Supernumerary teeth occur in a wide variety of sites, including the palate, mandibular condyle, coronoid process, orbit, maxillary antrum, and nasal cavity. Supernumerary teeth manifest in different ways depending on the site. Reported symptoms and signs associated with supernumerary teeth in the nasal cavity (nasal teeth) include facial pain, external nasal deformities, foul-smelling rhinorrhea, recurrent epistaxis, and oronasal fistula. Very rarely, septal perforation has been reported. We present a case in which eruption of a tooth into the nasal cavity was associated with nasal septal perforation. The tooth was extracted endoscopically.