Reviewed by Dr. Brett Broda
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When an upper back tooth is removed, its roots sometimes sit close to the maxillary sinus. If the thin bone or sinus membrane opens during the extraction, a small connection can form between the mouth and the sinus. This is called a sinus perforation.
Most perforations are small and heal on their own. Larger ones may cause sinus symptoms, discomfort, or infection if not treated.
Table of Contents
How Common Is Sinus Perforation After Tooth Extraction?
Sinus perforation is not common, but it is more likely to occur with upper molars or wisdom teeth because of their close proximity to the sinus. These teeth sit close to the sinus cavities, and some people have very thin bone between the roots and the sinus membrane.
Certain factors can make perforation more likely:
- Previous sinus problems or chronic sinus infection
- A large or infected root
- A fractured root tip during the procedure
- An extraction socket that extends close to the alveolar sinus
- Medical history that affects healing
When identified early and treated appropriately, sinus perforations usually heal without long-term issues.
Symptoms of Sinus Perforation After Tooth Extraction
Symptoms may appear immediately after the extraction or develop over the next few days.
Common signs include:
- Sinus pressure or nasal congestion
- A feeling of air pressure or air moving between the mouth and nose
- Liquid leaking from the mouth into the nasal cavity
- Nasal discharge after the extraction
- A whistling sound when breathing through the nose
These symptoms do not always indicate a perforation, but they are worth getting checked out.
How We Diagnose It
If you had a tooth extraction at Broda Family Dental, we will examine the area to look for any signs of perforation. We use high‑definition CBCT scans and dental X‑rays to assess the sinus membrane and the extraction site.
These tools help us:
- Confirm whether the sinus is exposed
- Measure the size of the opening
- Check for infection or fluid buildup
- Plan treatment
Our goal is to identify concerns early, protect the sinus, and support healing.
Treatment and Aftercare
Treatment depends on the size of the opening and whether the sinus is irritated or infected. Small perforations often close on their own once the area is protected, and we may place a collagen plug or membrane to support healing.
Larger openings, or those with active sinus symptoms, may require sutures or a soft-tissue flap to seal the site. If there are signs of a sinus infection, we treat the infection first and then close the opening when the area is stable.
Aftercare is essential for protecting the sinus as it heals. We advise patients to avoid blowing their nose, sneeze with the mouth open, avoid smoking and straws, and keep pressure off the area. These steps help stabilize the clot and prevent air or bacteria from entering the sinus. Most perforations heal predictably within a few weeks with proper care and follow-up.
When to Contact Us
Call us if you notice:
- Worsening sinus pressure
- Persistent nasal discharge
- Increasing pain
- A bad smell or taste
- Liquid leaking through the nose when drinking
These may be signs of a sinus infection or a perforation that needs further care.
Concerned About Sinus Symptoms? Visit Us in Boulder
If you think you may have a sinus perforation or are experiencing unusual symptoms after a tooth extraction, we can help. We will guide you through the next steps with clear, honest care.
To book an appointment at our dental office in Boulder, CO, call (303) 442-6141 or visit us at 777 29th St, Unit 300, Boulder, CO 80303.
FAQs
Is a perforated sinus an emergency?
Usually, no, but it should be evaluated promptly. Early treatment reduces the risk of sinus infections and helps the sinus membrane heal properly.
How common is sinus perforation after tooth extraction?
It is uncommon but can occur, especially with upper molar and wisdom tooth extractions. The roots sit close to the sinus membrane, which is why a perforation can happen in some cases.
How do I check for sinus perforation?
Do not try to test it yourself. Blowing your nose or forcing air through the extraction site can make the problem worse. If you suspect a perforation, schedule an exam so we can assess it safely.
Can a perforated sinus heal on its own?
Many small perforations can heal without surgical treatment when protected and monitored. Larger openings may require closure.
