Many cases of soft tissue emphysema have been reported; it is recognized as a common surgical and dental complication. This report adds to the number of recorded cases and emphasizes the potential for emphysema with the use of high pressure dental instruments. It also shows that the point of entry of air may be overlooked and will therefore delay diagnosis. Proper diagnosis and recognition of the potential for widespread secondary infection dictate the management of emphysema. If any doubt should exist, consultation should be obtained without hesitation.