For six months, a 45-year-old man dealt with foul-smelling discharge from his right nostril and nosebleeds that came and went. When doctors looked inside with an endoscope, they saw a hard white mass sitting on the floor of his right nasal cavity, surrounded by calcified deposits.
A CT scan answered the question. The mass was shaped like a tooth, complete with a central pulp cavity, the hollow core that normally holds a tooth's nerves and blood vessels, and it extended from the hard palate up into the nasal cavity. The diagnosis was an intranasal ectopic tooth, a tooth that erupted into the nose instead of the mouth, together with a rhinolith, a stone-like mass that forms when mineral deposits build up in the nose.
Physicians from Tribhuvan University's Institute of Medicine in Kathmandu and from hospitals in Tansen and Butwal, Nepal, reported the case online July 2, 2026, in Radiology Case Reports. It appears in the journal's October issue.
Six Months of One-Sided Discharge and Nosebleeds
His symptoms were the kind that can point in many directions. The authors note that teeth growing in the nose often cause nonspecific complaints, which can delay diagnosis. They are frequently tied to chronic infection, stone formation, and recurring sinus problems, and the man had signs of chronic inflammation, including recurrent sinusitis.
Left in place for a long time, these teeth have been linked to a range of complications, according to the authors, including abscesses of the nasal septum, blocked tear ducts, holes in the septum, abnormal openings between the mouth and nose, and bacterial or fungal sinus infections.
Why his tooth ended up in his nose is unclear. The authors say previous unrecognized trauma is possible, but no definite cause could be established.
A Pulp Cavity on the Scan Settled the Question
A hard mass in the nose can be mistaken for other things. According to a case summary in the Indian Journal of Medical Research, the list of possibilities includes foreign objects, nasal stones, and bony growths.
Two findings settled this case. The CT showed a well-defined, dense structure with the shape of a tooth and a central pulp cavity, and the endoscopic view showed a hard mass that looked like enamel. Together, the authors wrote, those features were diagnostic. They say the case underscores the value of CT imaging in establishing the diagnosis.
Doctors removed the tooth and the surrounding stone through the nostril with endoscopic guidance. His symptoms resolved completely, and he recovered without complications. "Early endoscopic removal is a safe and effective treatment," the authors concluded, adding that it can prevent complications such as chronic infection, stone formation and recurrent sinusitis.
Teeth That Erupt Into the Nose Are Rare but Not Unheard Of
Extra teeth are not unusual in themselves. According to the same journal summary, supernumerary teeth affect 0.1% to 1% of people, and only a small percentage of those cases involve a tooth in the nose. Ectopic teeth have also turned up in the maxillary sinus, the jaw joint and the eye socket.
Case reports keep accumulating. A systematic review of endoscopic removal of teeth in the nose and sinuses, published in 2019, found 27 patient cases across 23 studies. About 70% of patients were male, and their average age was about 27. Nasal obstruction was the most common complaint, affecting 48%, while runny nose, facial pain, and nosebleeds each affected about 22%. At 45, the Nepalese patient was considerably older than the average patient in that review. The reviewers noted that the classic approach was the Caldwell-Luc procedure, which reaches the sinus through the upper jaw from inside the mouth, but endoscopic approaches have become increasingly common. Simple extraction under general anesthesia was the most frequently reported technique.
Earlier this year, the same journal published another case involving a 27-year-old woman in Morocco with one-sided nasal discomfort and foul-smelling discharge caused by an extra tooth in her left nasal cavity. Her surgeons reached the tooth through the mouth, from the space between the upper lip and gums, rather than through the nose. They wrote that this approach remains a safe alternative to endoscopic removal when the tooth's position calls for it.
One-Sided Nasal Symptoms Deserve a Closer Look
The causes of teeth erupting into the nose are not fully understood. Another published case report lists associations with facial trauma, infections, developmental defects, and hereditary factors. Cleft lip and palate have been linked to some cases. A report of two Brazilian cases described teeth found in the nose of a 32-year-old woman and an 8-year-old girl, and the girl had undergone repeated surgeries for a cleft lip and palate.
The Nepalese team says the case shows why ectopic teeth belong on the list of possibilities when nasal symptoms stay on one side and do not go away.
The report describes a single patient, and most one-sided nasal problems have far more common causes. Still, persistent symptoms on one side of the nose, especially foul-smelling discharge or recurring nosebleeds, are worth evaluation by an ear, nose and throat specialist.
Key Questions Answered
What is an intranasal ectopic tooth?
It is a tooth that erupts into the nasal cavity instead of the mouth. It is a rare developmental abnormality that can cause nasal symptoms or go unnoticed.
What is a rhinolith?
A rhinolith is a stone-like mass that forms when mineral salts build up inside the nose. In this case, it surrounded the ectopic tooth.
What symptoms did the man have?
He had six months of foul-smelling discharge from his right nostril and intermittent nosebleeds.
How did doctors confirm the diagnosis?
A CT scan showed a tooth-shaped structure with a central pulp cavity, and endoscopy showed a hard, enamel-like white mass.
How was it treated?
The tooth and stone were removed through the nose with endoscopic guidance, and his symptoms resolved completely.
Should people with one-sided nasal discharge worry about a tooth in the nose?
This cause is rare. Persistent one-sided symptoms, especially foul-smelling discharge or recurring nosebleeds, should still be checked by an ear, nose and throat specialist.
