Abbott PV Present status and future directions: managing endodontic emergencies. Int Endod J. 2022; 55 Suppl 3:778-803 https://doi.org/10.1111/iej.13678
Cai C, Chen X, Li Y, Jiang Q Advances in the role of sodium hypochlorite irrigant in chemical preparation of root canal treatment. Biomed Res Int. 2023; 2023 https://doi.org/10.1155/2023/8858283
Shetty SR, Al-Bayati SAAF, Narayanan A Sodium hypochlorite accidents in dentistry. A systematic review of published case reports. Stomatologija. 2020; 22:17-22
Spencer HR, Ike V, Brennan PA Review: the use of sodium hypochlorite in endodontics–potential complications and their management. Br Dent J. 2007; 202:555-559 https://doi.org/10.1038/bdj.2007.374
Kleier DJ, Averbach RE, Mehdipour O The sodium hypochlorite accident: experience of diplomates of the American Board of Endodontics. J Endod. 2008; 34:1346-1350 https://doi.org/10.1016/j.joen.2008.07.021
Becking AG Complications in the use of sodium hypochlorite during endodontic treatment. Report of three cases. Oral Surg Oral Med Oral Pathol. 1991; 71:346-348 https://doi.org/10.1016/0030-4220(91)90313-2
Motta MV, Chaves-Mendonca MA, Stirton CG, Cardozo HF Accidental injection with sodium hypochlorite: report of a case. Int Endod J. 2009; 42:175-182 https://doi.org/10.1111/j.1365-2591.2008.01493.x
Witton R, Brennan PA Severe tissue damage and neurological deficit following extravasation of sodium hypochlorite solution during routine endodontic treatment. Br Dent J. 2005; 198:749-750 https://doi.org/10.1038/sj.bdj.4812414
Vianna ME, Gomes BP, Berber VB In vitro evaluation of the antimicrobial activity of chlorhexidine and sodium hypochlorite. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2004; 97:79-84 https://doi.org/10.1016/s1079-2104(03)00360-3
Jeansonne MJ, White RR A comparison of 2.0% chlorhexidine gluconate and 5.25% sodium hypochlorite as antimicrobial endodontic irrigants. J Endod. 1994; 20:276-278 https://doi.org/10.1016/s0099-2399(06)80815-0
Emergency multidisciplinary management of a sodium hypochlorite injury in an adolescent: Case Report Mira Shah M Lawrence Kathleen Fan Dental Update 2025 52:1, 707-709.
Authors
MiraShah
BEng (Hons), BDS, MFDS RCS (Ed)
BEng (Hons), BDS, MFDS RCS (Ed), Specialist Trainee in Periodontology, King's College London
This case report describes the multidisciplinary team (MDT) management of a severe sodium hypochlorite (NaOCl) injury in a 16-year-old male caused by NaOCl extrusion during emergency extirpation of the UL2 without the use of a dental dam. Ophthalmology, oral and maxillofacial surgery (OMFS) and acute dental input were required to manage this patient during their 72-hour inpatient hospital admission. Plain film and CT imaging were used to assess the degree of NaOCl infiltration and guide treatment. Serial dilution using sterile saline irrigation intra-orally and extra-orally of the left eye was required to reduce the cytotoxicity of NaOCl.
CPD/Clinical Relevance: Clinicians should be aware of the potentially hazardous complications of NaOCl incidents, their clinical presentation and the importance of early recognition and management by an appropriate MDT.
Article
The COVID-19 pandemic heavily disrupted access to routine dental examinations and treatment. This resulted in a backlog in NHS routine dental services, increasing the prevalence of untreated dental diseases in the UK population. Dental caries, if untreated, can infiltrate deep into the pulp of a tooth resulting in acute pain and pulpal infection/inflammation. Such cases may require emergency extirpation treatment,1 commonly with the use of sodium hypochlorite (NaOCl) as the endodontic irrigant. This case report describes the multidisciplinary team (MDT) management of an NaOCl injury, a complication of extirpation treatment.
A 16-year-old male, otherwise fit and well with an allergy to penicillin, was referred to the oral and maxillofacial surgical (OMFS) on-call team by the emergency department of a different hospital 36 hours following extirpation of his upper left second incisor (UL2). The cause of the pre-existing lesion of the UL2 is unknown, but is likely to have been due to dental trauma. The patient attended hospital in pain with significant left-sided facial swelling, extra-oral ecchymosis, peri-orbital oedema and intra-oral ulceration. Prior to treatment the patient had been experiencing significant pain from the causative tooth for several months. Extirpation was performed by an emergency private dentist, using sodium hypochlorite as an irrigant, without the use of dental dam. Immediately following the procedure, the patient reported pain and intra-oral ulceration, with progressive facial swelling occurring the following morning. The patient had contacted the dental practitioner, but was unable to be reviewed by a dentist for a further week, owing to a lack of available appointments.
Register now to continue reading
Thank you for visiting Dental Update and reading some of our resources. To read more, please register today. You’ll enjoy the following great benefits:
