Post-Operative Instructions Sinus Precautions

It is not unusual for the roots of the upper back teeth to be close to, and sometimes actually into, the maxillary sinus. The maxillary sinus is one of the several normal sinuses which are air chambers within the bones of the face, and open into the nasal cavity.

During removal of the upper posterior tooth, it is possible that a sinus opening can occur in the root area. There are many types of bacteria normally present in the mouth which are not usually present in the sinus. A sinus opening can allow oral bacteria to get into the sinus and could lead to a sinus infection (sinusitis).

Your doctor has indicated that you require sinus precautions. These special instructions need to be followed to avoid complications for the next 7 to 10 days.  Creating too much pressure in the sinus can prevent healing.

– AVOID BLOWING YOUR NOSE              -AVOID USING STRAWS

– AVOID SMOKING                                     -USE ORAL RINSES VERY GENTLY

– AVOID VIGOROUS SPITTING                -IF YOU HAVE TO SNEEZE, DO SO WITH THE MOUTH OPEN!

-To prevent further sinus complications, the use of a decongestant, such as Sudafed, may be helpful.

Day 1

  • Go home and get some rest! Keep your activities minimal.

  • The gauze you left our facility with will need to be changed every 1 to 2 hours for the next 4 to 6 hours, or until the gauze comes out without much blood on it.

  • It is recommended to start your pain medications within the first 1 to 2 hours after leaving surgery, or at the very first onset of pain. However, do not take your pain medications on an empty stomach! If you experience nausea, sipping on Ginger Ale or Sprite will help to soothe the stomach.

  • Soft foods that require little to no chewing are recommended. Be cautious of hot food and drinks when your mouth is still numb.

  • If your doctor prescribed an antibiotic, it is important to start as soon as possible- again, with food in your stomach. Take as prescribed until gone.

  • Do not go home and lay flat! Keep your head elevated while resting for 2 to 3 days- using your ice pack for the first 24 hours (alternating 20 minutes on, 20 minutes off).

  • Avoid brushing, flossing, rinsing or spitting today. Do not sleep with gauze in your mouth!

  • No smoking for at least 3 days after surgery. This can cause further complications and unnecessary pain.

  • If you have been sedated, the anesthesia may make you drowsy and tired for the rest of the day. You should not drive a motor vehicle, operate any dangerous machinery or make responsible decisions the day after surgery.

    Day 2

  • Today, you will start using your ice pack as a heat pack- instructions for heating are located on the back of the pack. Use this for 2 to 3 days, alternating every 20 minutes.

  • Gentle oral care can be resumed, but avoid brushing over the sockets for a couple of days. You may notice a small amount of blood the first day or two- this is normal and there is no need for gauze.

  • Continue your soft diet for 4 to 5 days. Gentle swishing with warm salt water is encouraged between meals and after all eating for the next week.

  • If your doctor prescribed you a medicated mouth rinse (Peridex), you will start that today. You should swish with a small amount morning and evening for 7 days with your regular oral care routine.

    Day 3

  • You should start to see your swelling decrease today and over the following days.

  • If you must resume work or an exercise routine, do so lightly- letting pain be your guide.

  • As your swelling decreases, your pain should be getting much better. Try to limit your prescription pain medication use as much as possible. Using over-the-counter pain medications, such as Motrin or Ibuprofen, are a good option, as directed by our surgical assistants.

  • If your pain, swelling, and symptoms are not improving by today, you may need to be seen by your doctor.

  • Your sutures may start to dissolve, which can take up to 1 week. If your sutures are not dissolvable, your doctor will remove them during your scheduled post-operative appointment.

    Day 4 and 5

  • You can slowly advance to more solid foods, as well as increase exercise intensity. A bad taste, odor, fever, increased swelling, or pain may occur if cleaning is lacking. If you are experiencing these symptoms, you may need to be seen by your doctor.

    Day 6 and 7

  • Stop the use of your medicated mouth rinse (Peridex), unless otherwise directed. You will start using the curve-tipped syringe to rinse the lower molars after eating. Food debris and small amounts of blood may flush out- this means that you are cleaning the socket. Continue using the syringe 1 to 2 weeks, or until food no longer collects in the socket. This is very important!

  • Increased pain and swelling by this time is uncommon- please contact the office if you are experiencing adverse symptoms. There is a 24 hour answering service after office hours.

Following these instructions, most problems with sinus openings can be avoided and the area should heal uneventfully. If you have any questions, do not hesitate to contact the doctor any time by calling Rapid City Office Phone Number (605) 348-6818. This is a 24-hour answering service which can reach the on-call doctor at any time.