What is an OAF (Oral Antral Fistula)?

Your cheekbone is hollow and the cavity in your cheek bone is connected by a small opening to your nose. If your finger was small enough, you could pass your finger up your nose and at the height of your nasal cavity if your finger turned 90 degrees out towards your cheek it would pass through a small opening and end up inside your cheek bone. The cavity in your cheek bone is called a Sinus or an Antrum.

The roots of your upper back teeth are very close to cavity in your cheek bone, the walls of the sinus are very thin. Sometimes the roots of the upper back teeth are actually inside in the sinus. When a tooth is extracted a hole may be created connecting your mouth and the cavity in your hollow cheek bone.

When does it occur?

It will occur most frequently following extractions of upper back teeth. Small openings are very common and will usually heal by themselves with no treatment. Often neither the patient nor the dentist will be aware of the hole. Infection, cysts or other pathology will weakens the bone around the roots of teeth may make an opening more likely to occur.

How is an oroantral fistula closed?

• It requires a small operation to close the opening. In this operation a flap of gum is stretched across the hole in the roof of your mouth to close it. This gum is held in place with several stitches.

• Closure of an OAF can be technically difficult and healing depends on how well the mouth is cared for in the days after. Occasionally more than one attempt will be made before it will be successful.

• If you smoke during the healing period the hole will more than likely remain open and attempts to close it will fail.

Oral Antral Fistula

What should you expect afterwards?

• You will have stitches in your gums.

• You will have some swelling on your face and possibly a black eye.

• You will have some soreness.

• You may have some trickling of blood from your nose on the affected side.

• You will be given review appointment to have your stitches out.

• You will be placed on an antibiotic.

• You will be prescribed painkillers.

• You will be expected to keep your mouth very clean during the healing period

Do’s and Don’ts:

• You must not blow your nose for at least ten days.

• If you have to sneeze you should do so with your mouth open.

• You may of course wipe your nose.

• You should take all prescribed medication exactly as directed.

• This will include antibiotics, painkillers and possibly nose drops.

• You should use frequent warm saline mouth baths beginning the day after your operation. Dissolve a half teaspoon of table salt in a glass of warm water and gently flush the area to remove food debris.

• Rinse your mouth with Corsodyl mouth wash twice a day for 10 days.

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