Yes, a complete perforation can occur or seem to occur a few weeks after the extraction of the tooth. These things are not always picked up right away which could lead to a late diagnosis. Also, the wall of the sinus membrane can be very fragile and close to being perfored after the extraction. Bacteria, inflammation, sneezing, nose blowing... could then cause the fragile membrane to perforate through. Again, this could occur sometime after the extraction during the initial healing phase.

Most of the time sinus perforations heal on their own. Some people have bothersome symptoms for weeks... while others say they have no symptoms. Some people think their symptoms are normal and ignore them...... every one is different. I've already had patients fail to come in for their post op checks.... only to see them a few months later and inform them that their extraction site is still open and they have a sinus perforation. I mean they had no idea it had not healed closed. I know that seems odd.... but I cannot count how many times that has happened and usually these patients are smokers.