Clinical Topics — Canine Extraction

Deciduous tooth eruption is associated with the onset of diarrhea, leading many mothers to assume a causal relationship.1 Deciduous canine follicle extirpation is a procedure in which unerupted canine follicles are removed with a sharp instrument such as a hot needle or thin knife, typically without anesthesia. It is most often performed on children from 4-18 months of age by a traditional practitioner known as a yetirs awlakiy (tooth extractor).1-3


In a group of 975 children in Addis Ababa, 5% had deciduous canines removed, 7% permanent canines damaged, 23% lower canines removed, and 7% upper canines removed.4 In 1502 infants less than one year old in Jimma in southwest Ethiopia, 38% had their deciduous teeth extracted.5 In a survey of 581 mothers with 853 children under 5 years old from Gondar in northern Ethiopia, 70% had deciduous teeth extracted, and 84.5% of mothers reported tooth extraction as useful in treating diarrhea.6


1.) Hodes RM. Cross-cultural medicine and diverse health beliefs — Ethiopians abroad. West J Med 1997; 166:29-36.
2.) Young A. Internalizing and externalizing medical belief systems: An Ethiopian example. Soc Sci & Med 1976; 10:147-156.
3.) Johnston NL, Riordan, PJ. Tooth follicle extirpation and uvulectomy. Australian Dent J 2005; 50(4)267-272.
4.) Welbury RR, Nunn JH, Gordon PH, Green-Abate C. ‘Killer’ canine removal and its sequelae in Addis Ababa. Quintessence Int. 1993; 24:323-327.
5.) Asefa M, Hewison J, Drewett R. Traditional nutritional and surgical practices and their effects on the growth of infants in south-west Ethiopia. Paediatr Perinat Epidemiol 1998;12:182-198.
6.) Dagnew MB, Damena M. Traditional child health practices in communities in north-west Ethiopia. Trop Doct 1990; 20:40-41.