Abstract
Dentists frequently use sharp instruments and high-speed rotary handpieces which carry an inherent risk for iatrogenic trauma in routine procedures. While most iatrogenic injuries are minor, trauma to the floor of the mouth poses a greater concern due to the proximity of vital structures. This report highlights a case of penetrating bur injury to the floor of the mouth during routine dental treatment, resulting in a submandibular sialocele with progressive complications. A 31-year-old male presented with submandibular swelling, dysphagia, and fluid tracking into the neck following the injury. Initial management included antibiotics , steroids, and close monitoring, but worsening symptoms required surgical exploration and drainage. Definitive management involved botulinum toxin injection into the submandibular gland, successfully resolving the swelling and symptoms. This case highlights the potential for acute swelling and airway concern following minor iatrogenic dental trauma. It is important for practitioners to exercise caution during treatment and remain vigilant for complications.