Extensive bilateral cervical and mediastinal emphysema following dental implant scaling: The unexpected airway risk

Bilateral subcutaneous emphysema of the head and neck region is a potentially life-threatening condition. We report a unique case of a patient who presented emergently to the on-call oral and maxillofacial surgery team with extensive bilateral emphysema extending into the mediastinum. It was identified that the use of an air-powder polisher during a routine scale of periodontal pockets of dental implants the previous day was the iatrogenic cause of the extensive emphysema. The patient was admitted for three days with anaesthetic-led airway management, intravenous antibiotics, and corticosteroids until full resolution of the emphysema. This case highlights a rare but severe complication of a routine dental procedure and the importance of urgent interdisciplinary intervention to prevent airway compromise.