Unusual Case of Ectopic Tooth in Teen

It’s a strange situation, to say the least.

While it’s not unheard of for teeth to develop outside the mouth—known as ectopic teeth—a 16-year-old boy in India has presented a particularly rare case. Doctors are calling it a first in medical history.

Typically, medical literature has documented several instances of extra teeth appearing in places like the nasal cavity or under the eyes. However, this teenager had what is referred to as the “first and only ectopic tooth reported in the superior orbit,” which is essentially the upper eye socket, as noted by Dr. Meghana Tanwar, co-author of the case study.

The boy initially noticed painless swelling on his left upper eyelid, which persisted for a few months. Eventually, he observed two sharp, white protrusions making their way into the area between his eyelid and eyebrow.

Initially, doctors suspected these projections were a teratoma, a rare tumor that can contain different types of tissues including teeth and bones. However, a CT scan revealed they were actually a mature canine tooth.

Surgeons successfully removed the tooth from the eyelid, and since imaging indicated no additional teeth were present, Dr. Tanwar expressed it’s unlikely the patient has any other ectopic teeth.

While ectopic teeth may not be common, they do happen. Around 2% to 6% of people can experience their first permanent molars growing out of alignment within their dental rows.

This case is particularly unusual as it involves a tooth that was entirely outside the dental arch, which is considered an extremely rare phenomenon.

“This was a first not just for us, but the world over,” Tanwar remarked, expressing surprise at the discovery.

In a prior case, Tanwar encountered a tooth located at the bottom of an eye socket. That incident was related to a benign growth consisting of normal tooth-forming tissue, called an odontogenic choristoma.

The underlying cause of the tooth in the teen’s upper eye socket remains unclear to the medical team.

Failing to remove an ectopic tooth could lead to permanent damage to nearby teeth or potential issues such as cyst formation, as well as sinus or nasal complications, depending on the tooth’s exact placement.

Some studies indicate that genetic factors, physical trauma, infections, or developmental disorders could contribute to the occurrence of ectopic teeth.

A different, notable case involved a man experiencing breathing issues due to a half-inch tooth growing in his right nostril, which was recorded in a New England Journal of Medicine case study.

This 38-year-old patient had been dealing with breathing difficulties for years. Medical examinations revealed not only a deviated septum but also bone-like growths in his nasal passage, which were eventually removed through invasive surgery.

Similarly, in 2019, another man discovered that the reason he had lost his sense of smell was due to a tooth lodged in his nostril.