Tumor Full of 232 'Toothlets': What's an Odontoma?

A woman smiles, revealing her teeth.
(Image credit: kurhan/Shutterstock.com)

A team of oral surgeons reportedly removed 232 teeth from the mouth of a 17-year-old boy in India on July 21. The boy was diagnosed with a condition called complex composite odontoma, a rare type of tumor that affects the jaw or gums, his doctors said.

Ashik Gavai was admitted to JJ Hospital in Mumbai with swelling in his right jaw, Dr. Sunanda Dhiware, head of the hospital's dental department, told BBC News.  

The boy had been experiencing discomfort from the swelling for 18 months, Dhiware said. His father, Suresh Gavai, told the Mumbai Mirror that his son began complaining of severe pain a month ago.

In people with complex composite odontoma, a tumor grows in the jaw and contains tooth-like structures, as well as blobs of enamel and dentin, the tissues that make up teeth.

"Once we opened [the tumor], little pearl-like teeth started coming out, one-by-one," Dhiware told the BBC. "Initially, we were collecting them, they were really like small white pearls. But then we started to get tired. We counted 232 teeth."

However, these pearl-like objects, aren't really teeth in the truest sense of the word, according to Dr. J. David Johnson an associate professor at the University of Tennessee Graduate School of Medicine and spokesperson for the American Dental Association. [16 Oddest Medical Cases]

"Some people call them 'denticals' or 'toothlets.' They're not really true teeth because, if they were to erupt, there would be no periodontal ligament or root structure, and they're always deformed," Johnson said.

Although these malformed teeth don't typically cause symptoms, he said they can lead to problems and do need to be removed, he told Live Science.

In the case of Ashik Gavai, the toothlets did seem to be causing some trouble, however.

"If they're growing into an area where there are nerves, that can generate some pain. Sometimes infections will form in association with them, and that can generate pain as well," Johnson said.

Odontomas are the most common type of odontogenic tumors, comprising about 22 percent of all of this kind of tumor diagnosed by dentists and oral surgeons. Although it isn’t clear exactly why these growths form, trauma, infection and possibly growth pressure may be responsible, Johnson said.

After the teeth are removed surgically, the tumor isn’t likely to return, he said. And for Gavai, now that the tumor is gone, the 28 teeth that remain in his mouth will likely be healthier.

"Typically we recommend the removal of the odontoma so it doesn’t affect the health of the adjacent teeth or interfere with the eruption of the other normal teeth," Johnson said.

Although Johnson said he has personally never seen an odontoma as large as the one described in this particular case, he did not express doubt that such a massive tumor could form. He said that, like Gavai, most of the patients he sees with odontomas are teenagers, with the average age for the condition being 14. Males are slightly more likely to develop these growths than females, he said.

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Elizabeth Peterson

Elizabeth is a former Live Science associate editor and current director of audience development at the Chamber of Commerce. She graduated with a bachelor of arts degree from George Washington University. Elizabeth has traveled throughout the Americas, studying political systems and indigenous cultures and teaching English to students of all ages.