A Case Report of Sodium Hypochlorite Accident

Abstract

Sodium hypochlorite is widely used as an irrigating solution in dental practice. Despite its safe properties, serious complications can result from inadvertent use. We report a patient presenting to the accident and emergency department for sodium hypochlorite accident during dental root canal therapy. The management of this dental emergency condition is discussed.

Nonsteroidal Management of Accidental Extrusion of Sodium Hypochlorite beyond Apex

“…It acts as a solvent for organic fat, dehydration of fatty acids which are transformed into fatty acid salt and glycerol which leads to saponification; also it causes dehydration of protein through the amino acid neutralization and chloramination reactions. 4 Sodium hypochlorite solution of 0.5% is less toxic than the 5% solution but the antimicrobial effectiveness is not intensified proportionately to its concentration. A 0.5% conc.…”

“…A reassurance and calming the patient is the primary step for a successful management as well the patient is alarmed of upcoming symptoms. 4 Pain control in the dental office can be done by using long acting local anesthesia further it can be controlled using narcotic analgesics but nonsteroidal anti-inflammatory drugs (NSAIDs) and asprin should be avoided initially due to high chances of interstitial soft tissue hemorrhage. Cold packs initially for 24 hours every 15 minutes helps to reduce pain and inflammation for first 24 hours; 10 followed by warm compression to shorten the clearing time of massive ecchymosis by increasing the circulation of the involved area.…”

“…Cold packs initially for 24 hours every 15 minutes helps to reduce pain and inflammation for first 24 hours; 10 followed by warm compression to shorten the clearing time of massive ecchymosis by increasing the circulation of the involved area. Prophylactic antibiotic coverage for 7 to 14 days is an essential as the extensive necrotic tissue in the dead space provides a medium good enough for secondary infection 4 steroid therapy with methyl prednisolone for 2 to 3 days has also been used in such cases to control inflammatory reaction. But contrary to this, we decided to treat the patient without using steroid based medications as even short-term administration of steroids can lead to aggravation of hypertension, fluid retention, stress ulcers, GI bleeding, silent perforation, psychiatric disturbances, delayed and abnormal wound healing, hypokalemia, osteoporosis, increased susceptibility to infection, and decreased glucose tolerance.…”

A review of medicolegal considerations of endodontic practice for general dental practitioners

“…To avoid such negligence, it is always better to do color coding for syringes and when in doubt, throw the syringe and use fresh needle, syringe, and anesthetic solution. [ 37 38 39 40 41 ]…”

Management of the sodium hypochlorite accident: a rare but significant complication of root canal treatment

“…The high pH (between 11 and 12) of NaOCl lead it to be particularly cytoxic and damaging to vital tissues 2 7. This chemical property increases the penetrating capability of the solution 3. Although rare, NaOCl accident during RCT can cause significant morbidity and distress for the patient and concern for the practitioner.…”