Mumbai: That’s really a mouthful. This teenaged boy could bite, but barely chew thanks to his many, many, many teeth – 232 to be precise. Ashik Gavai, 17, from Buldhana, stunned doctors at Sir J.J. Hospital 10 days ago when he came with an ugly large swelling on the right side of his face. A series of tests and examinations suggested a rare abnormal growth affecting the second molar on the lower right side of his jaw. “Initially, it was not very clear what it could be and so we decided to go in for surgery yesterday (Monday),” said Sunanda Dhivare-Palwankar, head of the hospital’s dental department.
As the surgery progressed, the team of medicos was aghast to see scores and scores of tiny teeth popping out of that abnormal molar, which was measuring around 3.5X2 cm, or the size of a large marble. “At the final count, we had a total of 232 small pearlies, all independently developing as teeth, coming out of that lone molar!” Dhivare-Palwankar said. Besides, there was another hard, rock-like formation inside the affected tooth in Ashik’s mouth which could not be removed by a dentist’s drill.
“We had to resort to the age-old, now outdated, ‘chisel-mallet’ procedure to break down that hard formation as it was putting immense pressures on the jaw bone and surrounding healthy teeth,” she explained. The entire operation took a whopping seven hours and was the first of its kind ever handled by the hospital, as well by Dhivare-Palwankar in her three decades’ practice as a dentist. Dhivare-Palwankar described the condition as a ‘developmental anomaly’, which had affected that particular molar at its formation stage in Ashik’s younger age, probably in the post-milk teeth years.
Medically, it is termed as ‘Complex Composite Odonntom’ or a benign tumour of the tooth, which can cause some difficulties in eating, swallowing, and lead to a grotesque swelling on the victim’s face, though it is not life-threatening, Dhivare-Palwankar assured. After everything was wound up, the team of medicos comprising doctors Vandana Thoravade, Anoop Atakil and Reshma Hanwate checked out global literature and found nothing comparable anywhere in the world.
“We believe this is a world record, but we will carry out more research before taking any further steps in the matter,” she smiled. Ashik Gavai, a Class X student in a school in Buldhana in Vidarbha region of eastern Maharashtra, had noticed and borne the abnormal but painless growth which had swollen his right side in the past few years. “However, as he came from a very poor family, they could not afford the luxury of expensive dental procedures. Since the growth continued unabated, they came to this government hospital,” Dhivare-Palwankar said.
The boy was found eligible for medical expenses under the Maharashtra government’s mega-health insurance scheme for the poor – Rajiv Gandhi Jeevdayi Arogya Yojana (RGJAY) – introduced last year. Gavai’s entire surgery as well as a fortnight’s hospitalization and medical expenses were covered under RGJAY – in a private hospital, it would have cost over Rs.200,000, beyond his family’s meagre means. The medical team found that despite the huge molar tooth growth, the jawbone had thinned but not weakened, and the surgeons straightened out the crushed wisdom teeth that were in the formative stage.
“Now, his face has changed and he will lead an absolutely normal healthy life after ejecting so many teeth,” Dhivare-Palwankar said.