Anthropology of dental suffering: A theoretical approach to pain, trauma, fear, and shame Antropología del sufrimiento dental: una aproximación teórica al dolor, trauma, miedo y vergüenza

Abstract

This article examines the epistemological crisis within dentistry in Ecuador, where the hegemonic biomedical model has systematically overlooked the cultural dimensions of oral suffering. Pain, trauma, and shame emerge as complex phenomena that extend beyond biological aspects. The article analyzes how gender, class, and ethnicity shape these experiences: hegemonic masculinities normalize silence in the face of pain, poverty stigmatizes oral conditions as “personal failure,” and Indigenous cosmovisions offer alternative interpretations of suffering. Dental trauma, transmitted intergenerationally as bodily memory, is exacerbated by authoritarian clinical practices and the imposition of Eurocentric aesthetic standards that transform the smile into a form of exclusive social capital.

Drawing on narrative bioethics, we propose decolonizing dental practice through intercultural tools: life histories in diagnosis, non-violent clinical language, the creation of rituals for fear management, and curricular reforms that include community rotations. These transformations face structural barriers, such as institutional resistance and the neoliberal commodification of oral health.

We conclude that humanizing dentistry requires more than cultural sensitivity: it demands recognizing oral suffering as an expression of structural inequalities and advancing toward a genuinely intercultural practice that restores the dignity of historically marginalized patients.