Late Clinical Manifestations and Documented Management of Infant Oral Mutilation

Infant oral mutilation (IOM) is a traditional practice involving manipulation or removal of unerupted primary tooth buds during infancy. Although its developmental effects on the permanent dentition are well documented, the clinical presentation and management of affected teeth later in life remain insufficiently characterized. The aim of this study was to characterize the clinical and radiographic findings and documented management of IOM-affected teeth in a clinically identified cohort of young adults.

This retrospective study included patients with documented IOM identified from institutional electronic dental records between 2010 and 2025. Potential cases were reviewed by four dental clinicians, and inclusion required consensus among all four reviewers. Demographic, clinical, radiographic, and management data were extracted from existing records, with the first encounter at the specialist dental clinic defined as the index encounter. Analyses were performed primarily at the tooth level.

Fifty patients with 58 IOM-affected teeth were included (mean age, 21.5 ± 2.8 years; 38% female). A negative response to pulp sensibility testing was documented in 40 of 57 teeth with available data (70%). Spontaneous pain, localized swelling, and sinus tract were all documented as absent in 28 of 58 teeth (48%). Management data were available for 52 teeth; documented management included root canal treatment (RCT) in 32 (62%), extraction in 7 (13%), biopsy in 3 (5.8%), follow-up in 6 (12%), and no treatment in 4 (7.7%).

In this clinically identified cohort of young adults with IOM, affected teeth showed a range of late clinical manifestations, including frequent negative pulp sensibility responses, and many had documented dental management, most commonly RCT. Nearly half had spontaneous pain, localized swelling, and sinus tract all documented as absent at the index encounter. These findings characterize the clinical presentation and documented management of IOM-affected teeth in young adulthood.