Ritual tooth modification in Bali (Metatah): Implications for dental assessment

Intentional dental modifications are valuable tools in human identification and profiling, helping to determine the cultural, ethnic, or regional origins of human remains. In the Hindu-Balinese tradition, a tooth-filing ceremony called Metatah, involving the six maxillary anterior teeth, is known. This study aimed to explore its prevalence and discuss the potential use in the analysis of dentition for human identification and profiling. An anonymous eleven-question e-survey (Google Forms, 2025) was conducted among Balinese individuals, and responses were quantitatively analysed using Microsoft Excel (2025, version 16.97.2, USA). Of the 55 participants, 49 (89.1%) reported having undergone the ritual. Among them, 28 (50.9%) stated that filing was performed until the incisal edges were smooth and the canines were reshaped to reduce sharpness. The reported reasons for the ritual included the elimination of Sad Ripu, the six enemies of the mind (60%), and as a rite of passage marking the transition from childhood to adulthood (25%). In 30 cases (54.5%), the ritual was performed by a sangging, a traditional Balinese ritual specialist. Most participants described the experience as not painful, while 26.5% reported moderate pain. This study confirms that Metatah in Bali yields characteristic dental modifications relevant to human identification and profiling. Incorporating knowledge of such practices alongside physiological and pathological tooth wear of anterior teeth enhances the accuracy of dental and anthropological assessments.