If you think your teeth are messed up, at least you don’t have one growing in your nose.

According to a report in the July American Journal of Case Reports, a 22-year-old man from Saudi Arabia sought medical attention after experiencing nose bleeds from his left nostril once or twice a month for three years. Sometimes they would be triggered by an act as innocuous as scratching his nose.

As it turned out, there was an actual tooth growing up into his nose. A nasal endoscopy revealed that a white, cylindrical mass of bone about 1 centimeter in length was emerging from the floor of his nose.

A dental consultation determined that the mass was an extra tooth, specifically because he already had a complete set of teeth that were well aligned and in good condition. In fact, he hadn’t had any significant dental problems before his extra tooth developed.

Only between 0.15-3.9% of people develop extra teeth, which can actually form upside down and grow upwards, in this case, into the nose. A third of extra teeth develop upside down, and, though it’s still a very rare condition the patient in the journal had a relatively common variety of extra tooth called a mesiodens. It’s extremely unusual for teeth to breach the nasal cavity like this one did without being detected sooner, however.

“For doctors like myself who have a CT scanner, we would have seen this extremely rare event and taken care of it,” said Dr. Ronald Receveur, a New Albany dentist.

Experts are unsure why certain people develop extra teeth, or how those teeth can get into the nasal cavity, but it’s possible that it has something to do with genetics. Extra teeth are often associated with cleft lips and palates, facial development birth defects that are usually repaired by surgery. It’s possible that correctional surgery for these defects has an impact on how teeth grow later in life.

The man was given a general anesthetic by surgeons at King Fahd Military Medical Complex in Dhahran and the tooth was extracted without incident. The tooth turned out to be the root of most of his health problems, so without it, he’s in excellent shape.