Subcutaneous emphysema secondary to dental extraction: A case report

Although less frequently encountered in dental practices, subcutaneous emphysema of the face and neck has been reported in patients following dental extractions, particularly when lower molar teeth are extracted with the use of a high-speed air-turbine drill designed for restorative treatment, which forces air into the cervical fascial spaces. As facial swelling and pain are the most common presentations, subcutaneous emphysema can often be misdiagnosed as an allergic reaction or odontogenic infection. While usually a benign and self-limiting condition, subcutaneous emphysema may have life-threatening complications such as tension pneumothorax, cardiac tamponade, air embolism, tracheal compression and mediastinitis, which are important to recognize in an emergency setting. Dentists should be aware of the serious risks of inducing subcutaneous emphysema and avoid performing tooth extractions with high-speed air-turbine drills which are specifically designed for use for restorative treatments only.