Why would a patient experience bubbling of blood and escape fluids through his nostril following the extraction second upper molar?

The bubbling of blood and escape of fluids through the nostril following the extraction of the second upper molar suggests the occurrence of a condition called oro-antral fistula. This is an abnormal communication or opening between the oral cavity (in this case, the maxillary sinus) and the maxillary sinus, which is a hollow space located above the upper molars.

During the extraction of the second upper molar, there may have been accidental perforation or damage to the maxillary sinus floor, which is the thin bone separating the roots of the upper molars from the sinus cavity. This perforation can lead to communication between the oral cavity and the sinus, resulting in the bubbling of fluids and air from the nose during breathing or speaking.

The presence of blood in the fluids indicates that there is active bleeding from the site of the perforation. The escape of fluids, such as saliva or sinus secretions, into the oral cavity can cause an unpleasant taste and discomfort.

Oro-antral fistulas typically require further evaluation and management to ensure proper healing and prevent potential complications. The dentist or oral surgeon who performed the extraction may recommend appropriate treatments, which could involve surgical closure of the fistula, antibiotics to prevent infection, and measures to promote healing.