In addition to dental extraction and dental and oral care, several procedures are performed on teeth as tribal customs, most of which are mutilating. Teeth are extracted for curative or hygienic purposes (and during shedding of milk dentition). When this is done, teeth sockets are sometimes cauterized to stop bleeding. Al-hayfat (milk teeth) may be troublesome, causing various illnesses, including diarrhoea. They have, thus, been managed carefully and frequently extracted. Crowfoot reported on how the Rubatab manage teething saying:

“Various teething troubles are diagnosed as the result of growths, called the haifat, in the places where the eye-teeth should appear. In such cases among the Rubatab the local “doctor” is usually called in to dig out the haifat with a hooked awl, a very painful operation which often results in the child’s having no eye-teeth at all. Others cauterize the bottom of the spine, and others, especially round about Omdurman vow four piastres, one for each tooth, to Sheikh Khogali of Khartoum North to save their child from this trouble.”[1]

A sibhat al-yasur (jet string of beads or ‘rosary of comfort’) is cut, and the beads allowed to tumble over a child’s head, in order to attain a cure. Waqar al-wattaya (literally heel’s sweat) is an interesting topical ointment used to manage erupting milk teeth. The mother’s heel is scraped off immediately after coming out of a talh smoke bath. The stuff obtained, is a precipitate of talh fumes and aromatic oils. When this material is applied to the gum, it is believed to soothe the itchy gum. Failing this, the gum is massaged with cloves or sheeh (wormwood, Artemisia absinthium).[2]

Swelling of the cheek due to alveolar abscess or severe gingivitis, is sometimes managed with a paste of fermented millet flour, to which some common salt is added and applied to the affected area. The cavity of a tooth that is affected by sus (tooth decay), is filled with a bit of sheep’s fat, then a needle is heated and inserted in it until it melts away. This, reported Ahmad Abd Al-Halim, is believed to give relief and kill the sus.[3]

When tooth extraction for the front teeth or bicuspids is necessary, either a forceps (kallaba) is used, or a piece of a one-metre-long strong thread is tied round the root of the tooth and pulled suddenly.

Several dental procedures, including extracting, separating, pointing and paring teeth are performed as tribal customs. Indeed, the custom of extracting front teeth is so universal among central African tribes that a person who has his teeth intact is considered ugly. The teeth involved are the upper incisors, lower incisors, and sometimes also the canines. The operation is performed at puberty, usually at the age of 14-16 years. Males are always subjected to this custom; females only in special situations. This procedure is that of extraction and not a breaking-off of teeth. A specially-constructed gauge, a spear head or knife blade is inserted between the middle incisors and levered from time to time until these two teeth are loose enough to be prized out. They are then readily freed in like manner and removed between the finger and thumb.

Teeth are also pared to definite shapes or pointed sharp. This procedure is carried out by a local expert who chops the teeth into the required shape with a small chisel and a stone acting as a mallet. The teeth are then filled down and smoothed by rubbing the surface with a hard stone. Separating teeth, however, is an uncommon practice. It is accomplished by inserting pegs of wood of gradually-increasing size between them until the required parting has been achieved.

The reasons given for these patterns of teeth are many and differ form tribe to tribe. Anderson studied these patterns among the Nyam Nyam and other southern tribes and reported on them in 1908 (see plate page 187). He listed the reasons people give to justify the custom. The shapes of teeth, he reported, in addition to being a sign of manhood and womanhood, may serve to distinguish tribes, make distinction between men and animals, or make a person bite and tear meat more effectively, or make them look more ferocious. The new configuration of teeth may be necessary for the pronunciation of, for example, the Dinka or Shulluk languages. It may also ease feeding in lock-jaw (a common disease among the Nuba), may be merely ornamental, or a custom of no apparent function.[4]

Among Heiban and Otoro of the Nuba Mountains with the onset of puberty—the filling out of the girls’ breasts and the growing of the pubic hairs of the boys—their ways diverge. But first they undergo the same mutilation, the breaking out of the lower front teeth—four in Heiban, two (of boys) or four (of girls) in Otoro.