A 38-year-old man presented to the otolaryngology clinic with difficulty in breathing through his right nostril, which he said had been ongoing for several years. He reported no history of facial trauma or craniofacial abnormalities. Physical examination of the nose showed a septal deviation, calcified septal spurs, and a 2-cm perforation in the posterior septum. On rhinoscopy, a hard, nontender, white mass was observed in the floor of the right nostril (Panel A). Computed tomography of the paranasal sinuses showed a well-defined, radiodense mass consistent with an inverted ectopic tooth in the nasal cavity (Panel B, arrow), which was thought to explain the obstructive symptoms and septal perforation. The tooth was removed during oral and otolaryngologic surgery by means of an intranasal approach and measured 14 mm in length. There were no postoperative complications. At follow-up 3 months after surgery, the patient’s symptoms of nasal obstruction had resolved.