O.O. Bankole1, F.B. Lawal2, and O. Ibiyemi2
1. Department of Child Oral Health, University of Ibadan, Ibadan, Nigeria
2. Department of Periodontology and Community Dentistry, University of Ibadan, Ibadan
Studies have revealed that Nigerians irrespective of social class have negative attitudes and practices towards children born with natal teeth and those who erupt teeth within the first 30 days of life. This has been associated with the strong cultural myths and beliefs that exist among the populace. Children with natal teeth and their families have been stigmatized and are believed to be cursed. This stigmatization affects their social life and consequently impacts on their quality of life. Therefore, there is a need to develop an intervention such as a video to help dispel these myths. Videotapes have been shown as an intriguing means of communication and valuable tool in health education. To help dispel the myths associated with natal teeth, and neonatal teeth a twenty-eight-minute culturally appropriate video in the a local Nigerian language (Yoruba) titled “Adunni”targeted for people from the low social class was developed. This film has been sent to primary health care centers in suburban and rural areas and will be shown to mothers, pregnant women, nursing mothers and traditional birth attendants with a view to appropriately inform them and the entire communities that eruption of natal or neonatal teeth is not a curse.
Keywords: Child, Natal teeth, Neonatal teeth, Health education, Video
Parents are usually overwhelmed with joy at the emergence of their baby’s first tooth. As this is believed to be a significant land mark in their child’s development.
Differences in time have been reported regarding eruption of primary teeth in children1-5 and many studies revealed that tooth eruption usually commences between 6-9 months of age.1-5 However, primary teeth occasionally erupt prematurely during the neonatal period.6 Natal teeth are teeth present at birth and neonatal teeth erupt within the first 30 days of life.7 Several theories have been postulated regarding emergence of natal and neonatal teeth. A possible etiology of natal/neonatal teeth has been thought to be related to heavy exposure of affected infants mothers to polychlorinated biphenyls. 8 In addition, natal/neonatal teeth have been associated with cleft lip and palate and syndromes namely Ellis-Van Crefveld, Pierre Robin and Sotos syndromes. 9 The most acceptable theory is the superficial localization of dental follicles probably related to hereditary factors. 10 Therefore, the condition may just be an individual variation in the child.
Some authors have reported prevalence rates of natal/neonatal teeth to be 1 in 2000-3667 live births11- 13 while others reported 1 in 6000 -8000. 14 Prevalence rates of natal teeth in Nigeria are not known even though individual cases have been documented in literature.15-18 In clinical dental practice, the alarming feature about infants who present with natal/neonatal teeth is the extremely high level of distress and anxiety in their mothers. This because in Nigeria, children with such teeth are culturally believed to possess evil supernatural powers and are viewed with disdain. Of greater concern are the health care workers who should be at the vanguard of dispelling associated myths but unfortunately believe in these misconceptions.
Bankole and Oke19 in their study on attitudes and beliefs of nurses in Ibadan, Nigeria to natal/neonatal teeth reported that 41.3% will be frightened and astonished in a labour ward if they helped deliver a baby with natal teeth. Furthermore, (39.7%), recommended extraction of such teeth and 11.1% of them would advocate traditional spiritual cleansing rites prior to the tooth extraction. Whist studying the beliefs and attitudes of Nigerian Traditional Birth Attendants (traditional midwives) to natal teeth in infants, Bankole et al.,20 revealed that (31.9%) believed natal teeth were caused by evil spirits, (31.3%), stated that children with such teeth behave strangely and (41.1%), were convinced that the children will develop evil spiritual powers. For this reason, (4.9%) of them would advise parents to get rid/or hide the child. 20 The inherent danger is that wrong counsel may be given to parents by these health care workers and affected children may be neglected, stigmatized and exposed to danger. To dispel these myths, oral health education is pertinent. One of the ways of intervening is by employing health education videos as a means of oral health education among community members and some health care workers.
The use of videotapes is an intriguing means in communicating with audience. Videos are valuable and effective health education tools. 21-26 Generally, visuals have been found to have greater impact than the written word as the message can be given at once in comparison to the written/printed message transferred over time to make its impact.27 An added advantage is that visuals gives the viewer a series of moving pictures that is buttressed with graphics texts and sounds which is not attainable with the traditional print. 28 The video tape can demonstrate procedures and concepts that may be difficult to explain or translate in print. Other advantages of videos have been attributed to better retention of what is seen, and having a lasting impression on the target population. Leake29 stated that visual memory is rapidly acquired and longer standing than auditory memory.
Health behaviours are known to be culture bound therefore, prevention intervention programmes should develop from a knowledge of and a respect for the culture of the target community. 30 Matthews et al.,31 stated that people are usually more fascinated with health promotion messages set in a story in their social and cultural background. Wong et al 32 while attempting to improve adherence to antiretroviral therapy among South Africans found culturally sensitive video tapes very effective.
Currently in Nigeria, there are no known documentation of a culturally appropriate health education video in a major local language such as Yoruba on natal/neonatal teeth. Based on inappropriate beliefs and poor attitude of Nigerians to natal/ neonatal teeth we decided to develop a culturally appropriate health education video on natal teeth in the Yoruba language targeted at the low social class with a view to appropriately informing the public that eruption of natal/neonatal teeth is not a curse.
Based on misconceptions about natal teeth among community health workers and nurses, it was necessary to produce an educational tool that will appropriately inform mothers, nursing mothers, pregnant women and other members of the public about these teeth. A twenty eight minute video in a major Nigerian language (Yoruba) titled Adunniwas developed. Adunni is the name of a girl in the video born with a natal tooth. This video was targeted at local community members (particularly mothers and pregnant women) and health care workers in rural and suburban communities. The purpose of this video was to demonstrate that the presence of a natal or neonatal tooth is not a sign of a curse or an abomination affected on the child and child’s family.
The video was developed with the following message: