University of Tennessee, Knoxville
Trace: Tennessee Research and Creative
Exchange
Masters Theses
Graduate School
5-1998
A Biocultural Analysis of Intentional Dental
Modifications
Derek Christiaan Benedix
University of Tennessee - Knoxville
Recommended Citation
Benedix, Derek Christiaan, "A Biocultural Analysis of Intentional Dental Modifications. " Master's Thesis, University of Tennessee,
1998.
http://trace.tennessee.edu/utk_gradthes/3240
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To the Graduate Council:
I am submitting herewith a thesis written by Derek Christiaan Benedix entitled "A Biocultural Analysis of
Intentional Dental Modifications." I have examined the final electronic copy of this thesis for form and
content and recommend that it be accepted in partial fulfillment of the requirements for the degree of
Master of Arts, with a major in Anthropology.
Michael H. Logan, Major Professor
We have read this thesis and recommend its acceptance:
Murray K. Marks, Walter E. Klippel
Accepted for the Council:
Dixie L. Thompson
Vice Provost and Dean of the Graduate School
(Original signatures are on file with official student records.)
To the Graduate Council:
I am submitting herewith a thesis written by Derek Christiaan Benedix
entitled "A Biocultural Analysis of Intentional Dental Modifications." I
have examined the final copy of this thesis for form and content and
recommend that it be accepted in partial fulfillment of the requirements
for the degree of Master of Arts, with a major in Anthropology.
We have read this thesis and
recommend its ace
Accepted for the Council:
Associate Vice Chancellor and
Dean of The Graduate School
A Biocultural Analysis of
Intentional Dental Modifications
A Thesis
Presented for the
Master of Arts
Degree
The University of Tennessee, Knoxville
Derek Christiaan Benedix
May 1998
•
Copyright© Derek Christiaan Benedix, 1998
All rights reserved
11
Dedication
As a mentor and friend, Dr. Murray K. Marks has taught me to
"appreciate the variation" in everything. I cannot thank him enough for
all the opportunities he has given to me throughout the past four years. It
is with utmost respect and admiration that I dedicate this thesis to him.
111
Acknowledgments
I would like to acknowledge many people who helped me complete
all the requirements for my Master's degree. First and foremost, I want to
thank the members of my committee: Dr. Michael H. Logan, for sharing
his knowledge and insight with me while helping formulate many of the
ideas this thesis draws upon; Dr. Murray K. Marks, for being a great
advisor, teacher, mentor, and friend; and Dr. Walter E. Klippel, for
teaching me above and beyond the world of zooarchaeology.
I would also like to thank two people who helped steer me in the
direction of anthropology: Jim Woods and Bill West of the Herrett Center
for Arts and Sciences and the College of Southern Idaho, respectively. I
also appreciate the help given to me by Dr. Guillermo Mata Amado and
Brisa Escalona. Additionally, I thank Dr. Michael Keene and Stephanie
Gibbs for editing many preliminary drafts of this thesis. Thanks to all my
colleagues and friends throughout the years (you know who you are).
To my sisters, Gretchen and Meghan, I extend a great deal of thanks.
You helped me cope through both good and bad. Because of you I am a
better person.
Additionally I acknowledge my mother and father, Miss Vicki and
The Rev. I would not be the person I am today without all the love and
kindness you showered upon me throughout my life. Thank you for
teaching and guiding me.
lV
And last, but not least, I would like to thank Mary, my wife, for
helping me get through this academic period. You have been the source
of great inspiration and have consoled me through thick and thin.
v
Abstract
When we consider how painful dental drilling is now in spite of the
advances of science with respect to anesthesia and modern instruments, we
cannot help but think how much those people must have suffered from the
filing and dental preparations which were performed. (Fastlicht 1948:319)
Human teeth provide an excellent source of information about an
individual's past. Because of this, scientists study the range of
characteristics manifested in teeth. One such characteristic is dental
modification. Modification of the human dentition has a long and varied
history in numerous cultures (see Milner and Larsen 1991). This study
explores the practice and theorizes on the purposes of dental modifications
from a biocultural viewpoint. There are three relevant questions to this
endeavor: What, if any, are the consequences accompanying the alteration
of teeth? What are the biosocial benefits associated with modified
dentitions? Is this custom a maladaptive trait? A definition of dental art
is presented along with an historical overview of this practice. This thesis
also provides a review of relevant literature on dental modification. The
effects of dental alterations on the oral complex are then discussed,
including their hygienic, morphological, and histological impacts.
Lastly,
a theoretical discussion is offered on the reasons why some cultures
engaged in this practice, and why some contemporary societies still do.
New areas of research on this subject are also advanced.
VL
Table of Contents
Chapter
1
Page
Introduction: A brief overview of dental anthropology..............
What is the history of the study of teeth?..................................
Why are teeth studied and what can be learned?....................
Bioculturalism in anthropology.................................................
What is intentional dental modification?................................
Effects of dental modifications on the oral complex...............
1
1
2
2
4
7
2
Oral histology and dental anatomy...................................................
Terms and tissues..........................................................................
3
Pathologies in modified teeth.............................................................. 21
The intentional filing, inlaying, and/or ablation (evulsion)
of teeth increases the likelihood of pathology to the orofacial
16
16
com.plex........................... .......... . .......... ........................ . . . ..... . ....... ....... 21
Pathological reactions of orofacial complex in response to
intentional dental modifications ........ ....................................... 22
Evidence of orofacial pathology directly associated with
intentional dental modifications ................................................ 23
.
4
Discussion.... ... ... ..................................... . ....................... ...............�.. . . 28
.
.
.
.
.
.
.
.
Why do dental modifications occur? .............................. ..........
Who possesses altered teeth? .......... .... ...... .. ...... ... .. .... ...... ... .. .. .. ..
Reasons for dental modification..................................................
Methods of modification...............................................................
Distribution of intentionally modified teeth............................
Temporal and spatial dimensions.......................................
Maladaptive traits..........................................................................
What is maladaptive?..............................................................
What is the power of conformity?........................................
Theoretical implications................................................................
.
5
Conclusions and summary........... ......... .............................................
.
.
28
29
30
35
37
37
39
39
44
47
50
Bibliography.......................................................................................................... 54
Vim.......................................................................................................................... 66
vii
List of Figures
Figure
Page
1.1
The oral complex.................................................................................
6
1.2
Diagram of longitudinal section of enamel, dentine, pulp,
and cementum.....................................................................................
10
Thin section of tooth showing dentine in its three forms:
primary (A), secondary (C), and tertiary (B) .. .. .. ..... ..... ... .. .. ........ .
11
1.4
Mineral inlays on labial side of anterior maxillary teeth .. .. ... .
13
1.5
Mineral inlay on maxillary
2.1
Diagram of tertiary dentine forming to protect pulp..... . . . .... ...
3.1
Periapical abscessing on maxillary alveolar bone above
right central incisor and left central and lateral incisors............
24
Tribal identification patterns in intentional tooth
mod�fications of African groups......................................................
33
Detail of fresco showing apparent tooth filing...... .. ..... .. ... .. ......
46
1.3
.
.
.
.
.
.
canine .. . ..... ... .. .... ..... ...... ..... ... .. .... ... . 14
.
.
.
.
.
.
.
.
20
.
4.1
4.2
.
Vlll
..
.
Chapter 1
Introduction:
A brief overview of Dental
Anthropology
What is the history of the study of teeth?
The study of human teeth has an important scholarly history in
biological anthropology. Because teeth are comprised of the hardest
substance in the human body and are not as susceptible to decay as the
non-mineralized elements of the human body, they hold the best
evidence for reconstructing demography, health, and
biological/phylogenetic relationships of past human communities (see
Hillson
1996). Put simply, dental anthropology is the study of both past
and present human behaviors from evidence revealed in teeth. Dental
anthropologists are interested in many anatomical and biological aspects
of the human orofacial complex. Many themes help dental
anthropologists understand the characteristics observed in archaeological
and contemporary populations. These themes range from studying
prehistoric and modern odontometric variation to examining the
processes that occur with dental embryology and development, histology,
eruption, occlusion, wear, and pathology (for review see Hillson
Jordan and Abrams
1992; Kelley and Larsen 1991).
1
1996;
Why are teeth studied and what can be learned?
Why study teeth? Dental anthropology provides answers to
research questions concerning morphology, odontometrics (the
dimensions of teeth), evolution, genetics, forensic odontology, dental and
oral pathology and health, tooth use and abuse, and cultural and
behavioral practices. From a behavioral viewpoint, "oral cultural practices
can leave their imprint on the dentition" as the teeth are used in
functions beyond normal food mastication Gordan and Abrams
1992:290).
In some cases, the teeth have been used as tools, such as vice-like grips to
hold pins, pipes, sinew, etc. This type of habitual activity can leave a
characteristic mark on the teeth that aids the dental anthropologist in the
reconstruction of past lifestyles. By studying the dentitions of individuals
within different cultures, dental anthropologists can interpret general and
specific cultural behaviors. In the present study, intentional dental
modification is examined from a biocultural perspective to glean
information from archaeological and contemporary populations that
embraced (or still do, in some cases) this interesting, if little understood,
cultural behavior.
Bioculturalism in Anthropology
The purpose of this study is to examine intentional dental
modifications from a biocultural perspective. To better understand this
endeavor, a discussion of biocultural anthropology is provided. The
discipline of anthropology studies humans and their biology and
behavior. Humans are the only animals with a complex set of learned
2
behaviors referred to as culture (Crooks
1996). Many anthropologists
utilize a biocultural approach when studying the behavior of humans.
Bioculturalism is the study of human behaviors using both biological and
cultural data. It attempts to build an understanding between these aspects
with respect to evolution. It also seeks to find answers regarding why
cultural behaviors are important for different populations and how those
behaviors affect, in both positive and negative ways, the people engaging
in them.
A concept fundamental to bioculturalism is that of adaptation (see
Carneiro
1968; Irons 1996). Anthropologists have used the term
adaptation to identify the behaviors that exist in groups. During its
history, anthropology has been criticized by some for over using the term
adaptation (Gould and Lewontin
1979). Today, anthropologists realize that
in fact some behaviors are not adaptive, but rather maladaptive.
The
behaviors within cultures elicit some purpose, but "many traits and
behaviors exist at functional cost" (Crooks
1996:131).
With a reexamination of culture and biology, scientists are now
beginning to observe the underlying function of maladaptive behaviors.
It is understood that "traits and behaviors may ... have survival value for
the individual or population . . . and therefore are adaptive in the
Darwinian sense" (Crooks
1996:131). I hypothesize that intentional dental
modifications are adaptive in the Darwinian sense, but may be regarded as
maladaptive because of the possible risk to the orofacial complex.
Much is written on intentional dental modifications especially from
a descriptive stance. However, there is a paucity of studies in the literature
3
that examine such dental modifications from a biocultural standpoint (see
Logan and Qirko 1996; Mata 1994). Logan and Qirko (1996) mention
numerous maladaptive behaviors spanning the entire globe. Amongst
their list of maladaptive behaviors affecting diet, health care, status,
parenting, religion, and ethnicity are many specific behaviors that
populations engage in as part of their cultural repertoire. While the list is
extensive and well organized, it is too long to reproduce here, but some
mention of specific behaviors is warranted. For example, foot binding of
Chinese girls, the use of corsets during the Victorian era, trephination of
the cranium among certain ancient Mesoamerican groups, silicon
implants among North American women, tanning of the skin among
different populations, and intentional dental modifications among the
Aztec are a few of the examples of maladaptive behaviors cited (Logan and
Qirko 1996). These examples show cultural behaviors and traits that are
perhaps harmful to the individual partaking in them. This thesis will
focus on intentional dental modifications as a potentially deleterious trait,
but one, when viewed from a Darwinian perspective, that may have
conferred a reproductive advantage.
What is Intentional Dental Modification?
The study of dental modification has interested anthropologists for
many years, but how and why did this practice ever start? Perhaps there
will never be a clear answer, but such modification is a result of various
cultural practices, including artificially shaping the teeth, decorating labial
surfaces with inlays, deliberate removal (ablation), and using them as non-
4
masticatory tools. Additionally, other factors such as attrition, abrasion,
tooth fractures, antemortem tooth loss, surgery, and pathological
conditions all characterize dental variation seen in the oral complexes of
individuals from different populations. The phenotypic differences in
modified teeth reflect a wide range of cultural practices and help
anthropologists in the process of reconstructing and understanding
human behaviors of the past (Milner and Larsen 1991). Ortner and
Putschar (1985) state that there are two kinds of intentional dental
modifications that involve fracture of the dentition, one is ablation of
specific teeth, and the other is mutilation of the dentition, usually
involving the labial, or lip, surface of the anterior teeth (i.e., incisors and
canines). (See Figure 1.1). Mutilation occurs when the teeth are ablated,
filed, or drilled and inlayed with carved materials.
Linne (1940) and Romero (1970) state that, judging from
archaeological evidence, there were three distinct trends in the types of
dental alterations practiced in aboriginal Mesoamerica. The first and
earliest of these involved filing, which then progressed into filing and
inlaying. The last trend consisted of filing the teeth, but with no inlays of
stone or coral.
In
Africa, the types of dental mutilation are limited to
ablation and filing (see van Reenen 1978a, 1978b, 1986). Fastlicht (1976)
believes that dental mutilation is a misnomer because it is presumed that
modifying the teeth was meant to beautify, not mutilate. As such, the
terms "intentional tooth modification" or "intentional dental
modification" will be used throughout the rest of this thesis when
discussing this cultural practice.
5
•
=
Anterior teeth
Figure 1.1 The oral comp lex. Modified from Bath-Balough and
Fehrenb ach (1997).
6
There are numerous cross-cultural examples and descriptions of
intentional dental modifications. Despite an abundance of cases, the
origins of intentional dental modification are difficult to trace. Perhaps
tooth modification derived from early attempts to maintain oral health
(Fastlicht 1976). Historical accounts in Mesoamerica after the Spanish
Conquest of the Aztec in 1521 are helpful in understanding the practice of
early dental modification in this culture area (see de la Cruz 1940, Sahagt1n
1950-1969). Among these accounts is the Badianus Manuscript written by
de la Cruz in 1552. This report is important because it was completed 31
years after the fall of Tenochtitlan, the Aztec capital. It contains
ethnohistorical information regarding 251 plants used by the Aztec for
medicinal purposes. Of particular importance, one chapter of the
manuscript deals with oral health and the treatments prescribed for many
oral and perioral ailments including halitosis, dental pathology, and oral
hygiene. Some of these botanical remedies may have been used to treat
the side effects resulting from intentional dental modifications.
Effects of dental modifications on the oral complex
Barring accidents or intentional ablation, the heterodontic dentition
of Homo sapiens sapiens is composed of 32 teeth with 8 incisors, 4 canines,
8
premolars and 12 molars. The teeth are just one part of a complex
system in the oral cavity and have diverse functions. The most basic is
mastication, or the chewing of substances. Mastication involves the
processing of food, which aids in digestion. Another function is
paramasticatory, where the teeth are used as agents not related to
7
processing food. There are studies of the use of teeth as non-masticatory
agents (see Blakely and Beck 1984; Gould 1968; Gould, et al. 1971; Molnar
1972; Merbs 1968, 1983). Teeth become tools with specific "signature"
marks reflecting their use. These signature marks differ from the normal
wear patterns associated with food mastication. For example, Blakely and
Beck (1984) describe symmetrical notches in anterior teeth of crania from
archaeological sites in Tennessee. This alteration was most likely caused
by the individuals using their teeth as gripping tools in the processing of
sinew. Gould (1968) and Gould, et al. (1971) provide an interesting case of
Australian aborigines using their teeth to flake stone tools. Merbs (1968,
1983) describes anterior tooth loss in Arctic populations, where the effects
of activity-induced pathology, not ritual ablation, resulted in the loss of
teeth.
Because the anterior teeth are visible to individuals while
conversing, dental hygiene may have originated first from an aesthetic
desire, not one pertaining to health.
In
fact, Scott and Turner (1997) state
that the mouth is a "social organ" that commands the viewer's attention.
The appearance of the teeth, then, becomes culturally important, as in the
case of intentionally modifying the anterior dentition. However, while
modification may provide some aesthetic benefit it may also cause harm.
That is, if the masticatory apparatus is compromised by accidental or
intentional modification, severe complications may result. To better
understand the deleterious effects of dental modifications on the oral
health of individuals a basic summary of odontology becomes necessary.
8
At a simplified macroscopic level, the teeth are composed of
enamel, dentine, pulp, and cementum (See Figure 1 .2). The enamel,
dentine, and pulp of the tooth are of particular importance when
examining the effects of dental modifications because these tissues are
most readily altered and susceptible to responding. Enamel covers the
entire anatomical crown of the tooth, providing protection. Given its
high mineral content, it is the hardest tissue in the human body. Dentine
constitutes the entire body and bulk of the tooth. It is found under the
crown and in all of the root. There are three types of dentine: primary,
secondary, and tertiary (See Figure 1.3). Primary dentine is laid down
during dentinogenesis, i.e., the formation of dentine. Secondary dentine
is produced during the lifetime of the individual and acts as a
maintenance mechanism. Tertiary dentine forms in response to irritation
from trauma or disease of the tooth (Avery 1992; Jordan and Abrams 1992).
Pulp is the living constituent of the tooth, containing nerves, blood
vessels, and lymphatic tissue. The pulp functions in a number of ways to
protect, supply nutrition, and repair itself in the tooth (Ten Cate 1994).
Trauma to the dentition is not uncommon and the teeth respond
accordingly to injury, as well as to the harmful effects of bacterial
introduction.
In
the case of intentional modification, enamel and dentine
are compromised and the pulp can be exposed or liberated. In such
instances, tertiary dentine is produced and laid down to protect the pulp
chamber and curb the effects of subsequent pathology such as caries or
abscess. Tertiary dentine is the result of pulpal stimulation and forms at
the site of odontoblastic activity, or where dentine forms. Damage to a
9
Dentinoenamel
junction
(DEJ)
Cementoenamel
junction (CEJ)
._--- Cementum
Figure 1.2 Diagram of longitudinal section of enamel, dentine,
pulp, and cementum.
10
Figure 1.3 Thin section of tooth showing dentine in its three forms:
primary {A), secondary (C), and tertiary (B). From
Berkovitz, et.al. 1992.
11
tooth may take several forms, including attrition, caries, abrasion, and
fracture. Restorative procedures such as amalgams or fillings, and
mineral inlays in culturally modified teeth, could also be placed into this
category (See Figure 1.4 and 1.5). Secondary dentine is continually
produced throughout life. However, pathologies cause changes in the
dentine (Bhaskar 1991; Moss-Salentijn and Hendricks-Klyvert 1990).
These changes may come in the form of dead tracts, sclerosis, and
reparative dentine. These changes, known as dentinal repair, are the
tooth's attempt to save itself from infection, abscessing, and subsequent
removal from the oral cavity.
Severe consequences may occur to the dentition after a traumatic
episode. Ortner and Putschar (1985) state that accidental or deliberate
trauma to the dentition will likely leave permanent signatures.
Therefore, the mere fact that the change in tooth morphology is
intentional does not save the individual from negative, possibly life
threatening, consequences. In most cases the crown (enamel and dentine)
is damaged and, in rarer cases, the root is damaged. Researchers warn that
exposure of the dentinal tubules increases the risk for infection of the
pulp, which may then lead to periapical abscess (Mata 1994; Ortner and
Putschar 1985). The present study proposes that intentionally modifying
the teeth increases the threat of pathology. Studies have confirmed that
dental modifications do not occur without pain (Fastlicht 1976; van
Reenen 1978a, 1978b). In fact, pre-Columbian Mesoamericans undoubtedly
used plant-based anesthetic agents, such as the prickly pear cactus (Opuntia
sp.) to dull the pain resulting from modification (Hernandez 1959; see also
12
13
14
de la Cruz 1940; Fastlicht 1976). Elsewhere, when anesthetic agents are not
used during modification procedures, pain is an inevitable outcome. If it
persists, normal mastication may be compromised (see van Reenen 1978a,
1978b).
15
Chapter 2
Oral Histology and. Dental Anatomy
Terms and Tissues
The terms utilized in this study concerning oral histology and
dental anatomy are presented at a simplified level. For those interested,
advanced sources on oral histology and dental anatomy exist (see Avery
1992; Bath-Balogh and Fehrenbach 1997; Bhaskar 1991; Jordan and Abrams
1992; Moss-Salentijn and Hendricks-Klyvert 1990; Ten Cate 1994). Dental
embryology is characterized by many intricate stages and a brief discussion
of oral development is necessary to explain tissue response to the areas
affected by dental modifications.
Dental anatomy encompasses a number of complex stages that
includes growth and development, histology, mineralization, and
emergence. Intentional dental modification primarily affects two tissues,
the enamel and the dentine. In addition, it may adversely affect a third
tissue, the pulp. In order to better understand the mechanisms at work,
brief outlines of the cellular stages of enamel and dentine are addressed.
Because teeth erupt in different sequences, the timing of these events are
highly variable. Enamel and dentine growth for the first deciduous teeth
occurs very early, beginning around the seventh week of embryonic life
(Moss-Salentijn and Hendricks-Klyvert 1990).
16
The formation and development of enamel at the cellular level is
called amelogenesis. It is first characterized by the primary production of a
thin layer found at the dentinoenamel junction (DEJ). This is the first
layer that mineralizes, allowing Tomes processes to attach. The
differentiated cells that make enamel are called ameloblasts. The
ameloblasts begin production and secrete an organic matrix comprised of
amelogin and enamelin seeded with hydroxyapatite crystals that
mineralize into keyhole-shaped prisms. Hydroxyapatite is one of the
main inorganic compounds found in enamel. As the ameloblasts migrate
outward, mapping out the crown outline of the tooth, mineralization
occurs immediately behind the ameloblastic cells. During amelogenesis,
daily incremental growth is observable in cross striations. Larger
incremental growth lines, or Striae of Retzius, are circaseptan events.
When these growth lines continue outward and terminate on the tooth
surface, they are demarcated as perikymata. The ameloblasts only travel as
far as communicated by cells during their production of enamel. The
result is that in the finished product, various enamel thickness is seen,
characterized by individual stresses and strains. Near cusp tips the prisms
bend at differing angles, producing what is called gnarled enamel to help
dissipate occlusal masticatory forces.
Similarly, the formation and development of dentine at the cellular
level is called dentinogenesis. Dentine forms the bulk of the tooth. The
process begins when a biochemical message from the inner enamel
epithelium (the pre-ameloblast) is sent from the enamel organ across the
DEJ to the dental papilla informing those mesenchymal cells to initiate
17
dentine production. Amelogenesis begins when 4J.Lm of dentine have
been deposited at the DEJ. The cells that give rise to dentine are called
odontoblasts, and they begin by laying down a thin layer of matrix called
pre-dentine, which eventually mineralizes into dentine. This layer of
dentine adjacent to the DEJ is known as mantle dentine. Odontoblasts
produce dentine and move inward toward the pulp in their production.
Odontoblasts are housed in dentinal tubules. The odontoblasts work by
secreting pre-dentine and then moving inward toward what will become
the pulp in the finished crown. Pre-dentine mineralizes into dentine and
follows in a front immediately behind the active odontoblasts. There are
three types of dentine: primary, secondary, and tertiary. Primary dentine
is laid down during dentinogenesis for original crown formation.
Secondary dentine is produced at a reduced rate during the lifetime of an
individual as a result of normal aging. Tertiary, sometimes called
reparative dentine, is produced and utilized during a traumatic episode to
the tooth. The tooth will attempt to protect itself from the effects of
traumatic episodes like caries or fractures. Dentine is different from
enamel in that it continually remodels itself throughout life in response
to the stresses placed upon it.
A third tissue byproduct of dental growth is the pulp. It is the living
constituent of the tooth and acts accordingly to protect and defend itself.
The pulp is filled with different and numerous tissues including blood,
lymph, and nerves. When a tooth is altered in
a
traumatic way, (e.g.,
carious lesion, fracture, intentional filing or drilling), and the dentinal
wall has been invaded, the pulp will act to save the life of the tooth by
18
causing tertiary dentine to form attempting to seal off the affected area (See
Figure 2.1).
In
some cases this succeeds.
In
other cases it does not, thereby
causing an inflammatory response and affecting the tooth and perioral
complex, in a severe manner.
The cellular level of tooth growth and development is the primary
stage in a tooth's life. With maturation, the teeth do not remodel as other
living tissues, such as bone, do. That is, teeth will not act to repair
themselves in response to the stresses placed upon them.
In
this sense,
the teeth will permanently reflect the use wear signature markings they
accumulate through the life of the tooth. As mentioned above, a mature
tooth's innervation is supplied through the pulp. The enamel and the
dentine are not connected vascularly and do not transmit pain. By
intentionally modifying the teeth, individuals significantly increase harm
to the masticatory apparatus if there is exposure of the pulp.
When enamel and dentine are compromised and pulp is exposed,
the physiological response of the surrounding soft tissues manifests itself
as pain. If bacteria
is
introduced this will likely lead to infection, decay,
and loss of alveolar bone and teeth. The potential pathological responses
to modified teeth are described in greater detail in the next chapter.
19
Preparation
-formlay
Tertiary dentine forming to protect pulp
Figure 2.1 Diagram of tertiary dentine forming to protect pulp.
20
Chapter 3
Pathologies in Modified Teeth
The intentional filing, inlaying, and/or ablation (evulsion) of teeth
increases the likelihood of pathology to the orofacial complex.
Aside from the specific function of such dental treatments within the
sociocultural values ... one must consider the pain suffered during the
treatment as well as the health complications that might have resulted
from having such work done (Mata 1994:257).
Although there are some who have declared there is no real health
risk from dental modification (Milner and Larsen 1991), others disagree or
at least make mention of pathologies directly related to intentionally
altering the teeth for cultural reasons (see Fastlicht 1976; Mata 1993, 1994;
Romero 1958). It is well known that trauma to the dental arcades increases
the risk of pathology, which in
tum
may compromise the overall health
of an individual (Ortner and Putschar 1985). Some researchers describe
intentional dental modification as a form of trauma (Merbs 1989; Schwartz
1995; White 1991). Mata (1994) reports that evidence of perioral pathology
was detected in a large number of archaeological specimens he examined.
Even though the teeth are being modified in ways to conform to cultural
standards, the problem with artificially modifying the dentition lies
directly in the risk placed to the health of the individual participating in
the procedure. The intentional filing, inlaying and ablation of teeth
greatly increases the likelihood of pathology to the orofacial complex.
21
This chapter begins by discussing the effects of trauma via
intentional dental modification to the human orofacial complex. It then
explores the instances found in the literature where perioral pathology,
i.e., abscess and alveolar resorption, is noted by the researcher. Many
researchers disregard the fact that pain, health complications, and even
death may result from such procedures. I contend that there are many
examples of oral pathology directly related to intentional dental
modification. These examples must be considered when attempting to
understand why intentional dental modifications occur along such a wide
historical and cross-cultural continuum.
Pathological reactions of orofacial complex in response to
intentional dental modifications
The pathological reactions after a traumatic episode has occurred to
the teeth are numerous and are reflected in the dentition and surrounding
orofacial structures. Mata (1994) explores the effects of postoperative
recovery and pain to the oral complex associated with intentional dental
modification. Mata's research examines dental treatments that occurred
in pre-Columbian Mexico. He contends that the treatments employed to
perform the operation of intentional dental modifications were
potentially harmful and,
in
some cases, even fatal. He states that
preparing a circular hole on the labial side of a tooth for an inlay produced
a tremendous amount of heat, which in tum, caused excruciating pain. In
some cases the damage was reversible and the pain would dissipate a few
days after the operation.
In
other cases, the damage suffered by the tooth
22
was irreversible, resulting in a swelling of the periapical tissues. Bacterial
infection could set in causing abscessing of the tooth and resorption of the
surrounding alveolar bone (See Figure 3.1). Side effects of infection
include loss of the modified tooth, loss of adjacent teeth, infection of
perioral musculature, and even death to the individual due to severe
bacterial infection.
Mata's description shows that intentional dental modification is not
without its risks to the perioral complex. It is interesting to note that
many of the researchers who describe the risk of orofacial pathology are
dentists.
Evidence of orofacial pathology directly associated with
intentional dental modifications
Most researchers agree that while dental modifications were no
doubt the work of skilled craftsmen, the modifications probably did not
originate as a therapeutic procedure (Fastlicht 1976; Mata 1994, 1996;
Romero 1958; Rubin de la Borbolla 1940). As previously mentioned,
pathological conditions such as caries and periapical abscesses may result
from oral infections if the teeth are traumatized when filed or prepared for
inlays. If the dentition is accidentally damaged and the masticatory
apparatus is hindered, serious consequences can result as well.
The literature is rife with examples of dental pathology directly
related to the intentional modification of the teeth. The following case
studies demonstrate there is significant risk associated with intentional
dental modification. For instance, Van Rippen (1917:870) says that "the
23
Figure 3.1 Periapical abscessing on maxillary alveolar bone above
right central incisor and left central and lateral incisors.
24
procedure must have caused considerable pain." Rittershofer (1937:132)
describes dental specimens from the Philippines and notes that "many of
the pulps were exposed during . . . (the) operation," increasing the risk of
necrosis to the tooth and surrounding alveolar bone. Alexanderson (1940)
describes the risk of pathology to the dental pulp and the intense pain
associated with the preparation of teeth for modification. Rubin de la
Borbolla (1940) finds that some archaeological specimens possessed
incomplete inlay operations and hypothesizes that the procedure had to be
halted due to intense pain, or, perhaps, the death of the individual.
Additionally, Rubin de la Borbolla (1940:356) mentions that in
several other maxillae and mandibles he examined, "alveolar infections
and tooth decay were the inevitable results of imperfect drillings made by
inexpert hands." Fastlicht (1948:319) provides evidence that filing and
inlaying the teeth "produced disorders such as the degeneration of the
pulp and .. . periapical alveolar abscess."
In
other examples he notes teeth
filed to such a degree as to inhibit mastication due to sensitivity caused by
damage to the innervated pulp. Further, he describes the risk of periapical
abscesses and dental caries.
In
short, "some defective mutilations cause
pathologic processes and the functional loss of the teeth" (Fastlicht
1948:323).
Romero (1958:232) states that numerous archaeological specimens
show "evident traces of alveolar abscesses which demonstrate that filing as
well as inlay on certain occasions was not successfully accomplished." He
supports this statement in later research: "The association of dental
mutilation with alveolar abscesses in certain other cases demonstrates . . .
25
the mutilation damaged the pulp chamber of the teeth, doubtless causing
pain and making mastication difficult" (Romero 1970:55) . Goose (1963)
notes that by examining radiographs of modified teeth he found evidence
in some cases that such filing operations lead to necrosis of the pulp with
related periapical pathology. Stewart and Groome's (1968) research also
'
shows clear evidence of periapical infection, i.e., infection occurring
around the apex of the tooth root, associated with intentional dental
modification in an individual from Grenada, West Indies.
Davies (1972) notes abscessing in the roots of inlaid teeth from
Borneo. He concludes: "There were more caries in filed teeth than in
unfiled teeth"_ (Davies 1972:96). Moreover, Fastlicht (1976:47) reiterates a
finding drawn from his earlier research: "Lesions with abscesses observed
in some of the maxillae are the result of injury to the dental pulp, and of
damage caused by faulty techniques in which the pulp cavity was
penetrated during preparation of the tooth." Carter, et al. (1987) state that
in some cases, a lack of knowledge of dental anatomy caused operators to
expose the pulp of some individuals after inlaying the teeth with
minerals. Both Pindborg (1969) and Weiss (1992) report trauma to the
permanent canines, such as malformation and agenesis, after the
deciduous canines have been forcibly extracted. Miller and Taube (1993)
conclude that intentionally modifying the teeth, as in the case of inlays,
could cause severe pain, even death. Mata (1993) describes a pathological
lesion associated with pulpal infection on a tooth and correlates it with
an
operative procedure to produce a hole to receive an inlay. In other
research, he notes that improper drilling procedures will produce intense
26
pain. Such modification may also lead to infections of teeth, bone, and
mouth (Mata 1996).
One important area of consideration is the alveolar bone that makes
up the jaws and holds the teeth. Infections as a result of traumatic
episodes to the oral complex may likely cause further damage in the form
of alveolar bone loss or resorption. There have been many studies on
overall health and alveolar bone loss associated with periodontal disease
(see Clarke and Hirsch 1991; Hildebolt and Molnar 1991). This is one area
that future studies in intentional dental modifications need to address.
In
conclusion, many examples of pain and perioral pathology
directly related to intentional dental modifications exist. These examples
all lend credence to the primary theme of this chapter. For whatever
reasons individuals modify their teeth, the choice to artificially shape the
teeth is clearly risk-laden.
27
Chapter 4
Discussion
Why do dental modifications occur?
Individuals in many cultures are not content with the natural morphology
of their teeth but feel a cultural or idiosyncratic urge to produce an
artificial morphology more in line with their value system (Scott and
Turner 1997:xiv).
Numerous reasons have been advanced in an attempt to explain
why the custom of intentional dental modification is found in a wide
variety of historical and cultural settings. Many authors point out that
intentionally altering the teeth affords specific privileges to those
possessing modified dentitions. For example, the literature exhibits a
wealth of differing theories on why people today or in the past would
modify their teeth. These theories pertain to animal imitation (Carter, et
al. 1987; Comas 1960), beautification and cosmetic adornment (Whittlesey
1935), cadaveric, or post-mortem, adornment (Dembo and Imbelloni 1938;
Hamy 1882), diplomatic and political markings (Mata 1996), ethnic
markers and tribal identification (Rojo 1909; van Reenen 1978a, 1978b,
1986), expressions of mourning (Comas 1960), initiation and rites of
passage (Krogman and Iscan 1986), medical purposes (Davies 1972; Goose
1963), religious practices (Mata 1996), sexual attraction (Thomas 1916), and
markings of social status (Fastlicht 1976).
28
Who possesses altered teeth?
Researchers have recorded dental modifications in both males and
females. Moreover, evidence points to young adults as the prime
candidates for intentionally modified teeth (Carter, et al. 1987; Romero
1970; Stewart 1941). Interestingly, Havill, et al. (1997:90) state that while
both males and females possessed dental modifications, "it appears to be
more common among one sex or the other in different time periods."
The practice of intentional dental modification is found most often in
stratified societies, although there are examples of nomadic groups such as
the !Kung who intentionally alter the morphology of their teeth for social
benefits (See !Kung example in Maladaptive Traits section below). The
practice of intentionally altering the dentition is not usually observed in
most egalitarian or hunting and gathering societies perhaps due to the
reliance on the teeth as tools. Dental modification in these cases is, most
likely, unintentional (see Gould 1968; Gould, et al. 1971; Merbs 1968, 1983).
In studies on living individuals in Africa, dental modifications
occurring in young adults have been associated with the transition
ceremonies from childhood to puberty (Goose 1963; van Reenen 1978a,
1978b). There may be a bias in the archaeological record because natural
tooth wear (attrition) in older individuals might erase evidence of
intentional modification on teeth (Milner and Larsen 1991). That is,
through the natural process of tooth wear consistent with a gritty diet,
individuals who possess dental modifications as young adults may
actually wear the modification away. Thus as time passes, when an
archaeologist examines a skull of antiquity, the teeth, if present, may not
29
reveal intentional modification even though those teeth may have been
modified .
There are few examples of children with altered deciduous
dentitions. Three reasons may account for this. First, the primary teeth
are relatively more fragile than their permanent counterparts. Second, the
rapid exfoliation, or loss, of the primary teeth seems to make them less
likely to be chosen for intentional modification. Third, Romero (1958)
suggests that adults in pre-Columbian Mesoamerica did not allow their
children to undergo intentional dental modification because of the risks
involved. Interestingly though, adults were either oblivious to, or chose
to ignore, these risks when modifying their own teeth.
Reasons for dental modification
The reasons for modifying the teeth are numerous. Early
researchers working in Mesoamerica thought that the very nature of the
dental operation itself indicated a postmortem practice because
modifications in live individuals would not be feasible due to the pain, as
well as the skill and time required for such alterati�(Dembo and
Imbelloni 1938, Hamy 1882). In fact, Fastlicht (1948) states that these
researchers believed modified teeth represented cadaveric adornment.
These accounts can be rejected, however. Fastlicht (1976), for example,
states that in post-conquest Mesoamerica there are historical data showing
that indigenous peoples had words for filing the teeth of living
individuals. There are additional sources of information that support the
claim that dental modifications were performed on the living, not the
30
deceased (see Fastlicht 1948, 1976; Goose 1963; Rittershofer 1937; Romero
1958, 1970; Rubin de la Borbolla 1940; Stewart and Groome 1968; van
Reenen 1978a, 1978b). Researchers point out that dental modifications
were performed on live individuals because dentinal repair often occurs.
Most evidence comes from radiographs taken of maxillae and mandibles
confirming the existence of dental pathologies resulting from intentional
modifications. In some instances, periapical abscesses resulted when the
dental pulp was damaged. Finally, recent ethnographic studies have
documented the occurrence of such practices among contemporary
peoples in southern African countries (Bachmayer 1982; van Reenen
1978a, 1978b, 1986). These accounts establish that modifications of the
dentition typically occur antemortem.
Blakely and Beck (1984) correctly observe that intentionally
modified teeth are/were meant to be seen by other individuals. Most
researchers report that cultural groups believe dental modifications serve
an aesthetic, beautifying purpose (Blakely and Beck 1984; Fastlicht 1948,
1976; Goose 1963; Milner and Larsen 1991; Pindborg 1969; Rittershofer 1937;
Romero 1958, 1970; Rubin de la Borbolla 1940, Whittlesey 1935). For
instance, among the peoples of Borneo, DuBois (1944:84) states that
modified teeth are "considered definitely attractive." Goose (1963:91)
reports that an intentional change to the dentition "makes men look more
warlike." Another example deals with the use of modified teeth to attract
the opposite sex (Thomas 1916). Whittlesey (1935) comments on the
observations of Bishop Diego de Landa in 16th century Mexico. According
31
to Landa, Yucatec women decorated their bodies and teeth to appear brave
and fearless (Whittlesey 1935).
Some researchers have argued that dental modifications function as
an ethnic marker (Bachmayer 1982; Entwistle 1946; Fastlicht 1976; Handler
1994; Marshall 1946; van Reenen 1978a, 1978b, 1986; Wilson 1946). For
instance, Bachmayer's (1982) and van Reenen's (1978a, 1978b, 1986)
research on Africans in Namibia is quite revealing in this respect. They
conclude that filing and ablation of the teeth in particular ways served as
an identification of tribal membership. Interestingly, members of one
cultural group would inspect the patterns of dental modification in a
visitor to establish, or re-affirm, ethnic or tribal identity (van Reenen
1978a, 1986). Van Reenen (1978b) also discovered that different tribes
sharing a similar geographical area possessed group-specific patterns of
dental modifications (See Figure 4.1). There are instances where an
individual may exhibit combinations of different styles in dental art. This
may have resulted from intergroup diffusion or perhaps marriage into a
different tribe (van Reenen 1978b). Fastlicht discusses Rojo's (1909)
argument that dental modifications served as ethnic markers among
ancient Mesoamericans. He lists Rojo's (1909) classification of different
cultural groups according to the type of modification practiced, as well as
the kind of material used for inlays. The Tarascans of Michoacan filed a
slash onto the incisal edge of the tooth; the Totonacans from Veracruz put
two cuts into the free edge of the anterior teeth; the Zapotecs used pyrite
inlays; the Mayans in Chiapas used jadeite inlays (Fastlicht 1976).
32
African Groups
Sambyu
w
w
Herero
Cokwe
Wanyemba
Typical style
Variations in style
(Xf) Cli) (Xf) Cli)
CJJJ\1\fJ
(}JrxJJ\) a
(fi)Cli) (fi)Cli)
(JJ CQ lJJ OJ a
())00\f) (J)00\f)
000000
(}0(7\U) a
CffJbJlll
� (X[)Ch) mDCJro CJJDCJro
CJJJ\1\fJ QOOOOQ a (]Jrxf\JJ b CJJJ\JJJ
Figure 4.1 Tribal identification patterns in intentional tooth modifications of African groups.
Modified from Bachlnayer (1982) and van Reenen (1986).
c
Because differential patterns or styles of tooth modifications are
observed in several Mesoamerican archaeological populations, some
researchers believe dental modifications, aside from being ethnic markers,
are indicative of status or rank (Fastlicht 1948, 1976) . Fastlicht (1976) gives
an example of intracultural patterning in dental modification among
residents of Palenque, a Classic Period (AD 300-900) Mayan ceremonial
center in Chiapas, Mexico. Pacal, one of the kings of this Mayan center,
was buried in a temple at Palenque. While Pacal's teeth were filed, some
of his attendants, presumably of lower status, possessed beautiful dental
inlays in their dentitions. Similar findings are reported by Milner and
Larsen (1991) for the Mississippian period Indians (AD 1000-1400) in the
southeastern United States. The authors also state that differential styles
of dental filings are indicative of variability in social status.
A third
example comes from Stuart's (1997) recent archaeological study of Copan,
an ancient Mayan city in Honduras. Stuart (1997:75) speculates that two
anterior teeth from an adult male possessing jade inlays "emphasized that
he was a highly esteemed person."
Not all researchers agree, however, that intentional tooth
modifications represent status markers. Romero (1958, 1970) believes that
there is no relationship between intentionally modified teeth and status.
He bases this on his studies of numerous burials assigned to all classes of
society. Mata (1996) notes that intentionally modified teeth have been
found in both royal and common burials. This suggests that modification
of the teeth was very widespread. The questions of whether this practice
34
was indicative of status differentials must go unanswered until more
research on intra-cultural stylistic differences is done.
Other reasons given for the intentional alteration of the dentition
pertain to rites of passage. Researchers have reported on cultural groups
that permanently alter the appearance of the dentition to mark the
transition between childhood to adulthood (Bachmayer 1982; Goose 1963;
van Reenen 1978a, 1978b, 1986). Goose (1963) reports that among the Ibo of
Nigeria, women were not permitted to bear children until their teeth were
filed. He also reports that some groups in South Africa require
modification of the dentition to produce a lisp because "language cannot
be spoken properly unless. . . [the] . . . front teeth are knocked out" (Goose
1963:91).
Methods of modification
There have been a variety of techniques developed to produce
dental modifications. Because there are many different types of dental
modifications, a variety of tool kits exist for the operative procedure
(Romero 1958, 1970; see also Fastlicht 1948, 1976; Rittershofer 1937; Rubin
de la Borbolla 1940; Saville 1913). Modifications include both filing and
inlaying the teeth with "plugs" of certain minerals.
In
other regions, filing
and ablation of teeth were present while inlaying was not practiced
(Bachmayer 1982; Goose 1963; van Reenen 1978a, 1978b).
For dental filing, Fastlicht (1976) and van Rippen (1917) report that
among ancient Mesoamericans, stones were the preferred tool.
Specifically, filing tools made from obsidian allow the person performing
the modification to cut the incisal, distal, and mesial margins of the teeth
35
to alter their natural morphology. Van Reenen (1978a, 1978b) notes that in
filing the teeth among South West Africans, the tools used for the
operation included an ax head, a knife, a file, or any combination of the
three. Ablation of the teeth required that the teeth be loosened from their
alveoli (sockets) using tools similar to those used for filing. Once
loosened, the teeth were removed manually and the alveoli cauterized by
inserting a heated stick in the wound (van Reenen 1978a). Inlaying
required greater skill as the individual performing the procedure was
required to drill small holes into the labial surface of the tooth, ideally
without piercing the pulp chamber. The holes would then be plugged
with sized mineral encrustations. Fastlicht (1976) and Whittlesey (1935)
report that Mesoamericans used iron pyrite, hematite, jadeite, jade,
turquoise, quartz, serpentine, rock crystal, Mother-of-Pearl, and cinnabar
for this procedure, while Rittershofer (1937) and Rubin de la Borbolla
(1940) note that gold was the preferred mineral for inlays in the
Philippines and Ecuador.
The techniques used to produce the holes for inlays likely included
a bow drill with a hollow tubular bit, not unlike those used to make
trephinations in the skull (Fastlicht 1976, Romero 1970). The tubular drill
bit was made of jade, copper, or bird bone, and powdered quartz or fine
sand was probably used as an abrasive (Fastlicht 1976; Romero 1970) . Some
researchers have begun preliminary replicative studies on dental inlaying
in Guatemala using middle range research methods on donated teeth
(Mata 1994, 1996; Woods 1996). The techniques for these studies involve
the utilization of both replica bow and pump drills with hollow bird bone
36
and copper bits. The labial surface of the tooth is covered with bee's wax,
and a small area is scratched to expose the enamel. A drop of acid derived
from plant extracts is used to start an indentation on the enamel. This
indentation acts as a guide for the rotating drill.
These studies are promising because they give insight into the
procedures for dental modifications. Whatever technique is applied,
when the dentition of a person is modified, the risk to the life of the tooth,
and perhaps the individual,
is
increased.
Distribution of intentionally modified teeth
Temporal and Spatial Dimensions
Intentional dental modification has enjoyed a diverse history.
There are accounts of many societies in many countries engaging in this
interesting cultural behavior. Dental modification is a trait that enjoys
wide geographic range and significant temporal depth. From the temporal
perspective, Alexanderson (1940) states that intentional dental
modification began with the ancient Egyptians. In Mesoamerica filing and
inlaying the dentition occurred for roughly 3000 years, ending with
European contact (Fastlicht 1976; Romero 1958, 1970). In Africa,
intentional filing and ablation of teeth are still widely practiced
(Bachmayer 1982; Briedenhann and van Reenen 1985; van Reenen 1986).
While this trait does not enjoy great antiquity (i.e., it is not present during
the Paleolithic), it has persisted in certain stratified societies for over 3000
years. The question that arises, of course, is why does this behavior
37
continue to be practiced if it proves to be deleterious to individual health?
Possible answers to this question are discussed in greater detail below.
Geographically, culturally induced modification of the dentition is
found throughout the world. There are both archaeological and
contemporary examples from Africa: Namibia (Bachmayer 1982;
Briedenhann and van Reenen 1985; van Reenen 1 978a, 1978b), Nigeria
(Goose 1963), Sierra Leone (Thomas 1916), South Africa (De Jager 1965),
Sudan (Davies 1972), Tanzania (Weiss 1992), Uganda (Pindborg 1969),
Eastern Africa (Singer 1953), and Western Africa (Entwistle 1 946; Marshall
1946; Wilson 1946); Asia: Borneo (Davies 1 972; Du Bois 1944; Gomes 191 1),
India (Kennedy et al., 1981), the Malay Archipelago (Davies 1 972), Mariana
Islands (Ikehara-Quebral and Douglas 1 997), Philippines (Rittershofer
1937), and Thailand (Frank 1926); Australia (Davies 1972; Spencer and
Gillen 1899); North America: Colorado (White et al. 1997), Illinois
(Holder and Stewart 1 958); New York (Handler 1 994), Tennessee (Blakely
and Beck 1984), and the West Indies (Stewart and Groome 1968);
Mesoamerica: Belize (Havill et al. 1997); Costa Rica (Weinberger 1948),
Ecuador (Saville 1913; van Rippen 1917; Weinberger 1948), Guatemala
(Lopez Olivares 1997; Mata 1993, 1994, 1996), Mexico (Alexanderson 1940;
Fastlicht 1948, 1976; Hamy 1882; Rojo 1909; Romero 1958, 1970; Rubin de la
Borbolla 1940; van Rippen 1917; Weinberger 1948; Whittlesey 1935); and
South America: Argentina (Weinberger 1948), Bolivia (Weinberger 1948),
Brazil (Weinberger 1 948), and Chile (Weinberger 1948).
As is seen by the above listings, intentional alteration of tooth
morphology is very widespread. Additionally, this practice has a long
38
history occurring in many cultures. Given the risks associated with this
custom, the question that arises is why has this trait enjoyed such
significant temporal depth and geographic range?
Maladaptive Traits
What is maladaptive?
"Sometimes pain, mutilation, and even death are acceptable risks in
the pursuit of perfection" (MacFarquhar 1997:68). Even with such risks,
intentional dental modification has enjoyed a long history. In order to
understand why people continue to modify their teeth it is necessary to
examine the ultimate benefits possibly gained by having altered dentition.
In their 1996 study, Logan and Qirko present a perspective on maladaptive
traits and the power of cultural conformity. They begin by discussing that
many human behaviors have traditionally been erroneously analyzed as
being adaptive (Logan and Qirko 1996). In the past, certain cultural
behaviors, however bizarre they may seem, have been written off as
functional for the group engaging in them. For example, Tindale (1974)
discusses the damaging, though "adaptive", consequences of rites of
passage involving circumcision and subincision among males in
aboriginal Australia. He views these rites as a latent means through
which population growth was reduced due to enhanced male infertility
and mortality. His claim can certainly be challenged.
MacFarquhar (1997) discusses cosmetic surgery -- in this case, face
lifts -- concluding that:
The fact is that there are still many retrogressive arguments circulating
against cosmetic surgery, despite its new prevalence: it's unnatural; it's
39
violence . . . to allow yourself to be sliced up and mutilated for the sake of
beauty, is a sign of pitiful mental imbalance (MacFarquhar 1997:68).
If this is being said for plastic surgery, perhaps dental modification is a sign
of mental imbalance as well, but only when viewed from an etic, not ernie,
perspective. Why then is intentional tooth modification so widespread
along a temporal and spatial continuum? There must be a reason why
people continued to expose their dentitions to such operative procedures.
What benefits come from having modified teeth? Perhaps this is a
culturally induced trait pertaining to beauty. The ultimate ideal for how
teeth should appear varies from one culture to another (Scott and Turner
1997). Researchers report that modified teeth are used to attract the
opposite sex (Carter, et al. 1 987; Coffin 1911; Thomas 1916; Scott and Turner
1 997). For instance, Scott and Turner (1997) report that an informal poll
among a college population showed that the appearance of the teeth
played a significant role in assessments of sexual attractiveness . They
stated that 94% of those students asked "felt teeth were an important
element of physical attraction" (Scott and Turner 1997:xiv).
Modification of the human body, whether through permanent or
temporary changes, has a long history. From a Darwinian standpoint, to
be genetically successful is to pass one's genes from one generation to the
next. In other words, to meet, mate, and procreate. If people can increase
the likelihood that their genes will be passed by adorning themselves to be
more noticeable by the opposite sex, then particular forms of somatic art
become more understandable, and this certainly includes the custom of
altering the dentition. Here, social and reproductive rewards may
overshadow any risks, whether known or unknown.
40
Selection and the
differential fitness of given traits is always environmentally dependent. If
an environment changes, so, too, will the process of natural selection.
An interesting case in point is provided by Weiner (1994), who
summarizes research done on the Galapagos Islands over the past 25 years.
The research was carried out on finches suggesting that natural selection
has served as a major architect of avian morphology and behavior. That
is, one bird may be more likely to mate with another bird that possesses a
particular trait. Initially, this trait may prove advantageous to the
surviving offspring, but with subsequent generations it may become
harmful. An example that illustrates this point comes from Weiner's
(1994) report on El Nino of 1982-83. El Nino is the environmental change
seen worldwide that is caused by an increase
in
ocean temperature, which
in turn produces major fluctuations in global weather patterns. During
1982-1983, El Nino caused a tremendous increase in the flora in the
Galapagos, and specific finches capitalized on the change. Mate selection at
that point reflected those specific traits helpful to gathering the plethora of
food. When El Nino ended, the result was many finches suited for
individualized types of food (which were more plentiful and available
during El Nino) died out. Those finches that did survive were better
suited for adapting to the more harsh and less plentiful environment.
Thus their traits were selected for in the subsequent mating season. This
example shows how mate preferences among finches can be affected by
periods of environmental change. Such fluctuating preferences can affect
their ability to be reproductively successful.
Cultural environments also change. As Denby (1997:56) points out,
41
not only is natural selection the center of biology but it explains more of
consciousness and morality than most people realize. For our choices and
character, our desires and deeds may be the result of long-ago accidents and
adaptive mechanisms, which improved chances of reproductive success in a
given environment, and then got passed along in genes, after numberless
generations, to you and me, where they function in a new environment,
sometimes successfully, sometimes not.
Obviously, the trait of dental modification is not passed from one
generation to another via biological mechanisms. However, Dawkins
(1986) uses the term 'meme' to suggest that a custom or idea can be passed
from generation to generation in a pattern similar or analogous to genetic
inheritance. Thus, behaviors can be replicated by cultural inheritance.
There is no doubt there is risk to the oral complex when the teeth
are intentionally modified. However, perhaps there is a greater reward,
one that outweighs the risk of altering the morphology of the teeth.
While the risk may be present for the individual, the population as a
whole may actually flourish. In fact, some have argued that cultural
maladaptive behaviors are maintained within populations (Logan and
Qirko 1996). With this in mind, a clearer understanding of human
behavior is achieved using Darwinian evolutionary theory. Different
behaviors seen in groups "carry differential rewards with respect to
fitness" (Logan and Qirko 1996:615). Fitness manifests itself in
reproductive success. In this light, Logan and Qirko (1996) present many
examples that do not fit the explanation offered by Darwinian
evolutionary theory. This leads them to ponder "the persistence of
behaviors which appear to reduce individual somatic and reproductive
success" (Logan and Qirko 1996:615). Woven among the many examples
they describe is tooth alteration, specifically the inlaying of teeth occurring
among ancient Mesoamericans.
42
Logan and Qirko's (1996) study of maladaptive traits provides a
possible answer for the persistence of such customs: individual benefits
may outnumber individual risks. For example, Chagnon (1988)
demonstrates that among Yanomamo males, status and rank are
dependent on warfare. High status and prestigious rank are earned by
those males who have killed someone in battle. These males (Unokai)
enjoy greater access to mates and elevated fertility than non-Unokai
males.
An
increasing number of other researchers have documented a
similar correlation, one long ago predicted by Irons (1979), between
"cultural success and reproductive success." The cultural behaviors
rewarded reproductively vary considerably from one society to another.
The behaviors affecting differential fitness include hunting skill (Kaplan
and Hill 1985), land ownership (Voland 1990), political power (Betzig
1986), assimilation into a foreign culture (Cronk 1989; Logan and Qirko
1990), and many others. And if deleterious or maladaptive customs
become valued culturally, might they also persist because of the social,
even biological, rewards they could convey?
It is proposed in the present case that individuals with modified
dentitions who reside in stratified societies may enjoy enhanced
accessibility to potential mates . From a Darwinian evolutionary
perspective, passing genes into the next generation is fundamental .
Perhaps for certain groups, especially those that practice polygyny,
modifying the teeth may be socially advantageous, thus allowing certain
individuals a better chance of securing a mate or mates through enhanced
status and associated personal adornment. Although this correlation
43
cannot be established in most archaeological contexts, it can be explored by
ethnographers.
However, there are clear risks to individual health when dental
modification is practiced. Fastlicht (1976) states that the inlaying of
semiprecious minerals into healthy teeth demonstrates that pre­
Columbian Mexicans either had limited knowledge of dental anatomy or
chose to ignore it. The cultural environment may have played a big role
in dental modifications: "prestige or presentability may have . . . surpassed
comfort or health as justification for these inlays" (Fastlicht 1976:13). De
Jager (1965) mentions that maxillary incisors in a !Kung San population
were absent due to carious lesions brought on by filing the teeth. In an
example of ablation of the primary canines in children, Pindborg (1969)
notes that the crude fashion used to remove the teeth increased the
chances for malformation or agenesis of the permanent canines.
From the information reviewed above, it becomes clear that
intentional dental modifications are deleterious to individual health.
Therefore, regardless of the reasons people engage in this practice, the
choice to modify the dentition carried definite risks to the oral complex.
The next section examines why this practice occurred.
What is the power of conformity?
Cultural conformity and diffusion may play big roles in the practice
of dental modification. But, if there is pain and risk to the perioral
complex when teeth are modified, why does this practice continue?
According to Logan and Qirko (1996), humans tend to conform to the
44
opinions and practices of the majority. The need to conform is viewed by
some as a deeply imbedded psychological design mechanism whereby
humans recognize and adopt behaviors and practices from those around
them even when those behaviors may be deleterious or harmful (see
Symons 1987) . When viewed in this light, intentionally modifying the
dentition may be an act of social conformity.
Dental modification has been widespread within most groups
where it is practiced, implying that it is an accepted human behavior. For
example, van Reenen (1986) and Bachmayer (1982) both found that tooth
modification was a highly visible avenue through which nomadic peoples
established beneficial ties and developed good diplomacy with their more
sedentary neighbors. During the lean months of winter when food is
scarce, nomadic groups such as the !Kung San would stay in and around
more sedentary groups where food was more plentiful.
In
an effort to
make sure they would be welcome, the !Kung San would intentionally file
and ablate their teeth in the same tribal pattern as their sedentary hosts.
This way, the !Kung San could come back year after year to reap the
benefits from their neighbors (see van Reenen 1986).
Fastlicht (1976) discusses a fragment from an ancient Mesoamerican
fresco representing "Earthly Paradise."
It depicts two figures, one
apparently using a stone to file the teeth of the other (See Figure 4.2). Due
to the shee! number of different societies that practiced dental
modification, this custom may represent an example of cultUral
conformity. . Logan and Qirko (1996:625) assert that "conformity . . . carried
important social and, ultimately, biological rewards." If this holds true for
45
.......
0
CJo
0
46
intentional dental modifications, the rewards from society may outweigh
the potentially damaging physical effects befalling the individual.
Theoretical Implications
According to Logan and Qirko (1996:622),
natural selection has likely favored conformity as a primary means
through which individuals compete socially for biological rewards: access
to mates and increased reproductive success.
Intentional dental modification becomes understandable when viewed
through the lens of Darwinian theory. Perhaps by highlighting the
rewards o_f such behaviors, we may better understand why risky,
potentially maladaptive behaviors, persist. The need and ability to
conform to one's social group is a powerful motivation for members of
any society to adopt given practices. The number of people in our country
today who engage in body piercing, tattooing, and cosmetic surgery is
surprisingly large. But, are these cultural fads, or do they help people feel
as if they belong to a specific group? MacFarquhar (1997:68) states that
"cosmetic surgery, in fact, is becoming an art form."
Some modem people
are willing to change their bodies to the point of surgically altering them
to fit specific cultural ideals.
Many different reasons have been advanced by researchers for the
presence of intentional dental modifications. "People engrave, color, and
even intentionally pull out (evulse) teeth for cosmetic purposes" (White
1991:355). Understanding a culture's notion of what comprises beauty. may
be a daunting task. For most mainstream Americans, the piercing,
scarring, mutilating, and other body altering practices that exist among
outlying sub-cultures are usually not regarded as beautiful. Additionally,
47
most people today would probably not find the intentionally modified
crania of prehispanic Mesoamericans, South Americans, and peoples of
the Pacific northwest coast to be appealing (see Brothwell 1981; Ortner and
Putschar 1985; Romero 1970). Another example is the contemporary fad
among many African-Americans of using ornamental gold crowns placed
on the anterior teeth (see Carter et al. 1987). This custom is so popular
there are some cases where edentulous (i.e., possessing no teeth)
individuals have decorative gold crowns placed on their dentures (Logan
1998). Logan and Qirko (1996:626) admit that the "means to valued ends
may be viewed as deviant by members of differing social units." While
the behaviors are perhaps not socially acceptable by all, the end result for
individuals engaging in these behaviors is considered attractive and is
desired. From this perspective, the power of cultural conformity is
observable. Cultural conformity requires only that individuals adopt
behaviors and traits from their surrounding group (see Flinn and
Alexander 1982). Conformity "does carry potential rewards, even when
chosen means and ends are risk-laden and denounced by other segments
of society" (Logan and Qirko 1996:626).
Conforming to specific behaviors varies greatly across cultural
boundaries. Such variation is easily seen in the examples cited above.
Not all people find tattoos appealing, but, more importantly, some people
do. Likewise, the practice of artificially altering the shape of the skull is
not embraced by many peoples, but this custom still found a way to exist in
certain cultures. Finally, the act of capping the anterior teeth with gold
crowns, which is a sign of pride and wealth among some African-
48
Americans, is not pleasing to most others. These behaviors vary across
ethnic borders. As mentioned above, some researchers contend that
intentional dental modifications are used by groups to maintain tribal
identity and group cohesion (Bachmayer 1982; Entwistle 1946; Fastlicht
1976; Marshall 1946; van Reenen 1978a, 1978b, 1986; Wilson 1946). For
example, among African groups studied by Bachmayer (1982) and van
Reenen (1986), the patterns of intentionally modified teeth are group
specific (see Figure 4.1). By artificially altering the morphology of the
dentition in a particular way, certain groups can identify friend from foe
with a flash of a smile.
Furthermore, there is evidence that some forms of dental
modification may be therapeutic. For instance, Davies (1972) and Goose
(1963) note that the ablation of selected incisors allows individuals
suffering from tetanus induced lockjaw to be fed. Pindborg (1969) and
Weiss (1992) report that the ablation of the primary canines in infants is
believed to be efficacious among groups such as the Bakiga, Acholi,
Batoros, and Bugisus of Uganda and the Haya of Tanzania. It is believed
that these teeth are associated with disease, so they are removed to
maintain health. While intentional modification of the dentition may at
times serve beneficial purposes, in the vast majority of cases this practice is
performed for social reasons, despite the pain and disease it clearly invites.
49
Chapter 5
Conclusions and Summar y
Humans in a variety of different time periods and cultural settings
have engaged in purposeful alteration of the teeth. Intentional dental
modification manifests itself in different forms: ablation of specific teeth,
the filing of teeth, and the drilling and inlaying of the labial surface of
teeth. Such dental modifications were meant to be seen and most often
involved the anterior dentition in either or both of the dental arcades.
The instruments used, as well as the individuals who specialized in this
art, are highly variable.
In
light of the fact that some researchers (see
Milner and Larsen 1991) only fleetingly touch on the harmful effects of
this practice, it is clear that dental modification elevated one's risk of
infection, notably in the form of caries and periapical abscesses.
Intentionally altering the teeth may be a maladaptive trait that,
interestingly, has persisted over time, a continuity owing most likely to
the power of cultural conformity.
Numerous authors have identified a variety of reasons for why
such modifications occur. Everything from cosmetic enhancement,
ritualistic initiation, and tribal identification to early dental practices have
been discussed. Whatever the reasons for this practice, dental
modification is a traumatic episode to the orofacial complex and there is
significant potential risk when the dentition is intentionally altered
50
(Merbs 1989; Schwartz 1995; White 1991). However, the custom of
purposefully modifying the teeth enjoys such wide geographic range and
historical depth that the practice must have carried some type of benefit.
The benefit gained was first social, then perhaps biological (notably greater
access to mates). While risk to oral health is certainly present, the benefits
of having artificially modified teeth outweighed that risk. From a
Darwinian perspective, perhaps the continuity of this trait allowed people
in given cultures to enjoy a greater chance of passing on one's genes.
Most research on intentionally modified teeth is concerned with
typological aspects surrounding this interesting cultural behavior.
However, the question that remains is how did this practice of decorating
the teeth begin? Further, why has it enjoyed such widespread acceptance?
Perhaps these questions will remain unanswered. From a statistical
standpoint, however, a potential answer might be, given enough time, the
odds are in favor that humans will eventually embrace the idea of altering
the appearance of their dentition. Afterall, there are only a limited
number of ways that the body can be permanently modified. And if,
through a conformity mechanism, a society adopts and deems important
this particular form of somatic art, explanations for how and why the trait
of dental modification arose and persisted for thousands of years may
become clear.
This thesis has explored intentional dental modifications from a
biocultural perspective advancing an exploratory interpretation about the
social, and perhaps even biological, benefits associated with dental art.
The literature on dental modifications has been examined in an attempt to
51
find patterns in pathological conditions to the orofacial complex of
individuals engaging in this practice. Based on the review of the
literature, such patterns certainly exist. These patterns open up many new
research possibilities and further study in this area is certainly warranted.
Future studies of intentional dental modifications should
implement new research strategies. For example, one area that should be
explored is the inspection, both at the macroscopic and radiographic levels,
of skeletal populations that possess dental modifications . The
information gleaned would provide statistical correlations between the
presence of dental modifications and poor oral health. This information
would be useful for better understanding why people would continue to
intentionally alter their teeth despite the health risks.
Additionally, research in cross-cultural comparisons of
archaeological populations that engaged in dental modification versus
populations that did not will likely show significant variations in orofacial
health . This research design should look at the skeletal remains of
individuals of the same age and compare their dental health. The
information from such a design could shed light on the underlying risks
to the orofacial complex in the individuals with modified dentitions
versus those with non-modified dentitions.
A third research avenue is analyzing living populations who
continue to engage in this practice. Radiographic examinations of the
modified dentitions compared with healthy dentitions would be useful to
find correlations linking the trait of dental alteration with the presence of
infection, alveolar bone loss, caries, and other oral ' pathologies. The age of
52
individuals in test and control groups would be controlled, thus clarifying
the impact of dental modification on the oral complex. Further,
ethnographic inquiries on how and why some people choose to undergo
the change in their dentitions would be helpful in understanding the
reasons behind choosing to modify the teeth. Also, the participants can
explain the sensations felt during and after the operation. Ethnographic
accounts may also shed additional light on intentional dental
modifications as an ethnic or status marker. More research on intra­
cultural stylistic differences is required to better understand if this practice
is indicative of status differentials.
Another research area to examine concerns the techniques and tools
used to modify teeth. One important point is the comparison of the
hollow tubular drills used to make the holes for inlays . As mentioned in
the previous chapter, there is a similarity in the techniques used to make
the holes on the labial surface of the teeth and trephination holes found in
skulls (see also Fastlicht 1976). Additional research is needed to find if
covariance between inlays and trephinations exists.
Hopefully the research lines identified above will be pursued. With
additional data, it may be possible to explain more fully why the trait of
intentionally modifying the teeth enjoyed such temporal depth and
geographic range. This phenomenon certainly represents a significant
question, particularly because the types of dental alterations reviewed in
this thesis caused pronounced pain and deteriorating oral health.
53
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65
Vita
Derek C. Benedix was born February 20, 1970 in Baguio City, Luzon,
Republic of the Philippines. During early childhood, he and his family
moved quite often traveling from the Philippines to California to Idaho.
In Idaho, the family abandonded its love for nomadic life and became
somewhat sedentary. Derek attended 5th grade through high school in
rural southern Idaho. He graduated from Filer High School in May of
1988 and in the Fall of 1988 he began his undergraduate career at the
University of California Santa Cruz. After graduating, Derek found
himself in a bit of a pickle so decided to move back in with his parents and
save some cash dollars (Yay for Derek, Boo for his parents). After 1 1
months, Derek decided to return schoot whereupon packing his b orrowed
Honda CRX to the hilt, he left Idaho on a warm August day and made the
three day trek across the good ol' USA to the University of Tennessee,
Knoxville. He graduated in May of 1998 with a Master's degree in
Anthropology.
66