Expert: Joel S. Teig, DMD, Diplomate ABOMS, retired - 6/16/2007

Question
I recently had my upper rear molar extracted.The dentist packed the hole because he said it may be infected.Ten days after the extraction the packing came out and i realised the hole goes right through to my nasal passage is this o.k and will it heal over. Thanks Stu.

Answer
Stu - The upper molars touch and frequently infiltrate the sinus.  Whoever removes a tooth needs to investigate, after removing an upper tooth, if there is an opening into the sinus at the depth of the tooth socket.  If this is the situation, and from what you describe I think it is the situation and your dentist knew it, you have an opening into the sinus called an oral antral fistula.  When this occurs the opening needs to be sealed.  Placing a packing rarely closes the opening, but it occasionally does.

Now that you are down the road in healing the opening needs to be surgically closed.  If left open you will develop a sinus infection from the bacteria filled saliva entrance into the sinus.  You will need to make an appointment, as soon as possible, with a local oral and maxillfacial surgeon.  The surgeon will need to make sure the sinus is not infected then seal the opening.

It is imperative that you take care of this as soon as possible or a major infection of the sinus can easily develop.

So, again, contact an oral and maxillofacial surgeon as soon as possible.  Your dentist knowing what is going on needs to refer you immediately.  If you have any further questions, please feel free to contact me again.