What Are the Symptoms of Sinus Perforation After Tooth Extraction?

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Sinus perforation (also called oroantral communication)  is uncommon after routine extractions, but it is a known risk. It is most likely to occur with upper molars because the roots of these teeth often sit close to the maxillary sinus.

Table of Contents

• Signs of Sinus Perforation After Tooth Extraction
• What Causes a Sinus Perforation?
• How Common Is Sinus Perforation After Tooth Extraction?
• When to Contact Your Dentist or Oral Surgeon
• Treatment for Sinus Perforation
• Periodontal Evaluation and Surgical Planning
• Periodontist in Highlands Ranch, CO
• FAQs

Signs of Sinus Perforation After Tooth Extraction

Symptoms can vary depending on the size of the opening and whether infection is present. In many cases, symptoms appear shortly after the procedure.

Common signs may include:

• Air or fluid passing between the mouth and nose
• A whistling sound when breathing
• Nasal discharge
• Sinus infection
• Liquid coming out of the nose when drinking
• Nasal congestion or pressure on one side
• A bad taste in the mouth
• Persistent drainage from the extraction site

What Causes a Sinus Perforation?

A sinus perforation can occur when an upper back tooth is removed, such as when an extraction is performed in preparation for a dental implant. The roots of upper molars often sit close to the maxillary sinus, and in some cases, only a thin layer of bone separates the tooth from the sinus cavity.

During extraction:

• This thin bone may be disrupted
• The sinus membrane may tear
• An opening may form between the mouth and sinus

Not all sinus perforations lead to complications. Small openings often close on their own, while larger openings may require additional care to support healing.

How Common Is Sinus Perforation After Tooth Extraction?

This complication occurs in a small percentage of upper tooth extractions. The risk varies depending on anatomy, tooth position, and the complexity of the procedure.

Factors that may increase the likelihood include:

• Proximity of tooth roots to the sinus cavity
• Bone thickness between the tooth and the sinus
• Complexity of the extraction
• Presence of infection or bone loss

In routine extractions, the risk is relatively low. However, in cases where roots are close to or extend into the sinus, the risk increases. Pre-operative imaging is used to assess this relationship.

When to Contact Your Dentist or Oral Surgeon

Some minor perforations can close on their own. However, certain symptoms indicate the need for evaluation.

Contact your provider if you notice:

• Fluid passing between your mouth and nose
• Ongoing sinus pressure or congestion
• Persistent bad taste or drainage
• Symptoms lasting more than a few days

Early evaluation helps determine whether the area is healing or if additional treatment is needed.

Treatment for Sinus Perforation

Treatment depends on the size of the opening and whether symptoms are present. Small sinus perforations often heal on their own with proper care and monitoring.

Your provider may recommend that you:

• Avoid blowing your nose
• Sneeze with your mouth open
• Avoid straws or forceful suction
• Limit heavy lifting or strenuous activity
• Use prescribed medications such as antibiotics or decongestants

If the opening is larger or does not heal on its own, treatment may involve closing the area with stitches or placing a protective material over the site to support healing. 

Periodontal Evaluation and Surgical Planning

At Highlands Ranch Periodontics and Implant Center, Dr. Mike Norouzinia, DDS, and Dr. Kerri Font, DDS, evaluate the relationship between upper teeth and the sinus using clinical examination and imaging. 

Their training in periodontal and surgical procedures supports careful planning when extractions involve areas close to the sinus.

Periodontist in Highlands Ranch, CO

If you had a tooth extracted at our office and notice signs of sinus perforation, book a follow up appointment as soon as possible. Call (303) 683-1144 or visit us at 9090 Ridgeline Blvd #225, Highlands Ranch, CO 80129.

FAQs