A man’s years of trouble breathing through his nose turned out to have a much stranger explanation than anyone could have imagined. His doctors, in a paper out this week, describe finding a tooth poking through his nasal cavity. Thankfully, the wayward chomper was removed with no complications, and the man’s stuffy symptoms went away.
The study on the nose tooth was published in the New England Journal of Medicine. According to the report, a 38-year-old man had visited an ear, nose, throat clinic at Mount Sinai in New York with complaints of difficulty breathing through his right nostril — a problem that had been going on for several years at that point.
Physical examination revealed a deviated septum (the cartilage in the middle that separates one nostril from the other, which can get displaced for various reasons), along with some kind of bony obstruction and a two-centimeter-long tear towards the back of the septum. When they looked closer using a rhinoscope — basically a camera attached to a tube — they found a “hard, nontender, white mass” sticking out of the floor of the nostril. And when they ran a CT scan, they clearly identified what this mass was: a tooth growing where it shouldn’t have been. You can click here to view moderately unsettling medical images of the tooth.
In anatomical terms, the man had an ectopic tooth, ectopic being a catch-all term for the abnormal placement of a body part. Ectopic teeth can happen for several reasons. Sometimes, our permanent adult teeth can grow out, or erupt, in an unusual path. Other times, the process of replacing our baby teeth doesn’t go quite right and a baby tooth ends up being pushed out by its adult counterpart, but doesn’t fall out as expected and just stays in our mouth, albeit in a very awkward position. Or, an extra tooth could spontaneously appear even in adulthood. The doctors don’t offer an explanation as to how this man’s stray tooth formed, but whatever the cause, genetics are considered a risk factor for the condition.
Ectopic teeth are thought to be rare, occurring in anywhere from 0.1% to 1% of the population. But most of the time, the unusual teeth don’t stray too far from their usual home and aren’t hard to miss. Even rarer is the sort of inverted tooth that ends up hiding in the nasal cavity, as was seen in this case. That said, there have been a few other case reports of nose teeth reported by doctors before.
Ectopic teeth don’t always need to be treated, since some might develop normally following their initial erratic eruption. Depending on their position, they can also be adjusted into their rightful place with braces or other dental procedures. But in this case, the doctors opted for a simple removal through surgery. Once removed, they confirmed its size, 14 millimetres in length, or about a half-inch. And the man’s bizarre story is ripe for sharing at his next holiday party, as it has a happy ending.
“At follow-up 3 months after surgery, the patient’s symptoms of nasal obstruction had resolved,” the authors wrote.