The dentist may suspect a communication, or one may have been confirmed. Either way, the advice is similar- you should follow their instructions which are aimed at preventing a rise in air pressure in the sinus. If this happens, for example by sneezing or blowing your nose, air will be forced down into the mouth, through the hole and it may worsen or prevent the communication from healing.
- When you sneeze allow air pressure to escape out of your mouth- don’t hold it in
- Use a decongestant or the one prescribed by your doctor/dentist
- Use an antibacterial mouthwash like chlorehidine (Savacol) – but not for the first 24 hours while the clot establishes
There is a risk, that a piece of root can fracture off the tooth move into the sinus and cause problems. If a root has been displaced into the sinus, it can sometimes be removed through the socket- if it is still under the lining of the antrum. If not, a different and more difficult surgical procedure such as a Caldwell- Luc approach may be needed. Referral to an oral surgeon will be necessary to have this done.
As we mentioned at the start, the communication will either heal spontaneously, or form a fistula. If a fistula forms then a small surgical procedure can be done to close the connection. This involves a flap of gum being raised and gently stretched across the socket to cover the hole- it is then secured in place with stitches.