We tested our hypothesis that use of the Parker Flex-Tip tracheal tube could reduce the incidence of nasal mucosal trauma during nasotracheal intubation when compared with a conventional tip tracheal tube. One hundred and two patients, who were scheduled for elective oral surgery in which nasotracheal intubation was indicated to optimise the surgical approach, were recruited into this study. Either a Flex-Tip tracheal tube or a conventional tip tracheal tube was chosen randomly for each nasotracheal intubation. The incidence of epistaxis using the Flex-Tip tracheal tube (6 (11.8%)) was significantly lower than that with the conventional tip tracheal tube (18 (35.3%); p = 0.009). Nasal pain due to intubation, rated on a 100-mm visual analogue scale, was less intense with the Flex-Tip tracheal tube (median, (10th-90th percentile) 19 (12-28) mm compared with the conventional tip tracheal tube (30 (22-35) mm; p < 0.001). The Flex-Tip tracheal tube thus appeared to reduce the incidence of nasal mucosal trauma during nasotracheal intubation and the incidence of post-intubation nasal pain, compared with the conventional tip tracheal tube.