Pneumoperitoneum, pneumomediastinum, pneumopericardium and subcutaneous emphysema developed in a patient following simple dental extraction. Other causes of this unusual complication, such as pneumatosis cystoides intestinalis, insufflation of fallopian tubes, pulmonary-peritoneal fistula, post-partum knee-chest exercises, laparotomy, paracentesis and peritoneal dialysis should be considered when peritoneal signs are absent so that unnecessary laparotomy can be avoided.