CHAITANYA.PIII MDSDept of Public Health Dentistry

IntroductionCauses for Taboo in Dentistry

Cultures.Supernatural Causes. Physical Causes.

Customs.Superstitions. Beliefs.

Myths: Taboo for Modern Dentistry.Studies related to taboos in dentistryConclusionReference

Contents

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Introduction

What is Taboo?

A Moral or Cautionary Restriction placed upon certain actions by authorities (kings, priests, shamans, etc.) of people, which if ignored will result in specific negative consequences.

Taboo is a strong social prohibition (or ban) relating to any area of human activity or social custom declared as sacred and forbidden; breaking of the taboo is usually considered objectionable or abhorrent by society. The term was from the Tongan language and appears in many Polynesian cultures. In those cultures, a tabu (or tapu or kapu) often has specific religious associations. Its first use in English was by James Cook in 1777.

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No taboo is known to be universal, but some (such as the incest

taboo) occur in the majority of societies. Taboos may serve many

functions, and often remain in effect after the original reason behind

them has expired. Some have argued that taboos therefore reveal the

history of societies when other records are lacking.

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Causes for Taboo in Dentistry

Culture is defined as “Learned behavior which has been socially acquired.” Culture plays an important part in human societies. It lays down norms of behaviour and provides mechanisms which secure for an individual his personal and social survival. It is now widely recognized that cultural factors are deeply involved in all the affairs of man, including health and sickness.

Culture:

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Many cultural practices exist in any society. These can be classified in to three types,

1.Practices that are of benefit to health, promotion, and prevention of disease. Eg: these include practices that include washing of mouth thoroughly after eating.

2.Practices that have no bearing on health, these are neither beneficial nor harmful.

3.Practices those are harmful in various degrees to health.

Taboos come in the third type, where culture restricts the individual or society from some of the acts that may actually benefit them. Some of the common dental and medical taboos associated with culture are of two types…

1.Supernatural Causes 2.Physical Causes

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1. Supernatural Causes:Wrath of Gods and Goddesses – There are people who

believe that certain diseases are due to the wrath of some God or goddesses like smallpox and chicken pox. And therefore there are misconceptions that administration of drug is considered harmful. Cases are not notified and poojas are made to appease the gods

Breach of taboo – Breach (breaking) of taboo is believed by some people to be responsible for certain diseases, Like Venereal diseases

Past sins – Diseases such as leprosy and tuberculosis are believed by some to be due to their past sins

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Evil eye – Children are consisted to be most susceptible to the effect of “evil eyes”. In order to ward off the effects of evil eye, charms and amulets are prescribed & incantations recited by the exorcist.

Spirit or ghost intrusion – Some diseases such as hysteria and epilepsy are regarded as due to a spirit or ghost intrusion into the body.

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2. Physical Causes:The effects of weather – The exposure to heat during

summer is responsible for an attack of loo (heat stroke). The folk remedies consist of application of oil and ghee on the soles of feet and administration of mango phool with a pinch of salt.

Impure blood – Skin diseases, boils and scabies are considered to be due to impure blood. Eating neem leaves & flowers is considered to purify blood.

Nervousness, fear and even sheer terror are words to describe the way millions of Americans and even some Indians going to the dentist. Visions of invasive needles and drills and memories of unpleasant and painful dentist visits during childhood continue to keep people away in droves. As a result, people all too often delay or skip a trip to the dentist, sacrificing the long-term condition of their teeth and health. 9

Each culture has its own explanations for occurrence of misfortunes, disasters and illnesses. The blame may be on supernatural forces or witch or a sorcerer Or it may be considered as punishment by God for the sins committed. It is necessary to remember the cultural influence in understanding how people will and do react to ill-health, pain, or death.

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Customs

Definition: A long-established practice common to a people or culture.

Custom—is a habitual group pattern of behavior that is transmitted from one generation to another and is not biologically determined. Since societies are perpetually changing, no matter how slowly, all customs are basically impermanent. If short-lived, they are more properly called fashions. Customs form the core of human culture and are stronger and more persistent in preindustrial societies than in industrial ones, in rural than in urban areas. When formalized in the social or religious sphere it leads to ethics, and when enforced in the sphere of rights and duties, custom leads to law.

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Customs are technically divided into “folkways” and “mores”.

The folkways are the right ways of doing things in what is regarded as the less vital areas of human conduct .

The more stringent customs are called as “mores”

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Superstitions An irrational belief or practice resulting from ignorance or fear

of the unknown. The validity of superstitions is based on belief in the power of magic and witchcraft and in such invisible forces as spirits and demons.

Ancient men and women worked hard to alleviate dental pain. As early as 1550 B.C., Egyptians used various remedies for toothache, which included such familiar ingredients as dough, honey, onions, incense, and fennel seeds.

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The Egyptians also turned to superstition for help in preventing tooth pain. The mouse, which was considered to be protected by the Sun and capable of fending off death, was often used by individuals with a toothache. A common remedy involved applying half of the body of a dead mouse to the aching tooth while the body was still warm

Ancient Greeks took a more superstitious approach, with some depending on the mythical power of the mouse to protect their teeth. A recipe for bad breath from the fifth century B.C. called for a range of ingredients including the bodies of three mice, including one whose intestines had been removed, and the head of a hare. The ingredients were burned and mixed with dust and water before consumption.

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Beliefs Belief is something believed or accepted as true or the mental

act, condition, or habit of placing trust or confidence in another. Belief, in philosophy is commitment to something, involving intellectual assent.

Belief in the psychological sense, is a representational mental state that takes the form of a propositional attitude. In the religious sense, "belief" refers to a part of a wider spiritual or moral foundation, generally called faith; historically generated by a group's need to provide a functionally valid foundation to sustain them. The generally accepted faiths usually note that when oppressive states are generated by it being exercised, and not a fact of reality, it was in need of more revelation or clarification.

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Belief is considered prepositional in that it is an assertion, claim or expectation about reality that is presumed to be either true or false (even if this cannot be practically determined, such as a belief in the existence of a particular deity). Historically, philosophical attempts to analyze the nature of belief have been couched in terms of judgment.

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There is a belief that alum rinses help the gums to become stronger .Some persons use alum for gingival massage. The feeling created by the astringent action of alum gives them a feeling that the gums have become stronger. Gingival massage does not reach places where gingivitis starts.

There is also a widely held belief that chewing tobacco strengthens teeth & gums. Tobacco is supposed by many to have an antiseptic effect in oral cavity. This belief leads to the practice of using tobacco& more often “mishri”,which is burnt tobacco as a dentifrice. Mishri is the most commonly used form of tobacco in women.

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There is a belief that diarrhea in children during primary dentition is a normal phenomenon. Some believe that diarrhea takes out the heat in the body. Mothers are therefore reluctant to get their children treated to stop diarrhea. Added to this is another misbelief that the child having diarrhea should not be fed milk or given any food. This leads to malnutrition in toddler age group when the nutritional status may already be compromised due to poverty, ignorance.

Offering betel leaf or pan is a way of showing that a visitor is welcome.

Fasting: People of one particular community in India during fasting time do not get extractions done as analgesia is to be given and at the same time scaling and polishing is also not allowed by them. As bleeding can occur and it may be swallowed also.

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People of upper casts don’t go to lower cast doctors for treatment thinking that their religion will be spoiled.

Jains of north India consider taking an injection as taboo, so strong is their belief that they go to the extent of getting a tooth extracted without an local anesthetic injection.

When deciduous teeth exfoliate children as well as parents believe that if they keep the exfoliated teeth under rock or throw on top of the roof they will get teeth as strong as stone. And they also believe that if they keep their exfoliated teeth in a rat hole they will get teeth as strong and sharp as rat teeth.

Some people believe that if the child was born with neonatal teeth, it is danger to be grand parents.

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Over the past 20 years there has been an explosion in the number of techniques, materials and concepts advocated for clinical dentistry. Unfortunately, this explosion is mild compared with the number of myths, falsehoods and downright lies which have accompanied these ideas.

Some of the myths are taboo for the development of modern dentistry…

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Myth- Removal of upper teeth affects vision. Fact - There is a taboo among many people that

removal of the upper teeth affects vision. This is a misconception. Vision is not affected in any way by undertaking treatment of the upper teeth including its extraction.

Mythri H, Santhosh Kumar R. Perceived myths about oral health in India. Indian Journal of Dental Research. 2015; 26(3):333.

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Myth - Thumb sucking by children leads to

forward placement of upper teeth.

Fact - Thumb sucking is a normal infant habit, which makes the child feel secure and happy. It usually decreases after the age of 3 years. However, if the habit persists beyond the age of 4-5 years it can cause problems of the teeth including forward placement of the teeth. In these children, depending upon the frequency and severity of the habit an intervention of the habit by a dental surgeon may be required.

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Myth - Once a decayed tooth is treated the dental problem is over.

Fact - Dental decay is treated by use of various restorative

materials. However the artificial material usually will not completely match the tooth in strength, colour, smoothness and other qualities. In addition if the patient does not maintain good hygiene, decay can start again around restorations. Hence, whenever a tooth is filled or replaced it requires use of additional cleaning methods like flossing, interdental brushes, etc, in addition to regular tooth brushing. In addition dental check up once a year becomes all the more important when you have a treated tooth.

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Myth - Professional cleaning/scaling/removal of tartar loosens the teeth.

Fact - Teeth are held firmly by the supporting tissues of the periodontium including bone. Bad oral hygiene results in the deposition of tartar /calculus on the tooth surface. These deposits irritate the gums and can cause inflammation and bleeding of the gums. If the tartar is not removed, the gums may recede and the supporting bone around the teeth gets destroyed. The tartar on the teeth thus causes great harm to the supporting tissues of the teeth. However, patients may experience slight mobility of the teeth after tartar is removed as it kind of binds the teeth together. Professional cleaning removes this tartar and arrests further destruction of supporting bone. Removal of tartar deposits only helps to recover the health of supporting structures. This chain of events does not take place in people who have dental checkup regularly

Mythri H, Santhosh Kumar R. Perceived myths about oral health in India. Indian Journal of Dental Research. 2015; 26(3):333.

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Myth- Dental procedures are always painful.

Fact - Most dental procedures are carried out under local anesthesia, which makes the procedures totally painless. In addition the modern day high-speed drills cause less vibrations and are more comfortable for the patients.

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Myth - Dental treatment should be avoided during pregnancy. Fact - The above notion is not true. Many a times dental treatment is

provided even during late pregnancy. Routine dental procedures can be carried out without any fear. However, major surgical procedure may require medical opinion before treatment. Dental X-rays are to be avoided during the first three months of pregnancy.

Myth - Cleaning the teeth with finger & powder is better than with toothbrush.

Fact – The use of a tooth brush with bristles to clean plaque and food particles from almost all the surfaces of the teeth. The finger may not reach all the areas as well as a brush does. Hence, it is recommended to use a toothbrush with paste to clean the teeth and freshen the mouth. Finger can only be used to massage the gums after brushing is complete.

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Myth- Charcoal, salt, rice husk, tobacco, etc, in powder form is better than toothpaste in cleaning teeth.

Fact - The objective of cleaning the teeth is to remove the plaque and food particles on and around the teeth by the bristles of a toothbrush with the help of a toothpaste or powder. A standard paste or powder contains proper sized particles, which are not harmful to the teeth. However, other powders are coarse and can erode the outer layer of the teeth and permanently damage them. Hence, only standard toothpaste or powder should be used with a toothbrush. Toothpaste is better than powder as it can easily be dispensed on the brush and it may contain fluorides, anti-tartar chemicals, etc. The foaming action of the toothpaste also helps to freshen the mouth. Tobacco should not be used. Users enjoy the euphoric effect of nicotine present in tobacco rather than cleaning of the teeth and slowly become addicted to it. Hence, it should never be used.

Mythri H, Santhosh Kumar R. Perceived myths about oral health in India. Indian Journal of Dental Research. 2015; 26(3):333. 27

Myth - A child never needs cleaning of milk teeth.

Fact - It is a myth that we need not clean a child's teeth. Children are as much prone for dental decay or gum diseases as adults. In fact children tend to have sweet food including sweetened milk and juices which can promote dental caries. So it is advisable to start the habit of cleaning the infant's teeth soon after they appear in the mouth. In fact it is advised to clean baby’s gum pads everyday by gentle massage even before the teeth erupt.

Mythri H, Santhosh Kumar R. Perceived myths about oral health in India. Indian Journal of Dental Research. 2015; 26(3):333.28

Myth - Milk teeth need not be cared for because they last only for a few years, and these teeth will anyway be replaced by permanent teeth.

Fact - Early loss of milk teeth will interfere with chewing and affect the child’s nutrition. Early loss of milk teeth leads to drifting of the adjacent teeth and closure of some of the space that is required for the succeeding permanent teeth to erupt into. Such a loss of space will cause the permanent teeth to erupt in irregular position and result in crowding. Therefore milk teeth need to be cared for as much as permanent teeth.

Mythri H, Santhosh Kumar R. Perceived myths about oral health in India. Indian Journal of Dental Research. 2015; 26(3):333.

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Myth - When the gums bleed, it is better not to brush the teeth.

Fact -Bleeding of gums is a sign that they are inflamed and are not healthy. This usually is a result of plaque and food particles accumulating around the teeth. Until this collection is removed, the gums continue to bleed. This is an indication that the individual needs to visit a dentist for opinion and treatment. Brushing the teeth with a soft toothbrush by the proper technique removes the plaque and helps the gums recover. Initial bleeding seen during brushing gradually reduces over a period of time.

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Myth - Keeping an aspirin tablet beside a painful tooth reduces the tooth pain.

Fact - A toothache cannot be relieved by placing an aspirin tablet anywhere in the mouth. In fact this is a dangerous habit as it causes burns of the soft tissues around the area of placement. Hence, aspirin tablets should not be placed in mouth but swallowed after eating some food to relieve the pain.

Myth - When an artificial set of teeth are worn, the upper denture

logically has to fall down in the mouth and create problems, however the lower denture that should rest in place does not stay.

Fact - Although the lower denture rests on the ridges of jaw, it does get easily dislodged because of the interference of the muscles of check, lips tongue and movement of the jaw during function. However, with time the muscles learn to co-ordinate with the lower denture and the patient overcomes this problem. The upper denture, on the other hand stays in its place due to creation of suction under the palate. 31

Myth: Tooth-whitening will make all my teeth, fillings, veneers, crowns and bridges white Reality: Only teeth whiten. No whitening products affect crowns, bridges, veneers, bonding and fillings. Be careful.. otherwise you may end up with light teeth and dark restorations. Also, if you require any dental work, consider whitening before you begin treatment, so that your crowns and other restorations can be made to match your newly whitened teeth!

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Myth: Now that my teeth are lighter, I will never have to do it again.

Reality: The color stability depends on how well you clean your teeth, the frequency of consuming foods or beverages that stain, and if you have kicked the smoking habit. In most cases it takes much less time to do a touch-up than the original whitening process

Myth: Cut brinjals will change their color to black

Reality: Some people believe that staining of the teeth is because of eating brinjal.

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Mythri H, Santhosh Kumar R. Perceived myths about oral health in India. Indian Journal of Dental Research. 2015; 26(3):333.

Myth : The mouth has no relationship to the rest of the body’s health.

Truth: The condition of your teeth can affect

our overall systemic health.

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Myth: Brushing, flossing and mouthwash will eliminate bad breath. Truth: These actions temporarily mask the smell, but are only

eliminated when your teeth are professionally cleaned by a hygienist or dentist.

Myth: Dentists do not need many credentials to practice. Truth: Licensing of dentists is heavily regulated. Dentistry has

become a full-fledged healthcare science that demands post-graduate certification training.

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Dr.N.Saravanan, Dr.R.Thiruneervannan. Assessment of Dental Myths among Dental Patients in Salem City. JIPHD. 2011; 18 (SUPPL. I): 359-363. 36

Dr.N.Saravanan, Dr.R.Thiruneervannan. Assessment of Dental Myths among Dental Patients in Salem City. JIPHD. 2011; 18 (SUPPL. I): 359-363. 37

Ref: Tasneem S Ain, Owais Gowhar, Saima Sultan. Prevalence of Perceived Myths Regarding Oral Health and Oral Cancer-causing Habits in Kashmir, India. International Journal of Scientific Study. 2016: 4(3);45-49.

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Archana Rai, Ipseeta Menon,2Aruna DS, Avnish Singh. Association between taboos in dentistry and oral health behavior among adult population of Ghaziabad. J Dent Specialities.2016;4(1):14-20. 39

Dr N Sarah Sheela Emerald, Dr VChandraSekhara Reddy, Dr N Sudhakar Rao. Dental Health Myths and Misconceptions among Yanadi Tribe of Gonepalli Village, Nellore District, India: A Cross-Sectional Study. International Journal of Humanities and Social Science Invention .2016;5(12):9-15 40

Dr N Sarah Sheela Emerald, Dr VChandraSekhara Reddy, Dr N Sudhakar Rao. Dental Health Myths and Misconceptions among Yanadi Tribe of Gonepalli Village, Nellore District, India: A Cross-Sectional Study. International Journal of Humanities and Social Science Invention .2016;5(12):9-15

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Ghanta Bhanu Kiran et al. Evaluation of dent-o-myths among adult population living in a rural region of Andhra Pradesh, India: A cross-sectional study. J NTR Univ Health Sci 2016;5:130-6.

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Ghanta Bhanu Kiran et al. Evaluation of dent-o-myths among adult population living in a rural region of Andhra Pradesh, India: A cross-sectional study. J NTR Univ Health Sci 2016;5:130-6.

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So these are some of the general taboos and the factors affecting them. As a dentist it is our utmost duty to educate people, remove myths from their mind, which may subsequently affect the general health and well being of the society. We should communicate with people in a manner, which will highlight the benefits which will result from treatment. They should be convinced. The patient who is convinced about the ultimate benefit has a better tolerance of pain(taboo which is usually associated with dentist) than a patient who is not highly motivated…

Conclusion

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Reference1. Dr.N.Saravanan, Dr.R.Thiruneervannan. Assessment of Dental Myths

among Dental Patients in Salem City. JIPHD. 2011; 18 (SUPPL. I):

359-363.

2. Mythri H, Santhosh Kumar R. Perceived myths about oral health in

India. Indian Journal of Dental Research. 2015; 26(3):333.

3. Tasneem S Ain, Owais Gowhar, Saima Sultan. Prevalence of Perceived

Myths Regarding Oral Health and Oral Cancer-causing Habits in

Kashmir, India. International Journal of Scientific Study. 2016; 4(3):45-

49.

4. Archana Rai, Ipseeta Menon,2Aruna DS, Avnish Singh. Association

between taboos in dentistry and oral health behavior among adult

population of Ghaziabad. J Dent Specialities.2016;4(1):14-20. 45

5. Dr N Sarah Sheela Emerald, Dr VChandraSekhara Reddy, Dr N

Sudhakar Rao. Dental Health Myths and Misconceptions among Yanadi

Tribe of Gonepalli Village, Nellore District, India: A Cross-Sectional

Study. International Journal of Humanities and Social Science

Invention .2016;5(12):9-15.

6. Ghanta Bhanu Kiran et al. Evaluation of dent-o-myths among adult

population living in a rural region of Andhra Pradesh, India: A cross-

sectional study. J NTR Univ Health Sci 2016;5:130-6.

7. Poonam Pandya et al. Dental Care: Social Myths and Taboos. People’s

Journal of Scientific Research. 2 0 1 6 ; 9(2):42-46

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