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Human Tooth Sharpening (Section 109)
Human tooth sharpening, a form of dental modification, is a form of altering one’s tooth or teeth. This practice is attributed to many different reasons in different regions of the world, such as cultural significance, medical implications, and modern practices of body alteration. Human tooth sharpening comes in many different forms including breaking, filing, or cutting parts of the tooth crown. As one of the most common forms of body modification, the non-therapeutic art of altering teeth is very prevalent in a multitude of different cultures and societies. González and colleagues have found that the various explanations for the practice of dental mutilation including religion, ornamentation, tribe member identification, and the indication of a person of higher social stature in a given society. Some variations of dental sharpening have medical consequences simply by nature of commonly being performed in environments with poor hygiene. Thus, possible effects include but are not limited to malnutrition, metal-allergic reactions from dental drilling, bleeding, various infections, diseases, and even negative psychological effects. Human tooth sharpening or dental mutilation still exists today as a form of cultural tradition among some ethnic groups and tribal communities around the world and can be used for purposes of identification, aesthetic beauty, or marking the transition from childhood to adulthood.

History of Tooth Sharpening in Africa
Some groups in Africa have practiced tooth modification for thousands of years. People have sharpened their teeth for religious reasons, for aesthetic purposes, and to signify social status. Methods, style, and techniques varied across different regions and tribes. Tooth modification has also been assumed to have been done for group identification.

Herman Wissmann, a German European colonizer, came upon a group of indigenous people living in the eastern Kasai region of Africa and named them Zappo-Zap after their tribe leader. The Zappo-Zap people lived in the present-day Republic of the Congo and practiced a variety of body modification rituals, including tooth sharpening. Nearly all members of this tribe sharpened their teeth. In 1904, a Congolese boy, Ota Benga, was taken to the United States to be displayed at the St. Louis World’s Fair in Missouri. Benga was later part of an exhibit at the Bronx Zoo. In 1916, Benga took his own life.

Human tooth sharpening is believed to have started as far back as the third millenium BCE. The earliest findings of dental modification exhibit the removal of mesial and distal occlusal angles in the incisors and mesial occlusal angles in the canines. The removal of these parts results in the appearance of sharp, pointed teeth. The earliest evidence of this is from eastern Mali and reveals similar practices to those found in the tribes of western, central, and southern Africa today. Examples of such tribes include the Efe, Aka, and Twa tribes in The Central African Republic and Democratic Republic of Congo, the Luvale Luchazi and Mbunda tribes in Zambia, and the Munchi in Nigeria.

Modern Day Practices in Africa
In some contemporary African tribes and cultures, tooth sharpening continues to be motivated by the desire to relate to or differentiate from specific animals. For instance, the Efe and Mbuti living in the Democratic Republic of Congo, the Dinka tribe of Sudan, and other tribes in Cameroon, Guinea, Zaire, and Uganda carry out tooth sharpening practices such as akuha, a practice used to mimic crocodile teeth. In Tanzania, Makonde tribes practice the ritual of chipping off parts of the upper and lower incisors so that the teeth are peg-shaped. Their belief is that the procedure is not only a decorative and aesthetic improvement, but also represents signs of strength and the passage from teenage to adulthood. While still practiced today, changes in religion, society, and education have led to the dwindling of tooth sharpening practices within the Makonde tribe.

In contrast to the desire to relate to animals, Williams claims that “tooth sharpening is performed for purely aesthetic reasons” because it is considered physically appealing and because it makes male members of the practicing tribe appear more fierce or warrior-like. For example, young males in the Kiv tribe of northeastern Nigeria sharpen their teeth for aesthetic purposes, whereas the Ibo women in other regions of Nigeria sharpen their teeth to indicate that they have matured and are ready to conceive. Furthermore, the Malinese Dogon people sharpen their teeth to resemble a comb-like structure that is representative of a “weaving loom." Culturally, it is meant to symbolize sharpened teeth as a “tool with which to weave the world."

Gender-based Differences in Tooth Sharpening Practices in Africa
In the African tribe Lou, male tooth extraction of six lower teeth is performed as a form of initiation into adulthood. Similarly, in the Maasai tribes of Kenya, sixth-month-old males undergo the extraction of their lower deciduous incisors and then the extraction of their lower permanent incisors at six years of age. This practice is performed to facilitate feeding if the males have tetanus or to combat the kidnapping of children. In Nigeria, the Ibo people use tooth sharpening as a rite of passage into womanhood, where sharpened teeth indicate that a female has reached sexually maturity. Females are forbidden from having children until their teeth have been sharpened.

Tooth Sharpening Practices in Asia
Tooth sharpening is also a common practice in parts of Asia and is most prevalent in Indonesian tribes where “tooth filing is a rite of passage into adulthood and a key indicator of social, aesthetic and spiritual well-being.” It is considered a method of connection between the spiritual and physical world for Indonesian tribe members, who believe that a strong spiritual connection leads to a long life. Groups from Southeast Asia modify their teeth through artificial deformation. These included practices of ablation, the intentional removal of teeth, and modifying the crown shape and form through filing, staining, chipping, as well as other methods.

Gender-based Differences in Tooth Sharpening Practices in Asia
There are two reasons for this practice, which differ between males and females. In some major Indonesian tribes like the Bali and Mentawai, both males and females file their teeth to demonstrate a person-to-spirit connection; however, women are specifically expected to file their teeth before marriage. Males are not required to file their teeth before marrying but often do so to demonstrate their body-to-spirit connection. Furthermore, women are seen as more beautiful if they have their teeth filed.

Tooth Sharpening Practices in Australia
The removal of particular teeth for religious, medical, and spiritual reasons is a common practice in some Australian groups and regions. For example, male initiation rites for many Australian aborigines involve the removal of teeth as part of a series of physical ordeals, and “the removed tooth may be associated with contagious magic."

Mayan Tooth Sharpening Practices
The burial of a four- to five-year-old Mayan child around eighth century A.D. indicated the unusual and symmetrical filing of the deciduous upper lateral incisors. The most likely reason for this was that the filing was done after death, symbolizing a shark’s tooth, a common Mayan sacrificial symbol, implying that the death of the child was a sacrifice.

Costa Rican Tooth Sharping Practices
In the Costa Rican site at Jicaro dated between 1000 and 1300 A.D, tooth smoothening was observed to occur only in males. The anterior teeth were the most prominently modified, including the central incisor, the lateral incisor, and the canines.

Introduction of Tooth Sharpening Practices Via the African Slave Trade
In prehistoric times, there were likely no direct interactions between Africa and the Americas that would lead to the spread of the practice of tooth modification. Since tooth mutilation was practiced in Japan in ancient times, it is possible that the practice was transmitted from Asia to the Americas as well as from Malaysia to southeast Africa. A wide variety of dental modifications were practiced. Some African groups focused on chipping the occlusal edges on their top incisors and they sometimes even knocked out some of their bottom incisors. In the Americas, some individuals focused on filing the occlusal edges of the teeth into different shapes, including sharp points, and they also drilled holes in their teeth in order to incorporate inlays for decorative purposes.

African individuals played a vital role in introducing tooth modification practices into the Americas. Certain native groups in Central and South America in post-Columbian times adopted aspects of some African practices of tooth mutilation. Specifically, they sharpened teeth into points and there is no evidence that suggest these Native American groups developed their own modifications independent of African dental sharpening practices. It thought that they were exposed to this custom through contact with African individuals.

African individuals introduced the practice of dental mutilation into the Americas and some also maintained the custom while living in the Americas. In fact, the practice survived among small populations of African individuals in the Americas well into the 20th century. One such example includes a deceased black female in Florida who was found in 1966 and had teeth that had been filed into sharp points.

Mesoamerica
The cultural practice of dental modification has been found in Preclassic, Classic, and Postclassic cultures of Mexico and Central America. Upon evaluation of skeletons that date back to 1,400-1,000 B.C., it was found that the practice of tooth mutilation, including tooth sharpening, was prevalent in Mesoamerica, and especially in Mexico, at that time. The custom of tooth mutilation spread from Mexico in the pre-Columbian time period southward to the Esmeraldas on the coast of Ecuador. In addition, the practice was found to have reached the northward regions of St. Louis in the Mississippi Valley.

A female hunter-gatherer from Chihuahua desert region, excavated in 1990, revealed that the ritual has also been practiced north of the Valley of Mexico. The dental modifications displayed by this female hunter-gatherer combined with the evidence that there was a Mesoamerican presence in that same area indicates there was co-existence and interaction between the complex societies in central Mexico with the neighboring hunter-gatherer groups northward.

There was no difference between sexes when it came to tooth modification in Mexico, as both male and female skulls were found possessing modifications. However, Mayan women filed their teeth to enhance their physical beauty, so the motivations behind acquiring dental modifications are thought to have differed between the sexes.

The most common dental mutilation found in Mexico was the practice of sharpening teeth into one, two, or three points on the incisal surfaces which resulted in an appearance that has been given the label of “saw teeth." This type of mutilation was found on central or lateral incisors, and no instance has been found on canines. Although much less common, this type of dental mutilation can also be found in the lower central teeth, with a notable case known from Plancarte in Tarascsan Territory.

Maya
The pre-Columbian Mayans are known to have performed various body modifications, such as cranial shaping and dental modification (including sharpening), as well as hematite inlays and other filing patterns. In response to excavations of burial sites in the Americas, Javier Romero Molina created a system to classify different forms of dental modification, which has since been added to as more data has been collected. Modifications in the pre-Columbian Mayans on average fall under these classifications, and are usually found in the anterior teeth.

According to Diego de Landa’s account of dental modification in the post-Columbian colonial period, old women performed modifications using stone tools and water. It is believed that dental modifications were performed on living subjects, based on tooth disease that occurred after the modifications were performed. Other tools for modification may have included flint blades and worked bone; it is believed that modifications were created using filing rather than chipping. Holes for dental inlays were created by drilling, and inlays were secured by pressure or cement.

The reasons behind dental modification in this population remain unclear. It is speculated that dental modification may have been performed to distinguish class, gender, or as a rite of passage. Excavations such as those conducted by the Programme for Belize Archaeological Project (PfBAP) has revealed that dental modification was performed not only on elite individuals (as inferred by grave contents), but also on non-elite members of society, though the forms of dental modification in the two groups remain distinct. For example, non-elite groups tended to have modifications falling under the Romero B category, with notched lateral corners. However, due to degradation of burial sites in tropical environments, sample sizes are small. In addition, some of the available burial data is from excavations performed before the development of standard guidelines for determining sex, making it difficult to discern differences in dental modification based on sex.

Tooth Sharpening in the Amazon Valley
Certain groups in the Amazon Valley file their maxillary central incisors into sharp points in an effort to resemble the teeth of piranhas, which are native to the Amazon River and greatly feared by the indigenous people of the Amazon Valley. This has become a mark of beauty among these people.

The sharpening of teeth in order to resemble animals is not unique to this region and is also practiced by certain groups throughout Africa in order to mimic the teeth of crocodiles.

Filed Furrows
Until the late twentieth century, the custom of ritualistic tooth modification has been found in all parts of the world except Europe. That changed when in 1990, findings from the Viking Age cemeteries in Fjälkinge and Trelleborg in Scania, Sweden revealed three cases of the dental modification of filing notches into the teeth. Not long after that, additional cases were found in Oland, Sweden and Denmark. These were crucial finds because they proved that Europe was no longer the exception when it came to the practice of dental mutilations.

The majority of these individuals were found to be adult men, who all possessed very deep horizontal filings on the front teeth of the maxilla; the net effect was the appearance of horizontal notches, termed filed furrows, on the outer surface of the teeth. Filed furrows were found on the medial incisors, lateral incisors, and canines. The majority of the filing marks on any one of a particular individual’s tooth were found to have been created at the same time. Although there is no conclusive answer, several hypotheses have been proposed for the significance of filed furrows in Vikings. One hypothesis is that the Vikings used their teeth as tools, perhaps the men found were saddlers or shoemakers who made a lot of sinew thread by pulling it across their filed teeth.

Decorative Dental Inlays
The use of dental inlays as a tooth modification has been found extensively in Mexico and other regions in the Americas. The inlay-cavities in known examples are circular and rectangular in shape. Precious stones such as iron pyrites, jade, and, less commonly, rock crystals and obsidian were used to fill in the intentionally created inlay-cavities for decorative purposes. Use of gold inlays has also been found in other regions of the Americas, mainly in Esmeraldas, Ecuador. Iron pyrites, jade, and, less commonly, rock crystals were used for decorative purposes in dental inlays. Inlays were never used to fill in cavities, the sole purpose dental inlays served was that of decoration.

Tooth Blackening
The dying of teeth is considered a form of dental modification, and is currently performed or has been performed by peoples in Southeast Asia, Borneo, Malay, Southern Africa, Peru, Equador, and Morocco.

Tooth blackening in Japan appears to have begun between 250-500AD, where teeth were blackened when women reached an age at which they were marriageable. Male warriors and nobility also practiced tooth blackening. In this period, blackened teeth were considered elegant.

The blackening of teeth has been performed in Vietnam since the Bronze Age, where it was performed in both men and women; it was recognized as a symbol of elegance. The indigenous Kammu women in Laos, Vietnam, and surrounding regions blackened their teeth for many generations for aesthetic purposes; this practice can still be seen in elderly women in the population.

In Cordiellera in the Philippines, blackened teeth distinguished between animals and humans, and was an aesthetic choice and ethnic symbol; as in Japan, people in the Philippines also believed that tooth blackening would preserve their teeth. Some elderly people in the area still blacken their teeth.

The Jivaro Indian people in Northern Peru and Ecuador, who still practice tooth blackening, believe that doing so preserves the teeth.

Methods in Vietnam kept teeth stained for several months to a year. One procedure involved etching teeth with slices of lemon for several days. Afterwards, a shellac was boiled with lemon juice and rice vodka; the teeth were covered with this sticky material, and applications were repeated several times. Another material made from boiling alcohol and a powder containing various plants and spices was applied afterwards for several days, after which nut oil or lard was smeared onto the teeth. Similar procedures were performed with variations based on local plant availability in other parts of Vietnam, Japan, and the Philippines.

Deliberate Tooth Extraction
Tooth extraction is seen in tribes in Kenya, Tanzania, in the southern Sahara, and Sudan, as well as in Cameroon, Borneo, South Africa, and the aboriginal people of Australia. In modern Cape Town, the removal of the front teeth is a rite of passage for teenagers, and is performed for aesthetic purposes. In Sudan, teeth are also removed as a rite of passage, to allow the pronunciation of certain sounds in their languages, for aesthetics, and for oral sex. In this case, canines and lower incisors are removed.

In some groups across eastern Africa, Ethiopia, and Sudan, the removal of deciduous canine tooth buds in children less than two years old is common practice. In general, it is believed that the tooth buds, referred to as “maggots,” lead to diarrhea, vomiting, fever, and other symptoms in children, and so the buds are removed to prevent these symptoms. The Maasai community in Kenya has been reported to have conducted this practice since the 1960s; permanent teeth are also extracted in children at six years of age for initiation or for feeding in case of the appearance of lock jaw or other diseases. Tooth buds are removed using a sharp knife or a thorn from the orgosua tree. Refusal to participate in the tradition in the Maasai can result in disagreements and excommunication.

Ota Benga
Ota Benga was a Congolese pygmy with sharpened incisors who was born in 1883 in the Kasai River region. In the early 1900s, his wife and children were murdered by a territorial police force, and shortly after, Benga was captured and sold as a slave. He was freed by a Presbyterian missionary named Samuel P. Verner.

Benga later chose to return to the United States with Verner, where he was displayed first in the St. Louis fair in 1904 and then in the Bronx Zoo in 1906 under the premise of being a primate caretaker. This caused controversy, which ultimately resulted in his release. After leaving the zoo, Benga relocated to Lynchburg, Virginia, where he attempted to assimilate into American culture by changing his name, capping his sharpened teeth, and learning American culture. However, his assimilation was unsuccessful, and in 1916, he committed suicide by gunshot to the heart.

Modern Tooth Modification
Tooth modification is still a common practice in the modern Western world. The most popular method of dental modification is likely within the field of orthodontics, which saw a 20% increase from 2010 to 2012, with most of the increase driven by minors. Another method of dental modification that is growing in popularity is the usage of porcelain veneers.

Process and Medical Implications
Although there is minimal literature on the direct implications of human tooth sharpening on individual health, inadequate sanitation associated with general dental mutilation practices increases the possibility for serious infections, diseases, and death. The possible risks of dental modification necessitate expertise and skill for practitioners.

Looking to the Baka pygmies in Cameroon, multiple dental health implications can be observed as a result of human tooth sharpening. Upon collecting data on fifty-six pygmies, nearly two-thirds reported having persistent pain as a result of the practice. Additionally, oral health problems such as tooth sensitivity, toothache, and dental abscess were caused by the sharpening of teeth.

Various tools are used among different regions for the sharpening practice. In tribal rituals in Indonesia, teeth are cut and shortened using a hammer, a chisel, and sometimes a saw-like tool. In addition, a metal file or a stone with a similar shape might also be used. For ethnic groups in Java, Sumatra, and Borneo, while files and stones are still commonly used tools, sand and bamboo are also used to file the teeth to a sharp point. (ADD CITATIONS)

Dental modifications in some tribal communities and ethnic groups symbolize beauty and pride as a trial of resistance to physical pain, cutting away part of the teeth or sharpening the teeth into points. The practice is done either “by sawing off the tips of teeth with a saw-toothed iron blade or by grinding the teeth down with a stone or file”. The process of sawing off the tips of the enamel on central incisors to a pointy shape without anesthetic is extremely painful.