Diverse Dental Care: Differing Cultural Perspectives on Pearly Whites

face of a smiling woman

With US culture’s focus on having a bright, healthy smile, you might think that brushing with electric toothbrushes and swishing with Listerine is a universal practice. How else do you take care of your teeth?

Hint: The US is a cultural island.

Something as basic as the concept of a healthy smile is still subject to different points of view. And where someone from Cincinnati would describe the most beautiful smile as one that includes all the teeth, someone from Ethiopia may have had their front teeth removed on purpose to achieve the ideal look.

Let’s take a world tour of teeth!

There’s More Than One Type of Toothbrush

It seems obvious that before the modern toothbrush existed people used other methods to brush their teeth, but maybe not so obvious that people still do! A bristled brush isn’t for everyone, and to many people, their tooth-brushing methods carry cultural significance:

  • Miswak is a twig used in many Muslim cultures for its high fluoride content, antibacterial properties and pleasant aroma. The Prophet Muhammed even recommended the miswak in the Qur’an.
  • Siwak is a twig with similar properties to the miswak. It’s used in the Sudan and Morocco, where it also possesses cultural significance.
  • Datun is a popular choice in Southeast Asia because of its antibacterial and astringent properties. It’s been used to clean teeth for centuries and is even mentioned in ancient Ayurvedic texts.

Some People Remove Healthy Teeth on Purpose

While most North American and European cultures only remove teeth for medical reasons like decay or orthodontia, the ritual removal of perfectly good teeth is a practice seen on every other continent:


Traditionally, young Maasai girls in Kenya underwent the removal of two lower incisors as part of coming-of-age rituals, and was associated with strength and beauty. Indigenous African cultures that practice ritual tooth removal are found across the continent, including Sudan (canines), Tanzania (6 lower teeth), Cameroon (4 upper incisors), and Mozambique (4 upper incisors).


In Central Sulawesi, young girls traditionally had their upper and lower incisors removed as a rite of passage. This was usually performed at the start of puberty. Archaeological evidence shows that ancient peoples in mainland China and Formosa also practiced ritual tooth extractions.

South Pacific

Cultures across Oceania practice ritual removal of teeth, including Australia and Vanuatu. Some Aboriginal Australian tribes remove teeth as a rite of passage, sign of mourning, or rites associated with kinship. In Vanuatu, teenage girls often had their 2 central upper incisors extracted as a sign of entrance into womanhood.

Many Cultures Ritually Mutilate Their Teeth

The US pop culture obsession with vampires has made sharpening teeth an underground fad, but the ritual alteration of teeth can be seen across time and space:

  • In Papua, young Mandi men traditionally sharpen their front teeth to points as a symbol of maturity and warrior readiness. This practice, called “ngise,” involves rubbing teeth with stones or files.
  • In Indonesia, Mentawai both men and women sharpen their teeth, believing it enhances beauty and attracts potential partners.
  • In Ghana, the Asante people filed their teeth to sharp points, particularly the upper central incisors. This practice symbolized beauty, social status, and bravery.
  • In South Sudan, Nuer men traditionally chipped or filed their upper front teeth into distinctive patterns. This practice served as a marker of age, social status, and belonging to a particular lineage.
  • In Mexico, the ancient Huastec civilization practiced filing their teeth down and then adorning them with gemstones as a marker of social status.
  • The Kuna people of Panama traditionally filed their teeth into pointed shapes and decorated them with gold caps to signal beauty, wealth and social status.

Beautiful Teeth Might Be Black, Red or Blue

White teeth are not the ideal color across the world – not even close. And historically, you’ll even find a preference for colorful teeth at some points in history! Examples of teeth painting include:

Teeth Blackening

The practice of staining or painting teeth black emerged in multiple regions independently way back in the Neolithic era. Some factors that drove this were:

  • Blackened teeth were often perceived as beautiful, enhancing smiles and contrasting with paler gums.
  • In some cultures, the darkness signified maturity, wealth, or belonging to a specific social group.
  • Belief in the practice’s ability to ward off evil spirits, strengthen teeth, or prevent decay played a role in certain communities.

Cultures in which you’ll find a history of teeth blackening include:

  • Southeast Asia: In Japan, geishas and women in certain tribes stained their teeth black as a sign of beauty. In addition, betel nut and lime mixtures were popular in places like Laos, Vietnam, and Myanmar, creating a deep stain.
  • Africa: In Senegal and Côte d’Ivoire, iron filings mixed with sap resulted in a distinctive bluish-black hue, traditionally representing status. These stains also had protective properties to tooth enamel.
  • Oceania: Papua New Guinea tribes used soot and charcoal, while Aboriginal Australians employed tree bark saps for blackening. These practices are done for aesthetic, social and ritual reasons, depending on the culture.

Lapis Lazuli Staining

This happened in Europe during medieval times, and has been confirmed by several skeletons with stained teeth or fossilized tartar that contain shavings of lapis lazuli. One such skeleton was a nun from Germany, implying it may have had religious connotations.

Red Ochre

Several cultures stain their teeth red for different reasons:

  • The ancient Maya elites stained their teeth with a red powder produced from the cochineal insect to denote high social status, wealth and power.
  • In Namibia, Himba women adorn their teeth with red ocher paste after removing two front ones. This vibrant color signifies beauty, cultural identity, and protection from evil spirits.
  • In New Guinea, Abelam men traditionally filed their upper front teeth into sharp points and decorated them with ochre paste. This signified masculinity, warrior status and attractiveness.

And those aren’t nearly it in the list of different perspectives on pretty smiles. Some cultures adorn their lower teeth with wire. Some ancient cultures used wood pegs or slave teeth as dental implants to replace missing teeth. Some modern cultures, like the Amish, aren’t concerned with the aesthetic of missing teeth and will pull a bad tooth without replacing it.

But here, we do love a full, bright smile, which is exactly what our oral surgeon can help you with. Whether you need teeth replaced, broken teeth fixed, sick teeth extracted, jaw grafts, and many more, we can help you get the smile you’ve been waiting for. Just don’t expect us to give you vampire canines.

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