Sinus Perforation: Symptoms and Treatment

Published June 3, 2022
Because they’re often associated with the nose, many people don’t realize that our sinuses are also closely related to our mouths. In fact, for some people, the floor of their sinuses is connected to the roots of their teeth.
This is why, sometimes, tooth extraction can lead to sinus perforation.
If your sinus walls are so close or even wrapped around the root of your tooth, the higher the risk of your sinus getting perforated after a tooth extraction procedure. In cases like this, it’s usually inevitable since there’s only a very thin membrane separating the sinus from the tooth root.
Most of the time, the dentist will tell you about it and treats the perforation before it does further damage. But in some cases, they don’t notice it or won’t own up to their mistake. When not treated in time, a minor sinus perforation can lead to severe health complications.
How Serious is a Perforated Sinus?
If diagnosed and treated immediately, a perforated sinus is usually no cause for concern. But if left untreated, it can lead to chronic sinusitis which can have serious health consequences.
You see, tears and perforations in the tissues lining your sinus walls make it more susceptible to infections. When viruses and bacteria enter your sinuses, it can trigger inflammation. This leads to sinus pain and pressure in addition to other sinus infection symptoms.
Sinus infection, in turn, can lead to severe complications like:
- eye infections
- bone infections
- brain abscess
- meningitis
- thrombosis
Though the above complications are rare, they can still happen and can sometimes be fatal.

Sinus Perforation Symptoms
Aside from facial pain, patients with perforated sinus may also experience symptoms like:
- air escaping to the mouth when breathing (this is often accompanied by a hissing sound)
- periodic bleeding at or near the extraction area
- liquid coming out of the nose when drinking
- change in voice timbre
- bad breath
To ascertain if you indeed have a perforated sinus, you can do a simple nasal test.
Start by slightly pressing your nose using your thumb and forefinger. Then while keeping your nostrils pressed, try to blow air through your nose. If you hear a hissing sound in the extraction area, it means air can pass through your sinuses to your mouth – a sign of sinus perforation.
But if there’s no hissing sound, then it means your sinus walls are still intact. If this is the case and you still feel pain in your sinus area, it can be a sign of sinus or gum infection. Consult your doctor to be sure.
How to Heal a Perforated Sinus
Most cases of perforated sinus heal on their own, especially minor ones. The results of a clinical investigation in Tokyo have also showed that 39% of the perforations in their test subjects have closed spontaneously.
In more severe cases, the dentist may recommend surgery to close the perforation. The process may differ depending on your dentist’s technique but it usually involves:
- placement of collagen membranes or other resorbable membranes at the meeting point of the sinus and the tooth root
- packing a bone graft particulate on the sides and securing it so it does not slide into the sinus
- suturing the membrane over the graft to keep it in place
After the surgery, you’ll typically be given antibiotics to avoid infections while your sinus is healing. You’ll also be given a set of post-operative instructions which can include:
- not blowing through your nose
- not to smoke
- avoiding anything that can irritate the nose and cause you to sneeze or cough
How Long Does a Perforated Sinus Take to Heal?
Sinus perforation usually takes about 4 to 6 weeks to heal depending on the extent of the puncture. But if it requires surgery and bone grafting, the healing period can extend to about 6 months.
If it doesn’t heal after that time period, you should go back to your dentist and tell them about it. If that doesn’t work, you may need to get a second opinion.
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About The Author
Judy Ponio is a professional writer based in the Philippines. Her commitment to communicating factual content in when writing is unmatched. She works hard to cross check reputable sources to ensure her work uses accurate facts.