About an oro-antral communication (mouth-sinus hole)

An oro-antral communication (mouth-sinus hole) sometimes appears after tooth extraction.

This is an unexpected hole between your mouth and the air-filled space either side of your nose inside your cheekbones (sinus).

It can happen because the roots of your upper molar teeth and your sinus are so close together.

The communication (hole) often heals itself, especially if it is small.

Sometimes we need to close this hole surgically, after the tooth extraction. We do this by raising a flap of skin and stitching the margins of the tooth socket.

Mouth care following the operation

Follow this guidance to help with your recovery.

  • Take the full course of antibiotics we give you.
  • Try not to sneeze, as this can put pressure on your sinus. If you have to sneeze, keep your mouth open.
For 2 weeks Do not blow your nose, even though your sinus may feel stuffy or fluids may drain slightly from your nose.
For 1 week
  • Inhale menthol oil twice a day.  This helps to keep your nose clear. You can buy menthol oil at any pharmacy.
  • Use nose drops twice a day. You can buy these at any pharmacy.
For several days

Do not do any of the following:

  • forcefully spit
  • smoke
  • drink through a straw.

These activities can create suction in the mouth and this can cause the skin flap to break down. 

Follow-up

Your stitches will drop out after 2 to 3 weeks.

We will review your recovery after 2 weeks, to check how the flap is healing. Sometimes we refer patients for further surgical treatment.  This is rare.

Risks and side effects

The following risks and side effects are possible after this operation.

Bleeding into the cheek

Swelling that does not resolve within a few days may be due to bleeding into the cheek. The cheek swelling will feel quite firm. There may also be limited ability to open the mouth opening, as well as swelling and bruising. All of these usually disappear over time.

Breakdown of the skin flap and return of the mouth-sinus hole

The flap used to close the mouth-sinus hole can break down. If this happens, we may need to repeat the procedure.

Flattening of the sulcus [???]

If the skin tissue we use to close the mouth-sinus hole is drawn from the cheek, then the space between the cheek/lips and the teeth is lessened (temporarily).  This tends to improve with time, but in some cases a permanent flatness will remain.

Contact information

Contact the Day Surgery Unit Advice Line, Monday to Friday 8am to 7pm, for help after discharge home

 

For urgent help, call 111 or go to the Emergency Department (A&E) at Kingston Hospital or St George's Hospital, Tooting

Telephone:

Telephone:

Kingston Hospital Day Surgery Advice Line: 020 8541 5370

 

A&E, St George's, Tooting: 020 8672 1255