When upper back teeth are removed, their roots sometimes sit very close to the maxillary sinus. If the thin bone or sinus membrane is accidentally perforated during extraction, it can create a small opening between the mouth and sinus. This is called a sinus perforation or oroantral communication.

Small perforations are usually harmless and close on their own. Larger ones, however, can cause discomfort, infection, or sinus complications if not treated properly.

How Common Is Sinus Perforation After Tooth Extraction?

Sinus perforation is uncommon, but it can occur when upper molars or premolars are removed due to their proximity to the sinus cavity.

It’s more likely to occur when:

• Tooth roots are very close to the sinus floor.
• The bone separating the tooth and sinus is thin.
• The extraction is complex or requires significant force.
• There’s pre-existing sinus inflammation or bone loss.

With careful technique and planning, most cases can be avoided or treated successfully.

Symptoms of Sinus Perforation After Tooth Extraction

A small perforation might go unnoticed at first, but certain signs suggest that the sinus has been affected.

Common symptoms include:

• Air or whistling sound passing between nose and mouth when breathing
• Fluid leaking from mouth to nose while drinking
• One-sided nasal congestion or sinus pressure
• Persistent bleeding or bad taste
• Pain or tenderness in the cheek area
• Postnasal drip or a runny nose that starts after the extraction
• Sinus infection symptoms such as fever, swelling, or thick nasal discharge

If you notice any of these after an upper tooth extraction, contact your dentist right away.

How It’s Diagnosed

If you had a tooth extracted at Argyle Family Dental, Dr. Khodakhast will carefully examine the area to determine whether a sinus perforation has occurred. She may:

• Visually inspect the extraction site for any signs of an opening
• Gently test for airflow between the nose and mouth
• Use 3D imaging (CBCT scan) to assess the size and exact location of the perforation

These steps help her determine whether the opening can heal on its own or requires additional treatment.

Treatment and Healing

Small openings that are less than 2 millimeters often heal on their own within a few weeks. A collagen plug or membrane may be used to help the tissue close. You may be prescribed antibiotics or nasal decongestants to prevent infection.

For moderate or larger openings, sutures or minor surgery may be needed. In more severe cases, a soft tissue flap can be used to seal the sinus completely. Most patients heal within two to four weeks, but larger or infected perforations may take longer.

Why Choosing an Experienced Dentist Matters

Sinus perforations are uncommon, but when upper molars are close to the sinus cavity, precision and experience make all the difference. 

Dr. Khodakhast combines advanced training with years of clinical experience to perform extractions safely and comfortably. She uses 3D imaging to plan each procedure in detail, protecting nearby structures and minimizing complications. 

Supporting Healthy Smiles in Centennial

If you suspect a sinus perforation or have unusual symptoms after a tooth extraction, prompt follow up care is important. 

To book an appointment at our dental office in Centennial, CO, call (303) 770-2254 or request an appointment online.

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