This report describes a life-threatening hemorrhage in the floor of a patient's mouth during routine implant placement in the anterior mandible. Airway obstruction caused by hematoma development resulted in acute nasotracheal intubation and subsequent surgical intervention. Surgical, radiographic, and anatomic considerations to prevent severe bleeding are discussed. An extraoral submental appraoch in cases with large sublingual hematomas is recommended. An outpatient should be treated in or close to a hospital where these complications can be dealt with promptly and effectively.