Intranasal ectopic eruption is an uncommon condition. Even if an intranasal tooth can be completely asymptomatic, sometimes a variety of nasal signs and symptoms may be associated, ranging from mild nasal congestion to recurrent epistaxis and purulent rhinorrhea. As a consequence, surgical removal is often required. Endoscopic extraction of the intranasal tooth has been reported to present several advantages with respect to traditional surgical approaches and thus recommended as routine treatment in such cases. However, when a tooth is impacted next to the nasal floor, an alternative approach could be needed. We suggest an alternative transoral approach to perform extraction of intranasal teeth, aimed at avoiding excessive bone removal to reach the nasal floor area and preventing the complications related to traditional intraoral buccal or palatal approach. It could represent a reliable alternative to traditional removal in the Oral Surgery Department.