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P u b l i c e a l t h (1992), 106,46 5-471 Th e Society of Publ ic He al th , 1992

Bel ie fs about P remature ly E rupted Tee th in Rura l Yoruba

C om m uni t i e s N i ge r i a

C . O . O y e j id e M B BS P h D 1 a n d G . A . A d e r i n o k u n B D S M P H 2

1Depar tment o f Prevent ive an d Soc ia l M ed ic ine Co l lege o f M ed ic ine

Un ivers i ty Co llege Hosp ita l Ibadan; and 2D epar tm ent o f Preven t ive

Den t is t ry Col lege o f M edic ine U nive rs i ty Col lege Hosp i ta l Ibad an Niger ia

A d e s c r i p t i v e s t u d y w a s c a r r i e d o u t i n tw o v i l l a g e s : B a d e k u a n d O l o d o , n e a r t h e c i t y o f

I b a d a n , b e t w e e n M a y a n d N o v e m b e r 1 9 90 . T h e o b j e c t iv e o f th e s t u d y w a s t o i n v e s ti g a te

t h e k n o w l e d g e , b e l ie f s a n d a t t it u d e s o f r e s p o n d e n t s t o p r e m a t u r e e r u p t i o n o f d e c i d u o u s

t e e t h i n b a b i e s . O f t h e 6 22 p e o p l e i n t e r v ie w e d , a l a r g e p r o p o r t i o n ( 3 0 . 5 ) b e l i e v e d t h a t

t h e f i r s t d e c i d u o u s t o o t h s h o u l d e r u p t b e t w e e n t h e a g e o f 5 - 7 m o n t h s ; t h e n e x t

c o m m o n l y m e n t i o n e d ti m e o f t o o t h e ru p t i o n w as 7 - 9 m o n t h s o f a g e ; a n d 50 . 3 o f t h e

r e s p o n d e n t s c l a i m e d t o h a v e s e e n a c a s e o f p r e m a t u r e l y e r u p t e d p r i m a r y t e e t h . T h e r e

w a s a s t a t is t i c a ll y s i g n if i ca n t a s s o c i a t i o n b e t w e e n a g e a n d a l s o b e t w e e n e d u c a t i o n a l s t a t u s

o f r e s p o n d e n t s a n d h a v i n g s e e n p r e m a t u r e e r u p t i o n o f t e e t h ( P < 0 . 0 1 ) .

T h e m a j o r i t y o f t h e p e o p l e ( 5 3 . 7 ) f e l t t h a t t h e c o n d i t i o n w a s a n i n d i c a t i o n o f a n e v il

c h i ld . O n l y 2 2 . 1 o f t h o s e in t e r v i e w e d th o u g h t i t c o u ld b e j u s t a n i n d i v i d u a l v a r i a t i o n .

O n t h e r e c o m m e n d e d r e m e d y o r m a n a g e m e n t o f t h e c o n d i ti o n , a s m a n y a s 2 6 ( 4 . I )

s a i d t h e y w o u l d g e t r i d o f t h e c h i ld . A h i g h p e r c e n t a g e f e l t t h a t s a c r if i ce s s h o u l d b e

o f f e r e d t o a p p e a s e t h e g o d s .

I t i s s u g g e s t e d t h a t a t r a n s c u l t u r a l a p p r o a c h b e a d o p t e d i n m a n a g i n g c a s e s i n w h i c h

t h e p a r e n t s f e e l p a rt i c u la r l y a n x io u s a n d u n c o m f o r t a b l e a b o u t p r e m a t u r e l y e r u p t e d t e e t h

i n o r d e r t o c a t e r f o r t h e s o c i a l w e l l - b e i n g o f t h e c h i l d a n d f a m i l y . It is a l so r e c o m m e n d e d

t h a t a p p r o p r i a t e h e a l t h e d u c a t i o n b e d i r e c t e d a t t h e s o c i e t y a s a w h o l e c o n c e r n i n g t h i s

c o n d i t i o n .

n t r o d u c t i o n

E m e r g e n c e o f t h e f i r s t d e c i d u o u s t e e t h in b a b i e s s h o w s a s m u c h v a r i a t i o n b e t w e e n

o n e i n d i v i d u a l a n d a n o t h e r a s it d o e s a m o n g d i f f e r e n t r a c i a l g r o u p s . 1-9 S t u d i e s o n

e r u p t i o n d a t e s o f d e c i d u o u s t e e t h h a v e n o t e d e r u p t i o n o f t h e f ir s t p r i m a r y t e e t h t o b e

a t o r a b o u t s ix m o n t h s o f ag e . ~-9 O c c a s i o n a l l y , h o w e v e r , e r u p t i o n o f p r i m a r y t e e t h

m a y o c c u r p r e m a t u r e l y . T h i s p r e m a t u r e e r u p t i o n c o u l d b e o f t w o t y p e s . S o m e b a b i e s

a r e b o r n w i t h t e e t h i n t h e m o u t h - a c o n d i t i o n g e n e r a l l y r e f e r r e d t o a s n a t a l t e e t h .

S o m e o t h e r s e r u p t t e e t h w i t h i n t h e f ir s t 2 8 d a y s o f l i f e , a n d t h e s e a r e r e f e r r e d t o a s

n e o n a t a l t e e t h . ~0

N a t a l a n d n e o n a t a l t e e t h a r e o f te n l o w e r c e n t r a l in c i s o r t e e t h b e l o n g i n g t o t h e

n o r m a l d e c i d u o u s s e r i e s . 11,12,13,14 T h e y c o u l d b e f u r t h e r q u a l i f i e d a s m a t u r e o r

i m m a t u r e t y p e s d e p e n d i n g o n t h e d e g r e e o f m a t u r i t y o f t h e e n a m e l a t t h e t i m e o f

e r u p t i o n . T h e s e p r e m a t u r e l y e r u p t e d t e e t h a r e u s u a l l y m o b i l e c o n s e q u e n t o n l a c k o f

r o o t f o r m a t i o n . F o r f e a r o f b e i n g a s p i r a t e d , t r a u m a t i s m t o m o t h e r ' s n i p p l e s a n d

d i s c o l o u r a t i o n o f t h e e n a m e l i n t h e i m m a t u r e t y p e s , t h e s e t e e t h a r e u s u a l l y e x t r a c t e d .

O c c u r r e n c e o f n a t a l t e e t h v a r i e s b e t w e e n 1 i n 2 , 0 0 0 a n d 1 i n 3 , 6 6 7 l i v e b i r t h s . 12,15

Cor r espondence to : Dr G . A . Ader inokun .

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466

C O Oyejide and G A Aderinokun

Records of the incidence in Nigeria to date are lacking. The condition is nevertheless

occasionally encountered in clinical dental practice. Mothers of young babies present

at times requesting the removal of such prematurely erupted teeth. A common

feature which is striking is the anxiety of such mothers that the teeth be extracted at

the earliest possible time. The explanation for this behaviour is the negative societal

reaction to seeing teeth in the mouth of such young babies.

Observation of this general unease among parents of these babies initiated a study

to investigate the myths, beliefs and mode of management of prematurely erupted

teeth in two rural Yoruba communities and thus to recommend appropriate clinical

management in the context of the findings.

a t e r i a ls a n d e t h o d s

A descriptive study was carried out in two rural communities: Badeku and Olodo,

which are about 20 km from Ibadan City. These villages serve as sites for Primary

Health Care activities of the Institute of Child Health, University College Hospital,

Ibadan. The objective of the study was to document beliefs about prematurely

erupted teeth and the usual remedy for the condition in the two villages.

Meetings were held with the community leaders during which the objective of the

study was explained and their consent sought.

A standardized questionnaire was designed to elicit, among other things relating to

tooth eruption, beliefs about the cause of premature eruption of teeth in babies and

the recommended management of the case. The questionnaire was translated into

Yoruba, the local language. It was then pre-tested in another village similar to the

study sites.

Field workers were recruited from the villages, hence they could conduct interviews

in the evenings when residents returned from their farms and market-places. Training

of the field workers consisted of sessions in which one of the investigators first

discussed and practised interview techniques with them in the office, followed by

further sessions in the field. The workers were evaluated after the training sessions.

One of them had to be dropped because his results varied markedly from those of the

others.

Every household in the two villages was included in the study and selected

respondents comprised every third adult on the list of inhabitants.

Each completed questionnaire was checked by the investigators for missing infor-

mation and immediately returned for correction. Data were entered onto an IBM PC

AT microcomputer using the data entry software DATASTAR. Data analysis was

done with SYSTAT, a comprehensive statistical package. Frequency distributions and

relevant tables were generated. The chi-square test of association was used where

appropriate.

R e s u l t s

A total of 622 questionnaires were completed from both villages; 40 of the

respondents were males. The age distributions are as shown in Table I: 14 were

under the age of 30 years. Their educational status is shown in Table II, with 51.1

of respondents having no formal education. A large proportion of respondents from

this rural population (30.5 ) believed that the first milk tooth should erupt between

the ages of 5-7 months. The next commonly mentioned time of tooth eruption was

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eliefs about Prematurely Erupted Teeth

Table I Perce iv ed norm al t ime of e rup t ion of f ir s t tooth in babies

4 6 7

A ge a t e r up t i on A ge o f r e sponden t s i n yea r s

o f f ir st t oo t h Be l ow 30 yea r s 31 - 40 41 - 50 O v e r 50 To t a l

( m on t hs )

3 -5 13 (14.9) 15 (11.6) 9 (5.8) 8 (3.2) 45 (7.2)

5 -7 39 (44.8) 58 (44.9) 52 (33.7) 41 (16.3) 190 (30.6)

7 -9 20 (23.0) 30 (23.2) 60 (38.9) 72 (28.6) 184 (29.0)

9-1 1 5 (5.7) 15 (11.6) 25 (16.2) 98 (38.9) 143 (22.9)

>1 1 7 (8.0) 11 (8.5) 8 (5.1) 32 (12.7) 58 (9.3)

Missing 1 (1.1) 0 (0) 0 (0) 1 (0.3) 2 (0.3)

T ota l 87 (100) 129 (100) 154 (100) 252 (100) 622 (100)

Figures in parentheses are pe rcentages.

X = 112.1; df = 12; P< = 0.01.

Tab l e I1 Pe r ce i ved no r m a l e r up t i on t i m e by educa t i ona l s t at u s o f r e sponden t s

A ge a t e r up t i on N o f o r m a l A r ab i c P r i m ar y Pos t-

o f f ir s t t oo t h s choo l ing educa t i on educ t i on p r i m ar y

( m on t hs ) educa t i on

T o t a l

3- 5 13 (4.1) 10 (9.1) 5 (5.1) 17 (17.9) 45 (7.2)

5 -7 93 (29.3) 28 (25.5) 44 (44.4) 25 (26.3) 190 (30.6)

7- 9 99 (31.1) 31 (28.2) 33 (33.3) 21 (22.1) 184 (29.6)

9-1 1 79 (24.8) 34 (30,9) 10 (10.1) 20 (21.1) 143 (23.0)

> l l 32 (10.1) 7 (6.4) 7 (7.1) 12 (12.6) 58 (9.3)

Missing info rm ation 2 (0.6) 0 (0) 0 (0) 0 (0) 2 (0.3)

T ota l 318 (100) 110 (100) 99 (100) 95 (100) 622 (100)

Figures in parenthe ses are percentages.

2 2 = 44.0; df = 12 P = < = 0.01.

7 - 9 m o n t h s o f a g e. T h e r e w a s a s ta t is t ic a ll y s ig n i f ic a n t a ss o c i a ti o n b e t w e e n a g e o f

r e s p o n d e n t a n d r e p o r t e d t i m e o f t o o t h e r u p t i o n ( P < 0. 01 ) w i th a h i g h er p r o p o r t i o n

o f t h o s e o v e r 4 0 y e a r s o l d b e l ie v i n g i n la t e t im e s o f e r u p t i o n , i . e . , 7 - 9 m o n t h s a n d

a b o v e ( T a b l e I ) . S i m i l a r ly , t h e r e w a s a s t a t is t ic a l ly s i g n i f ic a n t a s s o c i a t i o n b e t w e e n

e d u c a t i o n a l s t a tu s a n d p e r c e i v e d t i m e o f t o o t h e r u p t i o n ( T a b l e I I) w i t h a g r e a t e r

p r o p o r t i o n o f t h o s e w i th s e c o n d a r y e d u c a t i o n b e l i e v i n g in e a r li e r t i m e s f o r e r u p t i o n .

T h e r e w a s n o s ta t is ti c al ly s ig n i f ic a n t a s s o c i a ti o n b e t w e e n s e x o f r e s p o n d e n t a n d

p e r c e i v e d t im e o f t o o t h e r u p t io n .

O n t h e q u e s t i o n o f d ev i a ti o n f r o m p e r c e i v e d n o r m a l t i m e , 7 3 % o f t h e r u r a l

d w e l l e r s b e l i e v e d t h a t s u c h a s i t u a t i o n s o m e t i m e s o c c u r s .

A b o u t h a l f ( 5 0 , 3 % ) o f t h e r e s p o n d e n t s c l a im e d t o h a v e se e n a c as e o f p r e m a t u r e l y

e r u p t e d p r i m a r y t e e t h . T h e r e w a s a s ta t is t ic a ll y s ig n i fi c an t a s s o c ia t i o n b e t w e e n a g e

a n d a ls o b e t w e e n e d u c a t i o n a l s t at u s o f r e s p o n d e n t s a n d h a v i n g s e en p r e m a t u r e

e r u p t i o n o f te e t h ( P < 0 . 0 i ) , m e a n i n g t h a t t h e o l d e r p e o p l e w e r e m o r e l ik e ly to h a v e

s e e n t h e c o n d i t i o n ( T a b l e I I I) . A h i g h e r p r o p o r t i o n o f t h o s e w i th l o w e r l e v e l o f

e d u c a t i o n c l a im e d t o h a v e s e e n t e e t h t h a t e r u p t e d t o o e a r ly ( T a b l e I V ) . T h e r e w a s ,

h o w e v e r , n o a s s o ci a ti o n b e t w e e n s e x o f r e s p o n d e n t a n d h a v i n g s e en a c a s e o f

p r e m a t u r e e r u p t i o n .

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4 6 8 C O Oyejide and G A Aderinokun

T a b l e I I I N u m b e r o f r e s p o n d e n t s w h o h a d s e e n p r e m a t u r e l y e r u p t e d t e e t h b y a g e

R e s p o n s e s A g e i n y e a r s

< 3 0 3 1 - 4 0 4 1 - 5 0 > 5 0 T o t a l

Y e s 1 9 ( 2 1 . 8 ) 3 1 ( 2 4 . 0 ) 8 9 ( 5 7 . 8 ) 1 7 4 ( 6 9 . 0 ) 3 1 3 ( 5 0 . 3 )

N o 6 8 ( 7 8 . 2 ) 9 8 ( 7 6 . 0 ) 6 5 ( 4 2 . 2 ) 7 7 ( 3 0 . 6 ) 3 0 8 ( 4 9 . 5 )

M i s s i n g i n f o r m a t i o n 0 ( 0 ) 0 ( 0 ) 0 ( 0 ) 1 ( 0 . 4 ) 1 ( 0 . 2 )

T o t a l 8 7 ( 1 0 0 ) 1 2 9 ( 1 0 0 ) 1 5 4 ( 1 0 0 ) 2 5 2 ( 1 0 0 ) 6 2 2 ( 1 0 0 )

Figures in parentheses are percentages .

22 = 103 .5889 ; d f = 3; P < = 0 .01 .

T a b l e I V R e s p o n d e n t s w h o h a d s e e n p r e m a t u r e l y e r u p t e d t e et h b y e d u c a t io n a l s ta tu s

R e s p o n s e s N o f o r m a l A r a b i c P r i m a r y P o s t - p r im a r y T o t a l

s c h o o l i n g e d u c a t i o n e d u c a t i o n e d u c a t i o n

Y e s 1 6 9 ( 5 3 . 1 ) 6 5 ( 5 9 . 1 ) 4 2 ( 4 2 . 4 ) 3 7 ( 3 8 . 9 ) 3 1 3 ( 5 0 . 3 )

N o 1 4 8 ( 4 6 . 6 ) 4 5 ( 4 0 . 9 ) 5 7 ( 5 7 . 6 ) 5 8 ( 6 1 . 1 ) 3 0 8 ( 4 9 , 5 )

M i s s i n g i n f o r m a t i o n 1 ( 0 . 3 ) 0 ( 0 ) 0 ( 0 ) 0 ( 0 ) 1 ( 0 . 2 )

T o ta l 318 (100 ) 100 (100 ) 99 (100 ) 95 (100 ) 622 (100 )

Figures in parentheses are percentages .

2 2 = 11.90288; df = 3; P = 0.01.

W h e n a s k e d t o s t a t e th e c a u s e o f t h e c o n d i t i o n , 5 3 . 7 o f t h e p e o p l e f e l t t h a t t h e

c o n d i t i o n m u s t b e a n i n d i c a t i o n o f a n e v i l c h i l d . O n l y 2 2 . 1 o f t h o s e i n t e r v i e w e d

t h o u g h i t c o u l d ju s t b e a n i n d i v i d u a l v a r i a t i o n ( T a b l e V ) .

T h e r e w a s a s t a t i s t ic a l ly s i g n if i ca n t a s s o c i a t i o n b e t w e e n a g e a n d r e p o r t e d c a u s e o f

p r e m a t u r e e r u p t i o n o f t e e t h ( P < 0 . 01 ) . T h e d e f i n i t i o n o f a n ev i l c h i ld i n c l u d e d

' A b i k u ' , ' O g b a n j e ' , d e m o n - p o s s e s s e d c h i l d , o r a v e s s e l o f t h e g o d s . A f e w ( 8 ) ,

a t t r ib u t e d t h e c o n d i t i o n t o t h e m o t h e r ' s d e e d s in p r e g n a n c y w h i c h m i g h t h a v e

c o n t r a v e n e d t r a d i t io n a l t a b o o s . A s t a t i s t ic a l ly s ig n i f i c a n t l y h i g h e r p r o p o r t i o n o f

T a b l e V P e r c e i v e d c a us e o f p r e m a t u r e t o o t h e r u p t io n b y a ge o f r e s p o n d e n t s

P e r c e i v e d c a u s e s A g e i n y e a r s

< 3 0 3 1 - 4 0 4 1 - 5 0 > 5 0 T o t a l

I n d i v i d u a l v a r i a t i o n 1 9 ( 2 1 . 9 ) 3 1 ( 2 4 . 1 ) 4 1 ( 2 6 . 6 ) 4 7 ( 1 8 . 6 ) 1 3 8 ( 2 2 . 2 )

E v i l c h i l d 3 5 ( 4 0 . 2 ) 4 9 ( 3 7 . 9 ) 8 2 ( 5 3 . 2 ) 1 68 ( 6 6 . 7 ) 3 3 4 ( 5 3 . 7 )

M o t h e r ' s e x p o s u r e 7 ( 8 . 0 ) 1 6 ( 1 2 . 4 ) 1 5 ( 9 . 8 ) 1 2 ( 4 . 8 ) 5 0 ( 8 . 0 )

i n p r e g n a n c y

M o t h e r ' s e x p o s u r e

l e a d i n g t o c o n t a c t 2 5 ( 2 8 . 7 ) 3 2 ( 2 4 . 8 ) 1 5 ( 9 . 8 ) 2 1 ( 8 . 3 ) 9 3 ( 1 5 . 0 )

w i t h e v i l c h i l d

M i s s i n g i n f o r m a t i o n 1 ( 1 . 2 ) 1 ( 0 . 8 ) 1 ( 0 . 6 ) 4 ( 1 . 6 ) 7 ( 1 . 1 )

T o t a l 8 7 ( 1 0 0 ) 1 2 9 ( 1 0 0 ) 1 5 4 ( 1 0 0 ) 2 5 2 ( 1 0 0 ) 6 2 2 ( 1 0 0 )

Figures in parentheses are percentages .

2.2 56.35 179; df = 9; P = 1.49011 6.

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eliefs about Prematurely Erupted Teeth

4 6 9

r e s p o n d e n t s w i t h l o w e r l e v e ls o f e d u c a t i o n b e l i e v e d s u c h a c h il d t o b e a n e v i l c h i ld

( T a b l e V I ) .

W h e n t h e p e o p l e w e r e a s k e d t h e i m p l ic a t io n o f p r e m a t u r e e r u p t i o n o f te e t h o n t h e

c h il d a n d h i s f a m i l y , 5 2 . 9 b e l i e v e d t h a t i t w a s a c u r s e a n d a ls o a n e m b a r r a s s m e n t t o

t h e f a m i ly ; 3 5 . 2 , o n t h e o t h e r h a n d , t h o u g h t i t d i d n o t b e a r a n y s ig n i fi c an c e o r

s t i g m a t o t h e f a m i l y .

W h e n a s k e d t h e r e c o m m e n d e d m a n a g e m e n t o f s u c h a c h il d, q u i te i n c r e d ib l y , a s

m a n y a s 26 ( 4 . 1 ) o f t h e r u r a l d w e l l e r s s a id t h e y w o u l d g e t r id o f t h e c h i ld . A h i g h

p e r c e n t a g e f e lt t h a t t h e t e e t h s h o u l d b e e x t r a c t e d a f t e r th e a p p r o p r i a t e s a c ri fi c es w e r e

o f f e r e d to a p p e a s e t h e g o d s a n d r e v e r s e t h e c u r s e o n t h e f a m i ly . A l a r g e n u m b e r

r e s p o n d e d t h a t t h e y w o u l d n o t in s t it u t e a n y t r e a t m e n t .

S i m i la r ly , t h e s u b j e c t o f c h i l d e n w h o n e v e r e r u p t a n y t e e t h a t t r a c t e d s o m e e x t r e m e

r e a c t i o n s . A l m o s t a l l r e s p o n d e n t s ( 8 1 . 9 ) s a i d it w a s a n i m p o s s ib i li ty . O f th e f e w

w h o a d m i t t e d t h a t i t c o u l d b e a p o s s i b il it y , 2 5 . 1 a t t r i b u t e d t h e c o n d i t i o n t o e v il

f o r c e s w h i l e 3 3 . 7 s a id i t w a s m e r e l y a h u m a n v a r ia t i o n . N o t s u r p ri s in g l y , 4 1 o f

t h e p e o p l e r e c o m m e n d e d t h a t su c h a ch i ld s h o u ld b e m a n a g e d b y t h e t ra d i t i o n a l

h e a l e r s .

i s c u s s i o n

P a r s o n s ' s s i c k ro l e t h e o r y a s s u m e s t h a t i l ln e s s ha s n o t o n l y a b i o lo g i c a l d i m e n s i o n b u t

is a ls o a s o c i a l d e v i a n c e i n t h a t i t p r e v e n t s t h e i n d i v i d u a l f r o m f u l fi ll i n g s o c i a l r o le s .1 6

T h e s ic k r o l e c a r r ie s p r i v il e g es o f t h e i n d i v i d u a l b e i n g e x e m p t e d f r o m r e s p o n s ib i li ti e s .

F r i e d s o n 17 e x p a n d e d o n P a r s o n s ' s m o d e l b y s u g g e s t in g t h a t t h e s i ck r o l e e n c o m p a s -

s es th r e e t y p e s o f l e g i ti m a c y d e p e n d i n g o n t h e n a t u r e o f t h e c o n d i t io n :

1 . c o n d i t i o n a l i z e d l e g i t i m a c y w i t h t h e r i g h t s a n d p r i v i le g e s o f t h e s ic k r o l e - -

c o r r e s p o n d i n g t o P a r s o n s ' s s i c k r o l e t h e o r y ;

2 , u n c o n d i t i o n a l l e g i t i m a c y w h i c h a p p l i e s t o c h r o n i c i l l n e s s e s o r c o n d i t i o n s w h e r e

t h e r e i s n o c u r e ;

3 . s o m e f o r m s o f i ll ne ss a r e n e v e r l e g i t im i z e d a l t h o u g h t h e i n d i v i d u a l h a s b e e n

a s s i g n e d t h e s ic k r o l e . T h e i n d i v i d u a l h a s n o p r i v i le g e s i n t h e c a s e o f m e n t a l i l ln e s s

a n d e p i l e p sy .

Tab l e VI Pe r ce i ved caus e o f p r em a t u r e e r up t i on by educa t iona l s ta t u s o f r e s ponden t s

Pe r ce i ved No f o r m a l Ar ab i c P r i m ar y Pos t - p r i m ar y To t a l

caus es s choo li ng educa t i on educa t i on educa t i on

Indiv idual var ia t ion 68 (21.4) 20 (18.1) 20 (20.2) 30 (31.6) 138 (22.2)

Evi l chi ld 165 (51.9) 78 (70.9) 55 (55.6) 36 (37.9) 334 (53.7)

M othe r ' s expo sure 23 (7 .2) 6 (5 .5) 12( 12.1 ) 9 (9 .5) 50 (8 .0)

in p r egnancy

M o t h e r 's e x p o s u r e

leading to con tact 57 (17.9) 6 (5.5) 11 (11.1) 19 (20.0) 93 (15.0)

with evil child

Missing inform at ion 5 (1 .6) 0( 0 ) 1 (1 .0) 1 (1 .0) 7 (1 .1)

T ot al 318 (100) 110 (100) 99 (100) 95 (100) 622 (100)

Figures in parenthese s are percen tages.

X 29.52867; d f - 9; P< = 0.01.

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6/7

4 7 0

C. O. Oyejide and G. A. Aderinokun

T h e c a s e o f p r e m a t u r e l y e r u p t e d t e e t h s e e m s t o f a ll i n t o F r i e d s o n ' s t h i r d c a t e g o r y i n

t h e c o n t e x t o f t h e Y o r u b a c o m m u n i t y in w h i c h t h e p r e s e n t s t u d y ha s b e e n c a r r ie d

o u t .

S o c i e t y ' s a t t i tu d e t o w a r d s c e r t a in c o n d i t i o n s o r p h e n o m e n a p l a y s a n i m p o r t a n t ro l e

i n t h e li f e o f t h o s e w h o a r e s o la b e l l e d . I t m a y a f f e c t th e p u r s u i t o f a j o b , a p l a c e t o

l i v e , f r i e n d s a n d f u t u r e f a m i l y l i f e .

F r o m t h e r e s u l t s o f t h e p r e s e n t s t u d y , i t a p p e a r s a s if a c h i l d b o r n w i th t e e t h o r

w h o e r u p t s t e e t h w i t h i n a f e w d a y s o f b i r t h w i ll b e s t i g m a t i z e d a n d t h i s is b o u n d t o

a f f e c t h i s i n t e r a c t i o n e s p e c i a l l y w i t h i n t h a t p a r t i c u l a r c o m m u n i t y . T h i s e x p l a i n s t h e

a n x i e t y d e m o n s t r a t e d b y m o t h e r s o f s u c h c h i l d r e n p r e s e n t i n g a t t h e c l in ic . T h e r e s u lt s

f u r t h e r sh o w t h a t th e s e n e g a t iv e v ie w s a r e c o m m o n e r a m o n g t h e o l d e r a g e g r o u p s u c h

a s g r a n d m o t h e r s o r g r a n d f a t h e r s . I t is w e l l k n o w n t h a t t h e y a r e c u s t o d ia n s o f

t r a d it i o n s a n d h a v e a lo t o f i n f l u e n c e i n th e d e c i s i o n - m a k i n g p r o c e s s . T h u s t h e y w o u l d

s i g ni fi c an t ly c o n t r i b u t e t o m o u n t i n g p r e s s u r e s o n t h e y o u n g m o t h e r s o f b a b i e s w i th

n a t a l a n d n e o n a t a l t e e t h .

A s p r e v io u s l y m e n t i o n e d , t h e p r e m a t u r e l y e r u p t e d t e e t h m a y b e e x t r a c t e d i f t h e y

a r e t o o m o b i l e , i f t h e y t r a u m a t i z e t h e m o t h e r s ' s n i p p le s o r i f t h e y a r e g r e a t l y

d i s c o l o u r e d . T h e c u r r e n t l in e o f m a n a g e m e n t t e n d s t o p r e s e r v e t h e t e e t h u ti li zi n g

v a r i o u s p r o c e d u r e s . 13 15 T h i s is b e c a u s e t h e s e t e e t h o f t e n b e l o n g t o t h e n o r m a l

d e c i d u o u s s e r i e s a n d t h e i r r e m o v a l m a y l e a d t o m a l o c c l u s i o n a t a l a t e r d a t e . B a s e d o n

t h is c u r r e n t t r e n d , i t w a s e a r li e r s u g g e s t e d t h a t m o t h e r s b e e d u c a t e d , r e a s s u r e d a n d

e n c o u r a g e d t o c o m p l y w i th m e a s u r e s t a k e n t o p r e s e r v e n a ta l a n d n e o n a t a l te e t h . T

H o w e v e r , i n t h e l i g h t o f th e r e s u l t s o f th i s s t u d y , w h i c h b r in g s t o v i e w t h e s t r o n g

s o c i e ta l i m p l i c a ti o n s o f t h e c o n d i t i o n o n t h e f a m i ly a n d c h il d , it m a y b e n e c e s s a r y t o

r e v ie w t h e r e c o m m e n d a t i o n n o w v i ew i n g t h e p r o b l e m in a tr a n s c u lt u r al p e r s p e c t iv e .

T h e t r a n s c u l tu r a l a p p r o a c h r e q u i r e s a n a b i li ty to a d o p t a d e g r e e o f p e r c e p t u a l

d i s t a n c e f r o m a n y t w o c u l t u r a l t r a d i t i o n s i n v o l v e d in s p e c if i c h e a l t h - r e l a t e d i n t e r a c -

t i o n s . 19 O f t e n , t h e s i g n i fi c a n c e o f t a k i n g t h e ' t o t a l ' p a t i e n t w e l f a r e i n t o c o n s i d e r a t i o n

is f r e q u e n t l y l os t to t h e o r t h o d o x p r a c t i t i o n e r w h o p e r c e i v e s e v e r y s p h e r e o f

t r e a t m e n t a s b e i n g r i g h t o n l y f r o m h is o w n a n g l e a n d b e l i e v i n g t h a t h e h o l d s t h e

a n s w e r t o t h e c o m p l e t e w e l f a re o f t h e p a t i e n t . I n t h e c a s e i n q u e s t i o n , t h e

p r a c t i t i o n e r is a p t t o t ry a n d d i s s u a d e t h e p a r e n t f r o m r e m o v i n g t h e d e c i d u o u s t e e t h

w h i c h h a v e e r u p t e d t o o e a r l y e sp e c i a ll y if t h e y a r e q u i t e f i rm a n d w h e n f ac il it ie s e x i st

t o p r e s e r v e t h e m . H o w e v e r , s e n s it iv i ty t o th e c o n s e q u e n c e s o f t h e c o n d i t i o n o n t h e

p a t i e n t ' s w e l f a r e m a y m a k e t h e p r o f e s s i o n a l h a v e s e c o n d t h o u g h t s a n d c o m p l y w i t h

t h e p a r e n t s ' w i sh t o e x t r a c t th e t e e t h . T h e r e a f t e r , a s p a c e m a i n t a i n e r m a y b e p l a c e d

in t h e p o s i ti o n o f e x t r a c t e d t e e t h p e n d i n g t h e e r u p t i o n o f p e r m a n e n t t e e t h . T h i s

a p p r o a c h s h o u l d e n s u r e p a t i e n t s a t is f a c ti o n a n d f o s t e r t r u st in t h e d e n t i s t b y p a t i e n t s

w h o w o u l d o t h e r w i s e b e l o st t o f o ll o w - u p o r d r o p o u t c o m p l e t e l y .

e f e r e n c e s

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3 2 , 3 8 6 .

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4 . Yu n, Du k J in (1957). Eru pt ion of pr imary t ee th in Ko rean rura l ch i ldren .

American

Journal of Physical Anthropology 1 5 , 2 6 1 .

5 . M cG r egor , I . A . , Tho m s o n , A , M. & Bi llewicz, W. Z . ( 1968) . Th e deve l opm en t o f p r i m ar y

tee th in ch i ldren f rom a group of Gambian v i l l ages , and c r i t i ca l examina t ion of i t s use for

es t imat ing age . British Journal of Nutrition 2 2 , 3 0 7 .

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7. Barrett, M. J. Brown, T. (1966). Eruption of deciduous teeth in Australian Aborigines.

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9. Reddy, V. R. (1981). Eruption of deciduous teeth among the children of Gulbaga, South

India.

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10. Massler, M. Savara, B. N. S. (1960). Natal and neonatal teeth.

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12. Kates, G. A., Needleman, H. L. Holmes, L. B. (1984). Natal and neonatal teeth: a

clinical study. Journal o f the Amer ican Dental Assoc ia t ion 109 (3), 441-443.

13. Tomizawa, M., Yamada, Y., Tonouchi, K., Watanabe, H. Noda, T. (1989). Shoni-

Shikagaku

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27 (1), 182-190.

14. Berendsen, W. J. Wakkerman, K. L. (1988). Continued growth of the dentinal papillae

after extraction of neonatal teeth: report of case.

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55 (2), 139-141.

15. Cohen, R. L. (1984). Clinical perspective on premature tooth eruption and cyst formation

in neonates.

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psychological aspect in Yorubaland--Case Report (in press).

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communication in medicine.

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