What Happens If You Have a Sinus Perforation After Tooth Extraction?

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A sinus perforation after tooth extraction means an opening has formed between your mouth and the sinus cavity. This happens most often with upper molars or premolars due to their close proximity to the maxillary sinuses.

Air may escape through the site, fluids may leak, and sinus pressure can increase.

If this occurs, you need to take steps to protect the area and allow proper healing. Treatment depends on the size of the perforation, but in most cases, it can be repaired without long-term issues.

Table of Contents

• How Does a Sinus Perforation Happen?
• Symptoms of a Sinus Perforation After Tooth Extraction
• What Should You Do if You Suspect a Sinus Perforation?
• How Is a Sinus Perforation Treated?
  • Small Perforations
  • Moderate Perforations
  • Large Perforations
• Can You Still Get Dental Implants After a Sinus Perforation?
• How to Prevent Sinus Perforations
• Seeking Treatment for a Sinus Perforation

How Does a Sinus Perforation Happen?

Several factors can contribute to a sinus perforation:

• Thin bone structure: Some patients naturally have thin bone separating their maxillary teeth from the sinus.
• Large sinus cavity: A low-lying sinus floor increases the risk during tooth extractions.
• Trauma during extraction: Removing a tooth with extensive roots or infection can accidentally create an opening in the sinus membrane.
• Previous dental infections or surgeries: Chronic sinus infections or past dental procedures may weaken the bone and sinus lining.

Symptoms of a Sinus Perforation After Tooth Extraction

If a sinus perforation occurs, you may experience:

• Air escape sensation: Feeling air move between your oral cavity and nasal cavity when you breathe.
• Liquid drainage: Beverages leaking through the perforated sinus into the nasal cavity.
• Nasal congestion or pressure: A feeling of fullness or sinus discomfort.
• Prolonged bleeding: Slow-healing extraction sites with bloody discharge.
• Whistling sound when breathing: Air passing through the perforated sinus membrane.
• Unpleasant taste or bad breath: A sign of sinus perforation if food debris or bacteria enter the sinus cavity.

If you notice any of these symptoms, contact your oral surgeon for evaluation.

What Should You Do if You Suspect a Sinus Perforation?

If you think you have a sinus perforation, follow these steps until you see your dentist or oral surgeon:

1. Avoid blowing your nose: Blowing your nose can worsen the opening by increasing sinus pressure and the risk of complications.
2. Sneeze with your mouth open: This reduces pressure buildup in the maxillary sinuses.
3. Do not use straws: Suction can disrupt the blood clot and slow the healing process.
4. Follow post-op care instructions: Take any prescribed antibiotic therapy to prevent infection and avoid strenuous activity.
5. Contact your oral surgeon: Prompt evaluation ensures the best treatment outcome and reduces the risk of sinus membrane perforation.

How Is a Sinus Perforation Treated?

Treatment depends on the size of the perforation:

Small Perforations

• Typically heal on their own within a few weeks
• Your dentist may place a protective dressing to aid healing
• Antibiotic therapy and nasal decongestants may be prescribed to prevent sinus infection

Moderate Perforations

• May require sutures to close the opening in the sinus membrane
• A collagen membrane or tissue graft can be placed to encourage bone healing
• Follow-up appointments are necessary to monitor healing

Large Perforations

• May need surgical repair, such as a buccal advancement flap, where nearby gum tissue is stretched over the opening
• Bone grafting may be necessary if the sinus floor is severely compromised
• Larger perforations may require sinus augmentation procedures or endoscopic sinus surgery

Can You Still Get Dental Implants After a Sinus Perforation?

Yes, but additional procedures may be needed.

If significant bone loss occurs, a sinus lift procedure or bone graft can rebuild the area before dental implant surgery. Your oral surgeon will evaluate your bone structure and recommend the best surgical technique.

How to Prevent Sinus Perforations

While not always avoidable, these steps can reduce the risk:

• Pre-extraction imaging: X-rays or CBCT scans help assess sinus involvement and the risk of sinus perforation.
• Gentle extraction techniques: Your surgeon may section a tooth into smaller pieces to reduce trauma and risk of sinus membrane perforation.
• Preventive bone grafting: Filling the tooth socket with bone graft material (socket preservation) after extraction can reinforce the sinus floor and improve sinus health.

Seeking Treatment for a Sinus Perforation

If you had your tooth extraction at Oral Facial & Implant Specialists and suspect a sinus perforation, call our office immediately to schedule a follow-up appointment. Timely evaluation can prevent complications and ensure proper healing. 

If your extraction was performed elsewhere, our experienced oral surgeons can assess your condition and provide the necessary treatment to restore your oral and sinus health.

Our oral surgeons, Dr. J. Travis Thompson, and Dr. Stephen Martin, provide expert treatment for oral surgery complications, including perforated sinuses and sinus lift surgery.

To book an appointment at our oral surgeons office in Deer Park, IL, call (847) 381-0106 or visit us at 21660 W. Field Parkway, Suite 220, Deer Park, IL.