In June, my dentist extracted two teeth, and I’m waiting to get dental implants. For one upper right tooth, my dentist said he could see into my sinuses. He prescribed antibiotics for me to take for a week. I didn’t have any special instructions other than taking antibiotics. My other tooth healed fine, but the sinus perforations still isn’t closed. My primary care doctor prescribed more antibiotics. I have a continual headache and a low-grade fever. How long does it take for a sinus perforation to heal? It’s going to be months before I can get dental implants. I think I need a second opinion. Am I going to need an oral surgeon or an ENT doctor to close the perforation? Thanks. Clay
It seems that your dentist doesn’t know how to handle a perforation that doesn’t heal. It’s wise to get a second opinion.
How Long Will Does It Take for a Sinus Perforation to Heal?
If your sinus is perforated from tooth extraction, the tissue normally heals within four to six weeks. Bone grafting is often needed, though, and it will heal in about six months. If a perforation from an extraction doesn’t heal, there are several possible causes. Two possibilities include:
- A root tip from the tooth is pushed into the sinus
- A bone fragment remains
Has your dentist or primary doctor sent you or an x-ray of your sinus? It’s best to visit an otolaryngologist (ear, nose, throat (ENT) specialist) who will request an x-ray, see I something if blocking the sinus, remove it, and ensure the infection goes way by prescribing more antibiotics.
If there is a bone fragment in your sinus, it’s good that your dentist didn’t close the perforation. The irritation from the fragment would cause ongoing infection and fluid drainage into your mouth and nose.
Closing a Sinus Perforation
How is a sinus perforation closed? Although your doctor might have a specific technique, the procedure includes steps like these.
- Place collagen plugs or another resorbable membrane in the tooth socket
- Gently place bone graft around the sides
- Secure the bone graft and protect the site with another collagen plug or resorbable membrane
- Stitch the membrane over the graft to keep it in place
After closing the perforation, a specialist will prescribe antibiotics, and based on the severity of your infection, tell you how long to take them. You’ll have follow-up appointments to ensure the area heals well.
Tell your ENT doctor about your plans for dental implants to replace your two missing teeth. The doctor and your implant dentist can discuss the optimal time for implant placement. Both the perforation and bone graft must heal before you receive dental implants. Otherwise, the implant and your jawbone won’t fuse, and the implants will fail. Be patient.
Steven Brooksher, DDS, a Baton Rouge dentist and Fellow of the International Congress of Oral Implantologists, sponsors this post.