Tooth modification was done in Asia and Africa for cultural, religious and identification reason. Tooth blackening (Ohaguro) in Japan was a symbol of maturity and beauty. they also believed tooth blackening prevent from tooth decay. In Bangladesh, India, Vietnam tooth was darken by betel nut. Betel nut is more like a tobacco which leaves stained on the tooth. A betel chew is made up of several ingredients: betel leaf, slivers of areca palm nut and a bit of lime paste. The pieces of nut covered with lime paste are wrapped in a leaf of the betel pepper vine. In Africa nowadays they pull out maxillary four incisors (both central and lateral) for fashion in Cape Town. Years ago they would grind their teeth giving them a “v” shape; which was very painful. It was done for many reasons; one is to child should show no pain when entering to adulthood. Some did it for tribe identification and some sacrifice for religion.