Cultural signifi cance of primary teeth for caregivers in Northeast Brazil O signifi cado cultural dos dentes decíduos para cuidadoras no Nordeste do Brasil

This anthropological study critically evaluates Brazilian caregivers’ symbolic production and significance of their malnourished offspring’s primary teeth, as well as their own, and describes popular dental practices. From January to June 2004, ethnographic interviews of 27 poor, lowliteracy mothers were conducted at a public Malnutrition Treatment Center in Fortaleza, Ceará State. Participant observation of clinical pathways and home environments supplemented the data. Content analysis was performed. Results confirm that primary teeth are imbued with cultural significance in Northeast Brazil. Mothers examine mouths, perceive signs of decay, associate primary with permanent tooth healthiness, identify ethnodental illnesses, seek assistance, and perform rituals with exfoliated teeth. The mother’s motivation to care for primary teeth is sparked by her memories of past toothache and attempts to avoid stigma and discrimination. Social determinants, not mothers’ beliefs or behaviors, are the most critical obstacles to effective dental care. Legitimizing lay knowledge and empowering caregivers and children can improve oral health in Northeast Brazil. Deciduous Tooth; Maternal Behavior; Cultural Anthropology Cultural signifi cance of primary teeth for caregivers in Northeast Brazil O signifi cado cultural dos dentes decíduos para cuidadoras no Nordeste do Brasil Cad. Saúde Pública, Rio de Janeiro, 24(4):800-808, abr, 2008 800 ARTIGO ARTICLE