Supernaturalism and oral health: a case report

INTRODUCTION

Indian civilization is influenced and dominated by innumerable superstitious beliefs since time immemorial. Various types of magical practices, beliefs have been part of our lives since generations. Since health is a major entity or factor governing our social well-being, it is also not left untouched by such superstitious beliefs. Apart from the social and financial factors, that affected medical interventions there was again plethora of magical myths and superstitious practices that influenced medical treatment.¹

People had their own set of beliefs and practices regarding disease or health.² These practices or beliefs were also followed for oral health and disease. Since ancient period, the human face, oral cavity and dentition are subject of interest and intrigue for mankind and therefore are part of many habits, norms, customs, traditions and taboos. Various taboos and beliefs exist since long and continue to do so even now.³ These are considered as negative practices and traditions which are not good or fruitful for social wellbeing.⁴

In modern world with increasing emphasis on education and the resultant evolution of more reasonable approach, gradually such practices are declining, but are not completely eradicated from society. Many superstitious beliefs and practices are still reported and encountered. Dentistry is also not spared from such beliefs.⁵

Myths or superstitious beliefs are considered as stories by a group of people, which are part of their cultural identity. They have a strong influence in the life of individuals and on their way of living including seeking treatment during illness.⁶

Various myths related to dental treatment such as “professional cleaning causes loosening of teeth and extraction of upper teeth leads to loss of vision” were significantly observed in uneducated females. This kind of misconception is inherited due to false exaggerated information promulgated by those who had previous personal negative dental experiences.⁷

CASE REPORT

In this paper, we present a case of a 13-year-old boy who reported to the department of oral medicine and radiology, with chief complaints of pain in lower right back tooth region for the past 3 days. History revealed that the pain is severe, continuous, dull in nature which aggravates on mastication and relieved at rest. Pain did not subside upon medication. Patient underwent root canal treatment before 1 year. Patient has no systemic illness. Patient brushes his teeth once daily using toothbrush and toothpaste.

On enquiry patient first said a false history of fall, burn due to accidental fire from matchstick. On further probing, patient confessed that his father performed a procedure (ingestion of herbal smoke) for the purpose of removal of worm from a caries tooth. And he further added that patient’s grandfather had been regularly doing this remedy for many people facilitating removal of tooth worms.

The procedure which was done by patient’s father was that of placing a small piece of iron rod that was heated to red hot by placing in hot coal, which was placed in centre of plate that contains water in it. Two open-ended stainless-steel container is placed with one end on the plate. Then kandankathiri seeds (Solanum xanthocarpum) and Neem oil was added to it, and the other end was kept into the patient’s mouth. The time taken to complete this procedure was 10 minutes. They believed that the tooth worms would have been collected in the water as a result of smoke produced by mixture of neem oil and Kandan kathiri seed that was burnt using hot iron rod (but in this case he had not noticed any such thing).

As a result of this procedure patient developed burns in parts of eye, malar area, ala of nose, lips due to intense back fire when the procedure was done.

On extra oral examination brownish black crustations were seen in relation to upper and lower lip (Figure 1), left malar region (Figure 2), left eye lid (Figure 3), right and left ala of nose (Figure 4).

On intraoral examination the right lower posterior tooth was tender on percussion (Figure 5). The periodontium, alveolar, labial, buccal, palatal mucosa, tongue, floor of the mouth appeared to be normal. Intra oral radiograph in relation to tooth no. 46 revealed dental caries with pulpal involvement. The case was diagnosed as a case of extra oral burn with chronic irreversible pulpitis in relation to dental caries 46.

Patient was referred to department of conservative dentistry and endodontics for further opinion and management.

DISCUSSION

People still believe in superstitions all around the world. Superstitions are overwhelming in some cultures but limited in others-even though they still do exist.⁸

Legend of worm theory

The concept of a tooth-worm, which according to popular belief, caused caries and periodontitis, has existed in diverse cultures and across the ages. The theory of the tooth-worm was assigned by medical doctors almost exclusively to superstition. Even so, the idea that toothache was caused by gnawing worms held on even into this century. There were many different ideas with regard to the appearance of tooth-worms.⁹

In England, for instance, it was thought that the tooth-worm looked like an eel. In Northern Germany, people supposed the tooth-worm to be red, blue, and gray and in many cases the worm was compared to a maggot. The gnawing worm was held responsible for many evils and, in particular, was blamed for toothache provoked by caries. It was supposed that the disease was caused by small worms’ resident within the tooth, eating it away. This theory was disproved in 19^th century, when bacteria was discovered to be the true cause.¹⁰

The patient’s father probably relied on this theory and followed this procedure as a home remedy to treat his child. This purely is an ill effect of dental negligence and lack of knowledge about the cause for dental decay. The adverse effects can be acute lung damage, intra oral and gastrointestinal ulcers, cancer, nausea, heart disease due to the smoke inhaled. This case report could deepen the understanding of the superstitious belief about oral health.

CONCLUSION

To conclude Oral Health providers, need to play an active role in spreading knowledge and educate people on various issues. More work should be done to create awareness. Knowledge and awareness are necessary prerequisites for changes in behavior including behavior related to health disease and prevention. An effective approach by which this issue can be addressed to the community is only by understandable oral health promotion activities towards the consequence of these unethical practices.

Funding: No funding sources

Conflict of interest: None declared

Ethical approval: Not required

REFERENCES

1. 1. Park K. Park's textbook of preventive and social medicine (17^th edn), Banarsidas Bhanot Publishers. 2002;440-51.
2. 2. Rajkumar P, Anuj M, Vedapriya DR, Khan MI, Raghavia M. Taboos and misconceptions about food during pregnancy among rural population of Pondicherry. Calicut Med J. 2010;8(2).
3. 3. Kalipeni E, Mbugua N. A review of preventative efforts in the fight against HIV and AIDS in Africa. Norsk Geografisk Tidsskrift-Norwegian J Geography. 2005;59(1):26-36.
4. 4. Carr Hill R, Katabaro K J, Katahoire A R, Oulai D. The impact of HIV/AIDS on education and institutionalizing preventive education. Paris: International Institute for education Planning. 2002.
5. 5. Jafri R, Khan D. U. Z, Singh N, Chandel S. An Exploration of Misconceptions and Beliefs Related To Oral Health In India. EJMR. 2018;5(2):138-41.
6. 6. Lamster IB, Myers-Wright N. Oral health care in the future: expansion of the scope of dental practice to improve health. J Dental Education. 2017;81(9):eS83-90.
7. 7. Reddy KV, Bansal V, Singh PK, Bhambal A, Gupta M, Gupta S. Perceptions regarding treatment by dental quacks and self-rated oral health among the residents of Bhopal city, central India. J Indian Asso Public Health Dentistry. 2017;15(1):84.
8. 8. Mueller M, Schorle S, Vach K, Hartmann A, Zeeck A, Schlueter N. Relationship between dental experiences, oral hygiene education and self-reported oral hygiene behaviour. PloS one. 2022;17(2):e0264306.
9. 9. Gerabek WE. The tooth-worm: historical aspects of a popular medical belief. Clin Oral Investig. 1999;3(1):1-6.
10. 10. Suddick RP, Harris NO. Historical perspectives of oral biology: a series. Cri Rev Oral Biol Med. 1990;1(2):135-51.