In short
- The maxillary sinus sits right above the roots of the upper molars.
- Removing an upper tooth can leave an opening: the oroantral communication.
- Typical sign: water or air passes from the mouth to the nose.
- Small ones may close on their own; persistent ones are closed surgically.
- Closing it in time prevents the sinus from getting infected (sinusitis).
01What is an oroantral communication?
The roots of the upper molars and premolars sit very close to the maxillary sinus, a hollow cavity in the cheekbone. Sometimes the plate of bone separating them is very thin or absent.
When an upper tooth is extracted, a small opening connecting the mouth to the sinus can remain. This is called an oroantral communication. If it doesn't close and it epithelializes, it becomes an oroantral fistula.
02How do I know if I have one?
The clearest and most alarming sign is that when you drink liquids, water comes out of your nose. You may also notice air escaping when you blow or inflate a balloon, a change in your voice, or air passing through the gap when you pinch your nose and blow gently.
Other signs are a bad taste or smell, a feeling of pressure in the cheek, or bubbles escaping from the socket. If you recently had an upper tooth removed and notice any of this, it's worth an early assessment.
Water passing to your nose after an extraction isn't normal — but it does have a solution. Closing it in time changes everything.
03“It happened and no one told me”: what to do
An oroantral communication can occur even when the extraction was done well: it depends heavily on each person's anatomy. What matters is not finding blame, but diagnosing and closing it.
If you suspect it happened and it wasn't explained, don't self-medicate or wait for it to “go away”. See an oral and maxillofacial surgeon, the specialist in resolving this.
04What NOT to do while you're assessed
Until your assessment, avoid anything that raises pressure between mouth and nose: don't blow your nose hard, don't use straws, don't smoke and don't inflate balloons. Sneeze with your mouth open.
These precautions give a small communication the chance to close on its own and keep it from enlarging while the treatment is decided.
05How is it closed?
Very small communications may close on their own with care and sometimes medication. Medium ones, or those that have been there a while (fistulas), are closed with a simple surgical procedure under local anesthesia, moving healthy tissue to cover the opening.
Closing it properly keeps food and bacteria out of the sinus and prevents sinusitis. As a maxillofacial surgeon, I assess the size and the sinus with an X-ray to choose the best technique for your case.
·Frequently asked questions
Is it serious if water passes to my nose when I drink?
It's a sign of an oroantral communication and should be assessed soon. It's usually not life-threatening, but if it doesn't close it can infect the sinus. It's best to see a maxillofacial surgeon to diagnose and resolve it.
Does an oroantral communication close on its own?
Very small ones may close with care (no nose-blowing, no straws, no smoking) and follow-up. Medium ones, or those that have turned into a fistula, need a surgical closure, which is simple.
How long do I have to treat it?
The sooner the better. A recent communication is easier to manage. After weeks it epithelializes into a fistula, which then needs surgery. That's why an early assessment matters.
Does the surgery to close it hurt?
It's done under local anesthesia, so there's no pain during the procedure. Afterwards there's simple care and mild discomfort that's well controlled.
Who closes an oroantral communication in Cancún?
An oral and maxillofacial surgeon, the specialist in the relationship between the mouth and the maxillary sinus. In Cancún you can be assessed by Dra. Jessica López.
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