Ritual tooth ablation: Why did prehistoric people pull perfectly healthy teeth?

The Jomon culture in the Japanese Archipelago, dating from 13,000 to 2300 years BP, practiced this ritual extensively for ceremonial purposes and during rites of passage. This article highlights the commonalities and differences of ritual ablation practices between the Shandong-Jiangsu, Nukdo, Korea and Jomon-Japan populations — was there a corridor and zone of migration and cultural diffusion during roughly the same time periods?

According to M. Takenaka et al., 2001, “Tooth removal during ritual tooth ablation in the Jomon period”  ritual tooth ablation was practised from the Jomon through the protohistoric Kofun periods, but was most actively practised between the Late to Final Jomon periods. The study also confirmed above findings that ritual ablation was performed on teeth for visible effects, as incisors, canines, premolars were chosen (all visible teeth).

The same dental study also determined that the practice of tooth ablation was rather painful as it used not extractive methods (e.g. by means of a cord or forceps to remove the tooth), but the traumatic method (by strong force in a single blow) to remove teeth which sometimes resulted in incomplete removal of teeth leaving residual broken roots in about 10.2% of cases examined (5 out of 49 samples). OUCH!

According to FUNAHASHI Kyoko, her observations of tooth ablation through the ages was as follows:

1) In the Final Jomon period, the extraction of upper and lower canines and lower incisors were carried out when the recipients were between 13 and 20 years of age, and the percentages were 80-90%.
2) In the early Yayoi period, the extraction of upper and lower canines and lower incisors was carried out, at percentages of between 80-90%.
3) From the end of the Early Yayoi period, the extraction of upper and lower incisors, canines and premolars were carried out when the recipients were at adult and mature ages, and the percentage was low.

Anthropologists from the University of Nevada who studied Jomon tooth ablation samples detected five types of systems of tooth ablation, mostly based on kinship,  and the following extract contains their reasoning that the tooth ablation was practised because the altered appearance would be crucial for the Jomon person’s identity as well as indicating his or her status within the Jomon community:

The body is a physical symbol of membership in a social community, conveying social information in a permanent manner. It is shaped by and contributes to social rapport (Meskell, 1998). Changes in social environment can affect patterns of body modification, in this case dental ablation (Torres-Rouff, 2009). As the mouth is a primary social organ, teeth are one of the most visible parts of the body that are culturally treated through some form of cultural modification (filing, chipping, insets, ablation, etc.) to construct identity in relation to broader social and political networks (White et al., 2009).

Personal identity is a dynamic, multi-component concept that includes self-defined expressions of ethnicity, gender, sexuality, kinship, politics, religion, and age (Buikstra and Scott, 2009). The self-referential nature of the various parts of identity is limited by archaeological possibilities (Barth, 1969); hence,the body is needed to create a better understanding of how earlier peoples’ self identified social status within a community. Identity research is not a construction of who people were or where they came from, but represents an attempt to define who they thought they were  (Knudson and Stojanowski, 2009:5). It relates to the larger social phenomena that characterize an individual’s existence in society. Identity is a form of habitus   (Bourdieu 1977), indoctrinated into an individual’s sense of self by their culture.

For the Jomon, life milestones were commemorated by the extraction of different tooth classes. The removal of particular teeth immediately marked your place in society. The various examples (Figs. 1, 2,3, 4, 5, & 6) display individuals at different places/ranks within society. With a flash of a smile, one would know the individual’s family, if they were an adult or not, if they were married, if they had experienced the death of a loved one,or if they had children. There was no need to ask as your body openly displayed your identity.

All the common types of ablation noted by other scholars (Harunari. 1979; Kusaka et al., 2008; Kusaka et al., 2009; Temple et al., 2011) were observed in this sample.

Previously unnoted forms of ablation involved the extraction of the upper premolars (Type 4I4C2P in Figs. 6 & 6A) and upper and lowerpremolars Type 4C4P in Figs. 5 & 5A) for an unknown rite of passage. We do not attempt to attribute specific ablation patterns to particular life events, but scholars noted that ablation types vary between males and females, as well as between the young and the old, suggesting various levels of identity within the community.

It was considered that tooth ablation was carried out to shape the individual’s visage. Considering the human face is one of the most interactive parts of the body, not just a smile told of your place in society, but talking, laughing or even arresting open mouth, would indicate a person’s current identity or a change in social position within the Jomon community. Thus, dental ablation was an important part of Jomonese identity at the Yoshigo Shell Mound site.”

In the anthropology blogpost “Bones, Teeth and Climate Change in Japan“, whether tooth ablation was practised to indicate immigrant status was looked at. The relevant interesting passages are extracted from the post below:

“A new study by Kusaka et al (2012) seeks to address similar types of changes by looking at migration during a period of population increase in Japan due to improving weather conditions.

The study aims to test two hypotheses: first, that there was an increase in immigrants to Japan from the middle to late Jomon period (5000-4000 BP to 4000-2300 BP), and second that ritual tooth ablation is a feature that can be used to distinguish immigrants from locals. Analysis of climate in this region has revealed a warming period from 7000-4000 BP, followed by a cooling period from 4000 to 1500 BP. During the warming era there was an increase in large settlements based on archaeology and a focus on marine and faunal resources based on isotope analysis. However, in the cooling period these large settlements were disbanded, and an increase in caries prevalence shows a changing focus on plant resources. It is this period of increased immigration that they wish to examine through ritual tooth ablation patterns and strontium isotope analysis.

Ritual tooth ablation is removal of specific teeth for ceremonial purposes or rites of passage. Analyses of these activities in this period have determined there are a number of types of ablation as suggested by Harunari (1979): 1) individuals with two maxillary incisors removed, representing the coming of age tooth ablation; 2) individuals with additional four mandibular incisors removed, whose burial offerings suggest high prestige; 3) individuals who lacked all canines and who were immigrants married to type 2 individuals; 4) individuals with all canines and four mandibular incisors removed; 5)  individuals with all canines and two mandibular central incisors removed, which characterize people married more than once. Since migration into a group meant a specific type of tooth ablation it should be possible to use this as an indicator of increased immigration.

Strontium isotope analysis revealed that only one individual from the Ota site was an outlier and all individuals from the Tsukumo site were within the same distribution. This means of the entire sample only one individual was identified as a potential immigrant based on isotopic analysis. Based on these results, the authors argue that either people weren’t moving as much as previously thought or they were moving to areas with similar strontium isotope signatures. If populations from the coast remained in these areas or moved only along the coast it would be difficult to determine migration from their strontium ratios. Comparing types of ritual tooth ablation with strontium isotope levels shows that there is no clear correlation between the ritual and migration. The site contained a number of individuals with type 4I tooth ablation, which was proposed by Harunari (1979) to be a sign of an immigrant, however these had the same strontium ratios as the types of ablation thought to be associated with locals.

Based on their analysis, Kusaka et al (2012) argue that there isn’t a correlation between ritual tooth ablation and immigration, and that movement of people in this region during the Jomon period needs to be re-assessed. Previous studies have argued the migration increased throughout Japan, but Kusaka et al (2012) posited that it may be restricted to movement in specific regions and not in the region they studied.”


Finally, some light may be thrown on possible common origins or relationships with continental populations, through the HAN and T. NAKAHASHI study, “A comparative study of ritual tooth ablation in ancient China and Japan” which concluded:

 “In China, as far as it is known at present, ritual tooth ablation
first appeared among the people of the Shandong-North Jiangsu region, at least 6500 years ago, and then became very popular amongst the people of the Dawenkou culture of coastal China. In Japan, on the other hand, this custom was performed extensively among the people of the Late-Final Jomon period. This results in a time lag in their periods of prevalence of about 2000 years. There are also significant differences in the form of tooth ablation in ancient China and Japan. China is represented by the bilateral ablation of the upper lateral incisors (2I2 type), and with the exception of a small group, showed no remarkable temporal change after its inception. Ritual ablation in Japan was more complex and the number of teeth extracted during this custom’s most prevalent period was more numerous than that of China. On the other hand, there exist several points which may suggest some relation between both countries, such as the basic similarities in the age at commencement of ablation, the prevalence of extraction of under incisors from the Late Jomon period in western Japan and the existence of the same type of ablation in the peoples of nearly the same period in China. Especially, as the abrupt increase of extraction of the upper lateral incisors in the people of the Yayoi period, such as Doigahama, who show morphological resemblances with the neolithic people of northern China, may suggest the influence of Chinese tradition.”

Locations of ritual tooth ablation in China and Japan

Locations of ritual tooth ablation in China and Japan Source: Han and  Nakahashi

At the same time another paper reported evidence from the Nukdo site in coastal South Korea which faces Japan, of signs of ritual tooth ablation and given its strategic location, should be studied for possible cross-straits relations between the peoples (source: Fujita and Choi’s report, “Dental Information about Human Skeletal Remains from Nukdo, South Korea from a Period Corresponding to the Yayoi Period in Japan” J. Oral Biosci. (50)4 215-221, 2008

Ritual tooth ablation found in Nukdo site in Korea (compared with other ritual ablation sites in Japan)

Ritual tooth ablation found in Nukdo site in Korea (compared with other ritual ablation sites in Japan) Source: Fujita and Choi, 2008

“Evidence of tooth ablation practices in human skeletal remains of China, as far
as it is known at present, has been found principally on the eastern-southeastern
coastal region of ancient continental China and Taiwan. As shown in Fig. 1 and
Table 1, examples are particularly concentrated in the Neolithic sites of the
Shandong-North Jiangsu region. Archaeologically speaking, the sites where ablation
customs have been reported belong to the Dawenkou culture, Qinliangang culture,
Majiabang culture, Qujialing culture, Impressed Stone Ware culture in South China
and Taiwan’s Prehistoric Culture periods … One of the oldest examples among data uncovered so far in China is from an early Dawenkou Neolithic culture site in Shandong Province, and dates back to 6500 years ago (Table 1). Signs of tooth ablation have also been detected in human skeletal remains from the Tengxian Beixin culture in Shandong which is older than the Dawenkou culture, though the detail of their practice is unknown. It can, therefore, be assumed that tooth ablation originated at least 6500 years ago in the Shandong Province region. Accordingly, data unearthed to date tentatively suggests the possibility that China’s ablation practices started in the region of the Dawenkou-Qinliangang Neolithic cultures, that is, in the Shandong-North Jiangsu region (Fig. 2).
At either the end of the Dawenkou culture or the beginning of the Longshan
culture, approximately 4000 years ago, this custom declined suddenly (Han and Pan,
1981), with almost no example being found in the Zhou or Han period human
remains from the Shandong-North Jiangsu region (for example, 436 skulls without
ritual tooth ablation from Xindian site in Linzi, Shandong province).”

The upshot of all this is that it is a plausible theory that the practice of tooth ablation originated in the proximate area of the eastern-southeastern coastal region of ancient continental China (i.e. present-day Shandong) and spread to southern Korea and Japan, but the exact route of transmission is unknown.  How were the Beixin-Dawenkou cultures related to that of the Jomon (they shared mostly no similarities in pottery forms, although magatama-like shapes appear in the material cultures), it is also possible that an ancestor of the Final Jomon-to-early Yayoi peoples lived side by side with the various Shandong (Beixin-Dawenkou) cultures hence showing the shared culturally diffused practice of ritual tooth ablation.

However, an important differential between the Jomon and the Doigahama arrivals was highlighted by the Nakahashi study — Mandibular incisors were frequently extracted in Jomon skeletons but Doigahama skeletons possessed upper lateral incisor extractions:

“As shown in Figure 7, tooth ablation in the Doigahama people focused mainly
on the canines, especially in the upper jaw, and about 80 % of individuals at Doigahama show evidence of this type of tooth ablation (Nakahashi, 1990). … However, the upper lateral incisors were also frequently (54 %) extracted in the Doigahama people, and this feature distinguishes the Yayoi peoples of Doigahama and Northern Kyushu from the Jomon and native Yayoi people in North-west Kyushu.
Another aspect of tooth ablation which differentiates the Doigahama skeletons from the Jomon and North-west Kyushu native Yayoi peoples is the low frequency of occurrence of extracting the mandibular front teeth. The mandibular incisors are frequently extracted in Jomon skeletons. Overall, the type of ritual tooth ablation at Doigahama and in northern Kyushu is very different from that seen in the Jomon skeletal remains, a finding which parallels the results of morphological analysis mentioned earlier. The type of tooth ablation observed in the Doigahama skeleton may be similar to ancient Chinese. Han and Pan (1981) have reported that ancient Chinese favored ablation of the upper lateral incisors, but rarely the mandibular incisors. Clues to the origin of the ritual tooth ablation observed in the Doigahama Yayoi people may be elucidated through comparison of tooth ablation in ancient China and Japan.”

The Nukdo South Korean remains on the other hand, that corresponded to the Yayoi period of Japan with potteries that were similar to Sugu potteries of northern Kyushu, showed mandibular tooth extractions, but their diet however, indicated from the states of caries, they were a different agricultural culture from the hunter-gatherers of Jomon Japan. The other possibility is that the Jomon populations were not homogenous, and that later Jomon people were of a different identity (originating from an immigrant coastal population in SE China that may or may not have been genetically similar to the Nukdo population which is known to have trading relations with Japan) from those of earlier Jomon populations.

centre of diffusion of tooth ablation

The picture on immigration and origins or diffusion of the cultural practice, gets curiouser, and curiouser.

2020 update:

Earliest examples of tooth ablation are now said to have come from northern Laos (Upper Palaeolithic – 13,740 ± 80BP), Tam Hang site where lateral (I2) incisors were extracted ritually from early adolescent individuals (the author also speculated that the extractions may have conferred dental health benefits). Tam Hang is currently the oldest known case of ablation from mainland South-east Asia, and possibly the oldest, definitive case from the Late Pleistocene eastern Old World.

More recent studies have also turned up more MSEA skeletons with extracted maxillary lateral incisors and canines practices from among Iron Age inhabitants of the inland region of central Thailand at the archaeological sites of Ban Mai Chaimongkol
and Tha Kae (ca. 2650–1450 BP – i.e.  from a period later than either the Chinese or Korean or Jomon or Yayoi ones).

The most common pattern involved the maxillary lateral incisors, followed by maxillary lateral incisors and canines. Other discoveries include 13 unique patterns of deliberate ablation at the Neolithic site of Khok Phanom Di (ca. 4000–3500 BP), located along Thailand’s central coast, where all patterns involved removal of the maxillary or mandibular incisors. The most common pattern of ablation changed over time. The maxillary lateral incisors were most frequently removed in earlier burials, whereas maxillary central and mandibular central and lateral incisors were most frequently affected among later burials.  At  the sites of Phum Snay and Phum Sophy in northwest Cambodia (ca. 2500–1500 BP), Domett et al. (2013) identified 17 patterns of dental modification involving both ablation and abrasion (filing). The most common pattern involved the maxillary lateral incisors, followed by maxillary lateral incisors and canines. Other evidence of missing anterior teeth has been documented at the Neolithic site of Ban Kao in west‐central Thailand. 

We note here that:

1) Of the MSEA remains, only Kohk Phanom Di remains exhibited extraction of mandibular incisors (i.e. the Jomon and Nukdo type). The Kohk Phanom population (ca. 2100–1500 BC) in Thailand was an immigrant sedentary coastal community that relied on hunting, gathering, and fishing, but was part of the region-wide trend of transition to a rice agricultural society that was also seen in Ban Chiang northeastern Thailand. An increase in rich prestige burials for females with high quality ceramic vessels was noted.

2) The geographical and temporal range of the tooth ablation ritual practice is considerably broad.

3) More studies, particularly interdisciplinary studies, need to be made on the distributions of the differing types of tooth ablations comparing the respective local cultures, in order to make connections between the origins of these practices and the populations in East Asia and MSEA. Ancient DNA comparative studies on the different relevant populations, where they can be had, would be useful. 


Above: Group of Houli culture pottery with a grinding slab and handstone from the Exhibition on the Civilization of Eastern Yi-barbarian Neolithic Shandong,  Shandong Provincial Museum (Source: Wikipedia Commons) / Below: Jomon pottery Source: http://hongshanren.com/history

The Houli, Beixin. Dawenkou and Longshan are considered by archaeologists to be an uninterrupted lineage of Neolithic cultures, and the aboriginal inhabitants of Shandong Peninsula.  They are thought to be the “Eastern Y-barbarians” referred to in the historical records. Attributed to them are innovative technologies of stone tool manufacturing, jade working, pottery, metallurgy, textile and wine brewing.  And by the Longshan period, they began to construct walled settlements, these early states took birds as their totems and their leaders Tai Hao, Chi You, Shao Hao, Da Shun became the subjects of heroic epics written about in later times.

beixin culture magatamaThese objects in magatama-shaped forms of the Beixin culture resemble the magatama pendants of the Jomon and Yayoi cultures, were they prototype forms that spread to the Japanese archipelago?

Is it also possible that the lateral incisor extractions of teeth signify a movement of Shandong’s Houli-Beixin’s pre-Dawenkou/Longshan cultures across Southeast Asia, arriving also to Japan during Final to Early Yayoi period? Perhaps, the co-existence of upper laterals and mandibular tooth extraction practices suggest a co-existence of two different populations, and later merging of the two different descendants into the more distinctive populations? A combination of the pottery, magatama-like ornamental style and bird totem characteristic in addition to the tooth ablation (upper incisors) suggest a bundle of characteristics that could suggest a demic diffusion of migrants from Shandong towards Japan.


Data on tooth ritual ablation sites of China

Source and further readings:

FUNAHASHI Kyoko (Kyūshū University) “Ritual tooth ablation and social organization from the Final Jomon to the Yayoi in Northern Kyushu, Japan” – This study investigates the meaning of tooth ablation and its socio-cultural background in the period between the Final Jomon and the Yayoi in Northern Kyushu by examining a) the percentage of those who received tooth ablation among individual age/sex groups, b) attrition, and c) the pre-auricular groove of the ilium.

A Biocultural Perspective on Jomon Dental Ablation: Visage, Identity, and Social Status by Amanda R. Harvey, G. Richard Scott, and Evan Pellegrin

Kusaka, Soichiro, et al., 2009 A strontium isotope analysis on the relationship between ritual tooth:  ablation and migration among the Jomon people in Japan

Bones, teeth and climate change in Japan by Katy Meyers Emergy citing:

– Harunari, H., 1979. Postmarital modes of residence of the Final Jomon period. J. Facul. Low Litera. Okayama Univ. 4,; and

– Soichiro Kusaka, Takanori Nakano, Wataru Morita, & Masato Nakatsukasa (2012). Strontium isotope analysis to reveal migration in relation to climate change and ritual tooth ablation of Jomon skeletal remains from western Japan Journal of Anthropological Archaeology DOI: 10.1016/j.jaa.2012.05.004

M. Takenaka et al., “Tooth removal during ritual tooth ablation in the Jomon period

Funahashi, K and Tanaka, Y (2001) ‘A study of the social meanings of lower tooth ablation in Yayoi period’ in Basic Structure of Human Societies, Graduate School of Social and Cultural Studies of Kyushu university (ed), Study of the History of Exchange between the Kyushu island and the Korean Peninsula, Fukuoka: Midori insatsu

Funahashi, K (2003) ‘The age of tooth ablation and its ritual meanings in Jomon period’, Archaeological Research (50)1, 56-76

Funahashi Kyoko., 2000. Social meaning of a ritual tooth ablation in Doigahama group. Kobunkadanso, 25:pp43-71

Funahashi, K and Tanaka, Y (2001) ‘A study of the social meanings of lower tooth ablation in Yayoi period’ in Basic Structure of Human Societies, Graduate School of Social and Cultural Studies of Kyushu university (ed), Study of the History of Exchange between the Kyushu island and the Korean Peninsula, Fukuoka: Midori insatsu

HAN KANGXIN and Takahiro NAKAHASHI, A comparative study of ritual tooth ablation in ancient China and Japan, Anthropol. Sci. 104(1), 43-64, 1996

Takahiro Nakahashi, Transition from the Jomon to the Yayoi period
in the Northern Kyushu and Yamaguchi region as viewed from ritual tooth ablation and skeletal morphology

M. Takenaka et al., 2001 Tooth removal during ritual tooth ablation in the Jomon period Bulletin of the Indo-Pacific Prehistory Association 21:49-52

Himiko and Japan’s Elusive Chiefdom of Yamatai” by Jonathan Edward Kidder:  Tooth ablation was a dying practice during the Kofun period.

Willman, John, Incisor Ablation Among the Late Upper Paleolithic People of Tam Hang (Northern Laos): Social Identity, Mortuary Practice, and Oral Health,  American Journal of Physical Anthropology · April 2016 pdf

Bentley R. A. et al., 2007, Shifting Gender Relations at Khok Phanom Di, Thailand: Isotopic Evidence from the Skeletons Current Anthropology Vol. 48, No. 2 (April 2007), pp. 301-314

Pietrusewsky M, Lauer A, Tsang C-h, Li K-t, Douglas MT. 2016. Tooth ablation in early Neolithic skeletons from Taiwan. In Burnett SE, Irish JD, editors. A World View of(Bio)Culturally Modified Teeth: Past and Present.

This study reports “an unusually high frequency of tooth ablation in some of the earliest Neolithic (ca. 5000 BP) skeletons from the Nankuanli East (NKLE) site in southwestern Taiwan. The patterns of ablation and teeth missing in 15 adult male and 8 adult females from the NKLE site are compared. With one exception, the most common pattern of tooth ablation in the NKLE skeletons, male and female, was the symmetrical removal of the maxillary lateral incisors and canines. In contrast to these findings, we further report no tooth ablation among the Iron Age skeletons from the Shihsanhang (SSH) site in northwest Taiwan. The significance of the almost ubiquitous occurrence of tooth ablation among the earliest Neolithic skeletons from Taiwan, including the manner of tooth removal, …”


Gina Palefsky, Tooth ablation in Iron Age central Thailand: Evidence from the archaeological sites of Ban Mai Chaimongkol and Tha Kae International Journal of Osteoarchaeology 17 May 2019 https://doi.org/10.1002/oa.2766

Beixin culture

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