Vetnews | Mei 2026 42 « BACK TO CONTENTS Patient History & Presentation A two-year-old male Springer Spaniel was referred to the Small Animal Medicine department at the Onderstepoort Veterinary Academic Hospital (OVAH) for a nasal workup. The primary complaint was a chronic, intermittent, unilateral mucopurulent nasal discharge of approximately eight months’ duration. Prior empirical treatment with various antimicrobials and corticosteroids had provided only transient relief before clinical signs recurred. Crucially, history-taking revealed that the patient had been bitten on the face by his dam during puppyhood. Furthermore, the owners had noted that his permanent left maxillary canine (204) had never erupted (Fig. 1). Clinically, the patient appeared otherwise normal, and routine clinicopathological parameters (complete blood count and biochemistry) were within normal limits. As is standard protocol for nasal workups at OVAH, a CT scan of the head was performed. These scans can help with identification of foreign bodies, pathology present as well as guiding the area for biopsy. Diagnostic Imaging The CT scan provided a definitive, albeit highly unusual, diagnosis: the missing permanent canine tooth had erupted ectopically directly into the nasal passage (Fig 2). We hypothesized that the chronic rhinitis was secondary to localized inflammation, caused by nasal obstruction by the ectopically erupted canine tooth. The patient was then referred to the OVAH Dental Clinic for management. Surgical Intervention Surgical extraction was recommended to remove the foreign body from the nose and restore the normal anatomy. Following the induction of general anaesthesia and the administration of regional nerve blocks, a mucosal pedicle flap was raised (Fig 3). A buccal bone window was created using a spherical dental bur at a site corresponding to the anticipated apex of the ectopically erupted canine tooth root. Once adequate exposure was achieved, retrograde extraction was performed via careful elevation and luxation, culminating in removal with extraction forceps (Fig 4). The alveolar bone margins were smoothed, and the surgical site was closed without tension using a simple interrupted pattern (4-0 Monocryl). The patient recovered uneventfully and a complete resolution of clinical signs was achieved when the owner was contacted 2 weeks post operative. The owner returned to their referring vet for the post operative examination and no concerns were noted. Post-Extraction Findings & Discussion Post-extraction evaluation of the tooth confirmed our hypothesis that the tooth acted as a foreign body by blocking the nasal passage. Interestingly there was calculus present on the crown (Fig 5). Notably, the crown itself was misshapen and displayed a hooked morphology. This was most probably a direct sequel of the trauma inflicted on the developing tooth bud during the bite incident. This case highlights an intranasal presentation of ectopic tooth eruption. While impacted canine teeth are occasionally seen in brachycephalic, chondrodysplasia breeds (Lobprise 2019), they are more often managed by extracting the tooth if causing pain, cysts (like dentigerous cysts) or infection (as in this particular dog’s case), facial malformation or pain (Klim, Mestrinho et al. 2023). These teeth can also be managed via techniques such as surgical exposure, in the case of unerupted teeth. In some cases, a process similar to human orthodontics called “exposure and bracketing” is used, where an orthodontic device is bonded to the crown to actively guide eruption, however, reviewing the literature, it does not appear that this is commonly done. A retrospective study on ectopic tooth eruptions found that they mainly occur in the maxilla (69,57%) (Klim, Mestrinho et al. 2023). This study further mentioned that ectopic tooth eruption’s most likely causes can be genetic disturbances or congenital malformations, trauma, local infections, cystic lesions, retained primary teeth, tooth crowding or changes in bone density. The most interesting part of this case is, that the ectopically erupted tooth, in effect became a nasal foreign body, causing obstruction. This case just once again goes to show, that if a tooth is absent, it does not necessarily mean that it is not there, and not causing problems. Thorough imaging, whether it be dental radiographs and/or CT scans, are always a good idea in these cases. v Regulars I Dental Column “Mother Nose Best”: Case Report on an Ectopic Canine Tooth Eruption Secondary to Trauma Drs. Michael Ferreira, Mareli van de Wetering and Prof. Gerhard Steenkamp
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