Tension pneumothorax during dental anesthesia.

Subcutaneous emphysema of the face or neck which may extend into the mediastinum can complicate the use of high-speed air-turbine dental drills (1-5) or dental extractions (1). Pneumopericardium with subcutaneous emphysema has also occurred after maxillary surgery (6). Pneumopericardium, where air may have forced its way through a tear in the mucous membrane of the upper respiratory passages, has been reported to have occurred during a high-speed ride on a motorcycle (7). This case report describes the development of subcutaneous emphysema of the face, neck, and chest wall with mediastinal emphysema and tension pneumothorax that occurred during conservative dentistry using an air-turbine dental drill.