A 55-years-old man visited his family doctor because of a one-day existing, not painful, right-sided swelling of the cheek. It appeared to be a subcutaneous emphysema, caused at an attempt to remove mandibular third molar roots, using a water- and air-cooled air rotor. Rare potential sequelae resulting from subcutaneous emphysema are venous air embolism, airway obstruction because of neck swelling, pneumomediastinum, and mediastinitis. Using aircooled instruments in surgical orofacial treatments should be avoided because of the possible iatrogenic life-threatening complications.