional Healer is a person with no by village healers but also by priests and midwives, formal medical training but recognised in the as an accepted remedy for illness. community as competent to provide health In African countries it is known by many names, care. such as “ebiino” in Uganda or “nylon/plastic/false Uganda teeth” in and . DR Congo ♦ People in these areas strongly believe in the Kenya Infants presenting with diarrhoea and/or fevers are Tanzania work of the healers who are often the first to be subjected to the removal of unerupted baby teeth consulted even if modern health facilities are Burundi as the swelling of the gums is mistakenly thought to available. However, there have been several reports of IOM indicate the presence of “tooth worms”. being seen in immigrants from the above countries ♦ Well educated people such as teachers and to , , USA, , and the HOW IS IT PERFORMED? UK, which illustrate the need for dental even dental practitioners have been reported to professionals in the developed world to be aware of believe in “nylon teeth” and in the need to The tooth buds, usually of the eye teeth, are prised the possibility of seeing its consequences in their remove them. out of the gum, without anaesthesia, with unsterile patients. tools such as a bicycle spoke, a hot nail, a penknife etc. HOW DO WE RECOGNISE IT? TEETHING: MYTHS AND FACTS

Assuming a connection between important WHAT IS THE RESULT? The most common presentation is the absence of symptoms (such as fever and diarrhoea) and the Blood loss and shock due to the crude nature of the the baby eye teeth, accounting for 95% of “nylon eruption of baby teeth has been common over operation can lead to anaemia. The unhygienic teeth” extractions in Tanzania and Uganda. IOM is many years — but this is a dangerous myth . methods can cause septicaemia, tetanus, three times more common in the lower jaw than the transmission of blood-borne diseases such as HIV/ upper, probably because the swelling caused by the Fact: Careful medical studies have not found AIDS, and can on occasions be fatal. Long term unerupted tooth bud is more easily seen and felt teething to cause fever, infections or diarrhoea. effects can include eradication and/or malformation there.

of other primary Fact: Wrongly ascribing these to teething can delay and permanent the diagnosis and treatment of serious infections, teeth in the area. sometimes with tragic consequences.

Missing baby eye teeth Fact: Current medical observations indicate that This child died of in a Ugandan child septicaemia shortly after teething causes little more than discomfort,

this photograph was restlessness, drooling, finger sucking and appetite taken. She had her baby teeth dug out with a loss—and often no symptoms at all.

sharpened bicycle spoke by the village healer. Malformed permanent eye teeth are also an Learning Point: A child who has fever, or indicator as, when the baby tooth is removed, its diarrhoea, or is otherwise ill, needs medical successor can be damaged. attention. Teething is not the cause.