Subcutaneous emphysema after restorative dental treatment.

Subcutaneous emphysema is an uncommon phenomenon in dentistry, usually occurring with the use of air-driven, high-speed handpieces during dental and oral surgery, operative, endodontic, or periodontal treatment. Air is forced into a surgical wound or subepithelial laceration in the oral cavity, dissecting through the different layers of tissue fasciae, and usually creating a unilateral enlargement of the facial and/or submandibular regions. This occurs with or without crepitus, pain, and airway obstruction. Treatment usually consists of antibiotic and mild analgesic therapy, close observation, and reassurance by the attending dentist. Symptoms generally subside in 3 to 10 days; however, consultation with a physician is necessary to rule out further complications.