A Tooth for a Tooth: Not So Easy for Cohanim

There is a clear history of false teeth and an emphasis of

dental aesthetics throughout Jewish literature. In Judaism,
teeth are viewed as an essential part of the body, just as
important as an eye. The pasuk (Exodus 21:23-24) states if
there is a fatality, you shall give a life for a life; an eye for
an eye, a tooth for a tooth, where the phrase a tooth for
a tooth is parallel to an eye for an eye [1]. Teeth were
even viewed as essential for maintaining the health of the
entire body [2]. Cohanim, Jewish priests, have an even
greater imperative to maintain their oral health. If a Cohen
lost a tooth, it was considered a mum, one of the defects
making a Cohen unsuitable to serve in the Temple [3].
There are many other medical restrictions regarding the
issue of tumah, or impurity, involving Cohanim. These
restrictions are due to the prohibition for a Cohen to come
into contact with a dead body. Ironically, a Cohens
obligation to refrain from coming into close proximity with
a dead body may prevent him from using dental implants
as a means to maintain his teeths aesthetics.
Today, most dental implants include cadaver
grafts. This poses an array of issues concerning Cohanim
coming into contact with such materials and could even
prohibit a Cohen from entering a dentists office. One of
the most common dental procedures is tooth extraction,
which is accompanied by tissue scaffolding. Tissue
scaffolding is a bone grafting procedure where a graft is
placed on an area, post-extraction, for stabilization of
surrounding teeth [4].
There are various kinds of scaffolds: (a)
autogenous grafts - living tissue from another area of the
patients body, (b) allografts - a graft of cadaver bone, and
(c) xenografts - tissue from animals, including synthetic
grafts. Most of these grafts, excluding allografts, may cause
harmful host responses, including various immune system
defense mechanisms upon grafting of foreign matter into a
host body. According to halacha, xenografts are most
preferable due to their safer healing period and absence of
impurity issues involving cadavers. However, multiple
advantages have been found using allografts including a
less drastic host response, better bone remodeling, and a
greater penetration of fibroblasts and osteoblasts for bone
renewal [4].
Besides for the issues of tumah (such as being in
the same building, carrying/lifting, and direct physical
contact with a dead body) there are additional halachik
issues that arise regarding the use of allografts. Specifically,
there is a prohibition of nivul hameit, which requires a
Jewish body to be buried intact. The source for this
prohibition is Deuteronomy (21:22-23) which forbids
leaving a body that was executed and hanged to remain
hanging overnight. The Talmud (Sanhedrin 46a-b) adds that
not burying individual body parts would also violate this
prohibition [4]. The main question behind these issues that
DERECH HATEVAH

By Tamar
Shiller

we need to address is whether or not allografts attain the

status of a dead body in the eyes of halacha.
There are several ways to address the posed
halachik barriers. Rabbi Unterman, Ashkenazic Chief Rabbi
of Israel from 1964-73, states that the transplanted organ is
considered to come back to life after transplantation, and
therefore would no longer have the status of dead. This
would allow for parts of a cadaver to be used especially
when benefitting a life, and would not halachikally be
considered desecration of a dead body. The transplanted
area will also eventually be buried with the transplant
recipient when he or she dies, resolving the issue of kevurat
hameit [4].
Regarding tumah and Cohanim, there are areas of
leniency considering the size and source of the bone. While
benefitting from the dead is a debate, benefitting from a
Gentile corpse is only a Rabbinic prohibition (based on
Talmud Yerushalmi, Shabbat 10:6) and may thus allow for
leniency in a case where it is used to benefit the life of
another. Furthermore, most of the bones in bone banks
originated from non-Jews simply because there are fewer
Jews in the world, and thus one can reasonably assume that
the bone graft originated from a non-Jewish corpse.
Halachik consideration of these multiple factors would
allow more leniency for bone graft use on a Cohen [4].
The measurement used to determine an impure
status of an object in the Talmud is the size of a piece of
barley. If the bone size is less than a piece of barley, which
is true for the amounts used in most dental grafts, then it
would not transmit any tumah. When the graft materials
originate from multiple corpses and bone is pulverized, it
does not convey tumah according to the Brisker Rav, Rabbi
Yitzchak Zev Halevi Soloveitchik (Chiddushei HaGriz Vol.5
Nazir 52a). The graft would not transmit tumah because the
ground individual pieces are much smaller than a grain of
barley and the bone is coming from multiple sources.
Additionally, when the bone is dry as flour, it is considered
by the Talmud (Niddah 56a) basar min hameit sheyavesh and
is thus considered tahor (ritually pure) and can be used for a
Cohen [4].
All allografts are treated with multiple solvents and
acids for sterilization to produce a healthy host response
upon transplantation. This changes the form of the bone
and transforms the grafts essence and is therefore not
considered to transmit tumah. Additionally, the pulverized
pieces are not reassembled into their original structure and
the graft now has a changed status, making it tahor and
acceptable to be used on a Cohen [4].
While there is a great amount of debate
concerning this issue among Poskim, many make the case
based on the above arguments that the materials used in
allografts do not have the status of transmitting tumah.
Included in this is the halachik rulings of Rabbi J. David
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Bleich, Rabbi Moshe D. Tendler, and Rav Asher Weiss

(among others). Rabbi Dovid Feinstein and Rav Yisroel
Belsky say that it is permissible for a Cohen patient, but a
Cohen dentist must take certain precautions. The specific
conditions of their pesak can be read in the article by Rabbi
Dr. David J. Katz [4]. Practically, this relieves the issues of
tumah/tahara regarding a Cohen acting as a dental
practitioner, entering the office of a dentist, or receiving an
allograft treatment [4].

Acknowledgements
I would like to thank my parents for their constant support
throughout my education. I would also like to thank Dr.
Babich who inspired me to write this article and helped me
with sources throughout the writing process. I would also
like to thank Rabbi Binyamin Blau and Rabbi Benjamin
Shiller for helping me review the halachik content as well as
providing insightful feedback.

References
[1] Rosner, F. (1994). Dentistry in the Bible, Talmud, and
Writings of Moses Maimonides. Bull. Hist. Dent.
42:109-112.
[2] Davidson, M. (1983). Ancient References to Dentistry
and Biblical Bites. Bull. Hist. Dent. 31:30-31.
50

[3] Stern, N. (1996). Prosthodontics-from Craft to

Science. J. Hist. Dent. 44:73-76.
[4] Katz, D. (2011). Halachik Considerations in the Use
of Biologic Scaffolding Materials. Bone Grafts. J.
Halacha Contemp. Soc. 63:55-82.
DERECH HATEVAH