Some risk factors in relation to the occurrence of an oroantral perforation are discussed in the light of the existing literature. Factors relevant for the diagnosis and the treatment of an oroantral perforation, are discussed. Small perforations probably heal without problems, provided that the alveolus is deep enough and a blood clot will form without disturbance. Some pros and cons of buccal and palatal transposition flaps for closing clinically significant oroantral perforations, are discussed.