I got my wisdom teeth out less than a week ago, and at the time the surgeon informed me that a small perforation in the sinus occurred when the tooth was removed from the top. (That tooth was mostly impacted.) He said he placed a membrane there and did some sutures, but the entire socket wasn't sutured shut. Also been on antibiotics and post-op instructions like no straws, blowing nose, etc... I was told these mainly heal on their own, that its a minor complication, and he wasn't too concerned.

About 3-4 days later the swelling went down in all the sites. The other sites are healing quite nicely and uneventfully. The one site with the perf. though has begun to drip slowly a salty fluid which Im assuming is from the sinus. Although Im not really trying to do this for fear of making it worse, but I am not noticing any air going either way, just fluid coming down. So it doesn't seem to be a very large opening. There is still some soreness in that area but I dont think anything is infected, the fluid coming down seems to be clear to clear-yellow tint. Nothing coming out of the nostrils at all.

My question is, how long does this kind of perforation take to heal? And wonit it be prevented from closing by the sinus draining? I've read it could take 2 months or more. Im going to be out of antibiotics well before then, won't that lead to infection? Does the surgeon need to surgically close this at this point?

Anyone ever experience anything like this or have input...I'd appreciate it.

Hi runner292,

I am in the dental field and can offer you some help here.

Was this salty fluid leak a one time incident... say after some exercise or sneezing??

Small sinus perforations take various times to heal. Depends on the size and location as well as the patients overall health, activity and post op home care.

If the fluid is still leaking or it has stopped and then suddenly occurs again... call the oral surgeon and let him know what is happening. It may be a small perf and it was aggravated by something you did or it could be a larger opening than originally thought.

Hope this information helps.
Bryanna

Thanks for responding...

The fluid just started seeping out on its own and I dont think it was anything I did. The fluid seemed to slow quite a bit in the last 36 hours. But I am sure the opening is still there. I did call the oral surgeon and went to see him today. He put some kind of tissue glue in there, gave me more antibiotics, and wants to see me again in 7-10 days. But Im not thinking this will do much. The hole in the sinus is very small according to him, like a pin hole, but it was a difficult extraction. And he's now saying im in danger of losing the 2nd molar if this doesn't heal on its own soon.

So I don't know...im getting increasingly depressed over this.

Hi runner292,

What is wrong with the second molar? Is that tooth root canaled?

How is the drainage today? Any pain?

Bryanna

I haven't had any drainage since I was in the office on Monday. Whatever he did blocked that up apparently although it seemed to be decreasing somewhat that day beforehand. White granulation tissue seems to be filling in and around the socket. But while looking at it, I can still see the saliva on top pulling back and forth slightly as I breathe through my nose. It's not like the fluid is running freely back and forth, it's more like a slight pull and very small amount of fluid moving around. So the communication is probably still there and either it's healing or it's just being blocked by something. I dont know, but this hasn't changed any over the past few days. The only positive development is that it seems the socket is trying to heal.

Pain from the extractions is pretty much all gone. There is some slight sinus inflammation though that comes and goes, but i dont think there is any infection as nasal discharge is clear and ive been on antibiotics since the day of the extractions. No cold symptoms or anything like that.

The 2nd molar has a crown. Nothing wrong with it as far as I know. He just sort of vaguely mentioned it. I guess he's suggesting he wouldnt be able to surgically close the communication without pulling that tooth for some reason.

runner292,

It sounds like the perforation is healing. But definitely keep an eye on it.

Regarding the second molar...... I don't understand why he would have to remove that tooth to close the sinus perf. I think that his remark may need some further discussion at some point.

Glad you are feeling better!
Bryanna

So to update on this...
It seems the perf has healed. Im not getting any airflow for over 2 weeks now and it's been 3 weeks or more since i had any mucus coming down. And the surgeon says there doesn't appear to be any opening to the sinus any longer. He pinched my nose and told me to blow and didnt see anything. Which is great that might be over.

But when looking at it I still do see the open socket. The hole in the gum is noticeably smaller in circumference than it was but it's still there, and I can't see the depth. I know this can take a long time to fully fill in, especially since this was quite impacted. But is it normal for a month after extraction for that hole to still be there?

Hi runner,

Good to hear that the sinus perf has healed!

It is normal for the extraction site to not be closed completely after one month. It may take another month or so before it closes completely.

You can keep rinsing with warm salt water to flush out that small opening and just keep all of your other teeth very clean. Refrain from using mouthwash that contains any alcohol, chemicals, dyes... etc. as that will slow down the healing.

Thanks for updating us!
Bryanna