Sinus tracts (or fistulas) are a common manifestation of pulpal necrosis that requires conventional -or rarely surgical- endodontic treatment in order to heal. They are mainly identified intraorally and in rare cases they manifestate extraorally, depending on the causative tooth, root location, bone thickness and muscle inserts. Such conditions may be misdiagnosed and confused with other non-pulpal pathologies. A case of extra-oral submental sinus tract that was initially misdiagnosed by a physician as a non-odontogenic lesion is presented. Facial fistulas of endodontic origin, despite sparse, should be considered as an option in the differential diagnosis procedure. It is important that interaction occurs between physicians and dentists to avoid exposing patients to insufficient treatment schemes.