Extraction of primary canine tooth buds: prevalence and associated dental abnormalities in a group of Ethiopian Jewish children.

Recent publications have described a common belief, held in rural areas in Africa, that unerupted primary canines cause diarrhoea, vomiting and fever in infants. To relieve these symptoms a traditional native healer extracts these tooth buds. The emigration of Ethiopian Jews to Israel in 1991 allowed an investigation of this practice among this community. A group of 59 children (27 boys and 32 girls) aged 3-12 years were examined clinically and radiographically. Evidence was found of extraction of 63 primary canine buds in 35 (59%) of the children. Extraction of one canine was found in 16 children, two in 13 children and three in three children, and three children had all four canines extracted. Forty-six (74%) mandibular compared to only 16 (26%) maxillary canines had been extracted; the extractions were equally divided between both sides of the jaws. Another 19 primary canines had hypoplastic defects, probably the result of unsuccessful extractions. Associated dental abnormalities included hypoplasia of the permanent successors and adjacent primary and permanent teeth, displacement of permanent teeth, midline shift to the extraction side, missing primary lateral incisors (probably accidentally extracted) and distal eruption of permanent lateral incisors, leaving their primary predecessors retained. Parental enquiry revealed that the practice is more common in rural rather than urban areas and still exists in the Ethiopian community in Israel. The findings of this survey should urge the authorities to take steps to stop this practice.