Sinus "hole" punctured during wisdom teeth extraction

[KnowledgeIsPower]

Hi guys!

My wife just had her wisdom teeth extracted today, and the oral surgeon told us that in the process a small hole formed in one of her sinuses. He says this is common and it will heal within 2 weeks or so. I asked him if scuba diving will be a problem and he said that within 2 weeks she will be good to go.

While I trust his advice, I feel that 2 weeks is a very short time for a "hole" in one of her sinuses to be ok with the pressures we dive at while scuba diving. Has anyone had experience with this? I read online that sinus surgery usually requires 2-3 months healing before any scuba diving can be done. While this is not sinus surgery, it still is a hole in the sinus so it has me worried.

We have a dive trip planned for November so that is 3 months away, but we were hoping to dive a little in September as well locally over here. Any advice or past experience?

 

[Laurence Stein DDS]

It is not uncommon for the roots of upper molar teeth to rest against or penetrate the border of the maxillary sinus. During extraction, occasionally a small opening into or just up to sinus may be found. In many cases, the sinus membrane is still intact with no actual communication between the mouth and sinus. Other times a very small hole might exist following the extraction. If the blood clot in the extraction socket properly forms and is not disturbed, this hole will heal spontaneously.

For larger holes, a collagen plug or membrane may be inserted and sometimes bone particulate is then packed into the socket. The skin of the palate may also be moved over the socket opening and sutured to place in order to seal the hole.

Successful closure of such exposures usually heal quickly. While I would be uncomfortable in suggesting diving after just two weeks, I would not have the same feelings at one month. Especially if the site has been symptom free.

3 months is certainly enough time for a bony seal to occur. To put this into perspective, when teeth are extracted and the sockets are grafted prior to dental implant placement, the bone in these sites are usually ready to receive an implant at 3 months.

If, however, a patient complains that air or liquids escape from the mouth through the nose or if there is an ongoing sinus infection, then there might well be an oral-antral fistula that requires secondary closure and this would require a longer healing period before resuming diving.

Barring any complications from the surgery, why not split the difference in waiting period....longer than 2 weeks and less than 3 months.

Laurence Stein, DDS

 

[KnowledgeIsPower]

That is great, thank you! I think that is a good option, we will wait until everything appears healed with a minimum of 1 month between the surgery and any diving.