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Supporting Your Practice

How Do You Recognize and Manage a Sodium Hypochlorite Accident?

Dr. Jackie Lopez-Gross
Endodontist, London ON

A sodium hypochlorite accident during root canal  treatment may be a rare occurrence, but statistics show that it will happen to many clinicians at least once in their careers. In this edition of CDA Oasis Live, Dr. John O’Keefe invites Dr. Jackie Lopez-Gross, an endodontist from London ON, to discuss the recognition and management of a sodium hypochlorite accident.

“Although it is a rare event, it will happen to many clinicians at least once in their lifetime. It is important to be ready for it, which is why recognition is important for proper diagnosis and treatment.”


Reflecting on her own professional experience, Dr. Lopez-Gross walks through the clinical, legal and emotional management of this type of event using a case study from her own practice.

Here are the key takeaways…

RECOGNITION

  • Sudden Pain
  • Burning Sensation
  • Profuse bleeding from the canal
  • Swelling and ecchymosis (can be immediate or hours days after the accident)

CLINICAL MANAGEMENT

  • Irrigate with saline solution/anesthetic solution
  • Local anesthesia to manage pain
  • Cold compresses for first 24 hours and then change to warm compresses
  • Prescribe analgesics and antibiotics
  • Consider prescribing a steroid
  • Monitor patient closely
  • Advise patient to go to hospital if symptoms get worse

LEGAL MANAGEMENT

  • Proper record keeping
  • Contact PLP (your indemnifier) and report the event
  • Contact the referring doctor if applicable

EMOTIONAL MANAGEMENT

  • Be empathetic with the patient
  • Be kind to yourself
  • Learn from your mistakes
  • Share your experience with colleagues

We hope you find the conversation useful. We welcome your thoughts, questions and/or suggestions about this post and other topics. Leave a comment in the box below or send us your feedback by email.

Until next time!
CDA Oasis Team

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