ENDIOM | WHAT WE DO

WHAT IS IOM?

Infant Oral Mutilation (IOM) is an alarming traditional practice executed upon young children suffering from diarrhoea and fever. Corresponding swelling on the gums mistaken for ‘tooth worms’.

Commonly performed in East African countries, it involves the barbaric removal of unerupted canines as the corresponding swelling on the gums are mistaken for ‘tooth worms’.

This is a highly dangerous and sometimes fatal practice.

There is blood loss and shock borne from rudimentary surgery that often leads to anemia. Poor infection control after this practice offers an extremely high risk of septicaemia, tetanus and transmission of blood-borne diseases such as HIV/AIDS. Governments and aid organizations are unaware of the dangerous implications.

It has no health benefits associated.

How is it done?

Children are forcely held on their mother’s lap and IOM is undertaken without anesthesia and using crude, unsterile instruments such as a bicycle spokes, a hot nails, or penknives.

It is performed through either the loosening of the deciduous canine teeth or tooth buds with such crude instruments or even merely using fingernails, metal clasps or strong wire filaments which is then subsequent to levering of the tooth or germ.

The wound is often dressed with inefficient contortions made out of various herbs to control bleeding and facilitate healing.

Why IOM?

Tribes performing IOM believe it to be a remedy for the children’s illnesses. Such include fevers, vomiting, loss of appetite and diarrhea.

These are illnesses commonly associated with teething and changes in the immune system.

However, these tribes often tend to associate such illnesses with a “tooth worm” within the jaw. Since the canine tooth bud is the most prominent in the oral cavity at this young age, it is the chosen site for the “worm”, “ebinyo” or “nylon tooth”.

The swelling of the gums is thus considered indicative of worms, weevils or maggots residing in the gingiva and responsible for pathogenic agents causing such illnesses.

Other Reasons

It is also relevant to acknowledge that tooth mutilation is also done in other tribes.

Similarly to IOM as a cure to illness, in these tribes it also involves early removal of teeth, as for the lower permanent incisors and/or canines. However is a practice associated with geographic, cultural, religious and/or aesthetic perspectives of these tribes.

In this case, IOM signifies a transition from one age group to the other, enhancement of beauty, a symbol of membership of the tribe, and as a superstitious local remedy to ailments that may either be real or perceived.

In addition, it is also perceived to create space for feeding and as an additional airway in case the jaw is locked by disease (e.g. tetanus).

Consequences

Performing IOM to children can result in unbearable pain, severe loss of blood and

transmission/spread of infectious diseases through unsterile tools. Such may include HIV/AIDS, hepatitis, tetanus, osteomyelitis, osteitis and septicaemia.

Other possible outcomes include critical dehydration, malnutrition and growth

retardation due to inability to drink, suck and swallow. In addition to possible dislocation of permanent canines.

Less frequent outcomes consist in odontomas and loss of or hypo-/dysplastic

deciduous and/or permanent teeth and mesial drift of teeth in order to

compensate and close the gap.