A 16-year-old boy in India had a fully formed canine tooth growing out of his upper eye socket, the first case of its kind doctors say they have ever documented.
The teen noticed a painless swelling in the upper part of his left eyelid for months. He did not seek care until two hard white points began poking through the skin between his lid and eyebrow. A month after those whitish points appeared, he went to the hospital.
The Sun reported that medics at Aravind Eye Hospital in Madurai, India, examined the eyelid and found the spikes were hard with a fairly smooth surface. They considered teeth or a teratoma, a type of growth that can contain tissue such as teeth, and ordered a CT scan.
The scan settled it. A lone, fully formed canine tooth sat in the superior orbit, the upper eye socket.
Dr. Meghana Tanwar, a medical consultant at Aravind Eye Hospital who co-authored the case report, described the finding in plain terms.
"The structure of a lone tooth in the superior orbit [upper eye socket] was quite obvious."
Doctors then performed surgery and removed the ectopic tooth from the eyelid. An ectopic tooth is one that develops or erupts in the wrong place, outside the mouth. They found no teratoma and no additional ectopic teeth.
Tanwar stressed how unusual the location was.
"To the best of our knowledge this is the first and only ectopic tooth reported in the superior orbit."
She added that the case was a first not just for the hospital but worldwide, and that the team was very surprised by it.
Medics could not pin down an underlying cause in this patient. Broader medical background helps explain how such a misfire can happen.
Dr. Saroash Shahid, a reader in dental materials at Queen Mary University, has written on ectopic teeth and the developmental process behind them.
"The face develops from several groups of cells and tissues that move and join together in the womb. Tooth development depends on interactions between some of these tissues. If this process goes awry, a tooth can sometimes develop in an abnormal location, even away from the mouth. A review of ectopic teeth in the upper jaw also lists injuries, dental treatment and growths such as cysts and tumours as possible causes."
A separate review of 61 related ectopic-tooth cases notes that such teeth can go unnoticed for years. They can also cause pain, swelling, headaches, or trouble opening the mouth. In this teen’s case, the main signs were months of painless swelling and then those hard white points breaking through the skin.
The hospital’s work, exam, CT confirmation, and surgical removal, ended the odd eruption. No calendar date for the visit or the operation appears in the available account, and the patient’s name was not released. What is clear is the anatomy: one fully formed canine tooth in the upper left eye socket, removed, with nothing else abnormal found beside it.
Nature still produces cases that stop even seasoned surgeons cold, and good medicine still meets them with a scan, a scalpel, and a straight answer.
