Subcutaneous facial emphysema (SFE) is a potentially serious complication of dental treatment typically associated with surgical removal of teeth using air-driven handpieces. A case of SFE is presented occurring after routine dental restoration, along with a framework to aid prevention of this complication and guide management where it occurs.

Subcutaneous facial emphysema (SFE) following routine dental operative procedure is an uncommon but potentially life-threatening complication. The present case details a Class V restoration where air was introduced into the fascial tissue planes via the gingival sulcus from the use of an air-driven dental handpiece. Although the SFE is usually self-limiting within 3-10 days, such instances should be regarded as a medical emergency as in severe cases, the air may spread to the neck, mediastinum and thorax to result in cervicofacial emphysema with potential pneumomediastinum and pneumothorax.