The word "hiālp" and the hole at the top make the object similar to other protective amulets such as that of Kvinneby (Öl SAS1989;43).
Together with these inscriptions, the Ribe Skull fragment seems to have been part of a common North Sea belief that dwarfs could cause illnesses and that protective amulets could be worn to fend these off.
It has been pointed that there is a general lack of wear in the hole of the type that would be expected if it had been worn using a chord as a protective amulet.
However, most scholars have read it as a u and Nordström (2021) found that the twig again crossed the main stave too high up to be read as an n. Furthermore, the interpretation auk dværg unninn is linguistically highly unlikely, since the nominative subject dværg[ʀ] lacks the palatal ʀ, which was obligatory by 700 and present on the other nominative masculine nouns (Ulfʀ and Tīwʀ).
Furthermore, the interpretation offered by Nordström viðʀ þæim dværgi auk dværgyniu is also more plausible since it represents an alliterating masculine-feminine pair like æsir ok ásynjur.