A new report published in the British Medical Journal reveals that the "tooth fairy" has been up to no good, and instead of collecting teeth and leaving money beneath pillows the tiny nocturnal nymph has been accused of lodging a tooth into the left ear of an 8-year-old schoolboy.

According to the report, further investigation of the boy's claims against the "tooth fairy" was right. The boy had been taken to an allergy specialist for profuse mucopurulent rhinorrhoea, a medical term to describe his chronically runny nose. Doctors wrote that X-ray scans revealed that his sinuses were severely inflamed and that a "calcified foreign body" or tooth appeared to have been inserted in his ear canal.

According to the boy's parents, three years before the unusual discovery, the boy had lost his tooth and left it underneath his pillow for the "tooth fairy" to come collect. However, during the night he had woken up from sleep, extremely distressed because "the tooth fairy had put a tooth in his left ear".

Thinking that their son just had a nightmare, the parents reassured him and dismissed the boy's fears. But mystery remained, because no one could find the boy's missing tooth.

The boy continued to complain and suffer a chronic runny nose before his parents took him to the allergist who then discovered the problem.

"Repeat auroscopy by the allergist confirmed the presence of a deciduous tooth in the auditory canal," researchers wrote in the report. "The tooth was removed by an ENT surgeon under microscopic vision, and the patient decided to keep the tooth for posterity rather than taking the risk of attempting a further pecuniary reward."

The latest case wasn't the first time the tooth fairy felt like playing mischief. Apparently, the tooth fairy inserted missing teeth into the windpipes of two other children. According to the report, the two children had kept their lost teeth under the pillow, but the missing teeth later ended up in their oesophagus, causing tracheal obstruction in a trauma situation.

In another case involving an adult, a father ended up needing treatment for a nasty nipple abscess after he put his child's tooth through his pierced nipple so that it would be "near his heart".

The researchers do not have clear recommendation on how to avoid such complications, but they suggest that medical professions have a "high index of suspicion with tooth related presenting complaints."

"As far as we are aware there is no revalidation procedure for the tooth fairy and no clear guidance or standard operating procedures in place to ensure outcomes are avoided," they added.

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