Indian Journal of Dental Research

SHORT COMMUNICATION
Year
: 2011  |  Volume : 22  |  Issue : 4  |  Page : 606--607

Incisor tooth in the nose: Anecdotal sequel to dog bite in a 3-year-old child


Sanjeev K Uppal, Ashish Gupta, Rita Rai, Nupur Nippun 
 Department of Plastic Surgery and Burns, Dayanand Medical College and Hospital, Ludhiana, India

Correspondence Address:
Ashish Gupta
Department of Plastic Surgery and Burns, Dayanand Medical College and Hospital, Ludhiana
India

Abstract

A 3-year-old male child presented to the casualty with history of unprovoked dog bite over the right lateral wall of nose. He was managed conservatively with antirabies prophylaxis and dressings. He presented after 3 months with a healed wound and the right upper central incisor projecting into the nostril. The Orthopantomogram showed a rotated temporary incisor with the roots of the permanent incisor placed normally. The tooth was extracted intranasally. Among the mutilating dog bite injuries referred to a plastic surgeon, this injury though thought provoking was also comical.



How to cite this article:
Uppal SK, Gupta A, Rai R, Nippun N. Incisor tooth in the nose: Anecdotal sequel to dog bite in a 3-year-old child.Indian J Dent Res 2011;22:606-607


How to cite this URL:
Uppal SK, Gupta A, Rai R, Nippun N. Incisor tooth in the nose: Anecdotal sequel to dog bite in a 3-year-old child. Indian J Dent Res [serial online] 2011 [cited 2019 Oct 19 ];22:606-607
Available from: http://www.ijdr.in/text.asp?2011/22/4/606/90313


Full Text

Dog bites are a major public health problem. [1] Infants and adolescents are the worst afflicted as they are defenseless and gullible. Numerous rare and ghastly canine bite cases have been reported. We present an anecdotal case of a 3-year-old toddler who presented with a malrotated central temporary incisor growing into the right nostril. It is the first reported case to the best of our knowledge among the various rare incidences of dog bite reported.

 Case Report



A 3-year-old male child presented to the casualty with history of canine assault with a lacerated wound over the right nostril. The wound was thoroughly washed with soap and water and then with povidone iodine. Rabies prophylaxis and immunoglobulin were given intralesionally and intramuscularly. The wound was allowed to heal by secondary intension. X-rays of face did not reveal any fractures.

After 3 months of the incidence, the child presented again with the right central incisor projecting into the right nostril [Figure 1]. Intraoral examination showed a missing incisor with normal mucosal cover. Orthopantomogram study revealed a malrotated temporary incisor projecting into the nostril with a normally oriented permanent right central incisor [Figure 2]. The scar of the previous injury was well healed.{Figure 1}{Figure 2}

The abnormal tooth was extracted through the intranasal route and nostril packed with a hemostatic foam [Figure 3].The child had an uneventful convalescence.{Figure 3}

 Discussion



Bite wounds are among the most common trauma to which man is subjected. In urban areas, the main suspects are dogs, cats, and humans. Dog bites have a recognized mortality and there are at least 15 deaths per year in the United States. In the young, the most documented injuries have been to the face, head, and neck areas. In older children and adults, the bites are most commonly on the limbs. Dog bites are frequently complicated with a crush injury as a result of the high masticatory forces that can be delivered by certain breeds. [2]

The annual incidence of dog bites in UK in children aged under 15 years is 22 per 1 000. [3] 94% of dog bites are unprovoked and 67% implicated canines are stray animals.

The rare presentations of canine assault on children have been well documented in Dog bite- fracture of the mandible in a 9 month old infant by Walker et al., [4] Rare case of exostosis following dog bite by J. Srinivasan, [5] and Penetrating brain injuries from a dog bite in an infant by Iannelli and Lupi. [6] Our search of literature for a malrotated incisor growing into the nostril did not yield any results.

The singular nature of this case report lies in the odd presentation of the temporary incisor growing into the nostril and normal orientation of the permanent incisor roots with no apparent maxillary bone fracture at the time of injury.

The case highlights the importance of regular follow-up along with a thorough examination of the facial wounds along with intraoral search for telltale signs of injury.

Man's best friend may statistically be the man's most common fiend!

References

1Hoff GL, Cai J, Kendrick R, Archer R. Emergency department visits and hospitalizations resulting from dog bites, Kansas City, MO, 1998-2002. Mo Med 2005;102:565-8.
2Wolff KD. Management of animal bite injuries of the face: Experience in 94 patients. J Oral Maxillofac Surg 1998;56:838-43.
3Palmer J, Rees M. Dog bites of the face: A fifteen year review. Br J Plast Surg 1983;36:315-8.
4Walker T, Modayil P, Cascarini L, Collyer J. Dog bite-fracture of the mandible in a 9 month old infant: A case report. Cases J 2009;2:44.
5Shariff Z, Giannas J, Srinivasan J. Rare case of exostosis following dog bite: A case report. Internet J Plast Surg 2006;2:2.
6Iannelli A, Lupi G. LupiPenetrating Brain Injuries from a Dog Bite in an Infant. Pediatr Neurosurg 2005;41:41-5.