Expert: Frederick R. Liewehr DDS, MS, FICD - 11/9/2008

Question
My dentist is working on a root canal,  He could not finish because I started to bleed.  He asked me to come back that same afternoon and he tried once more to finish the procedure.  One he began he started to clean the tooth out with the liquid the is injected into the tooth and imeediately my face swelled up like a ballon. He said he could not continue until it stops bleeding and the swelling went away.  This was on Thursday, today Saturday another specialist wanted to see me.  He tried to clean the tooth a bit more and put some sort of medicine in the tooth.  He all gave me a stronger antibiotic.  I am very concerend about the swelling it is very painful and in the past 3 days its has gone done very little.  Is this normal?  Is there anything i should be doing? Warm/Cold compress?

Answer
What you experienced, Vicky, was a sodium hypochlorite accident. This happens when the bleach goes through the hollow root(s) of the tooth and into the bone beyond. It is a very painful condition and there is not a lot that can be done about it. It is not a bacterial infection, so there is really no need for antibiotics. Sodium hypochlorite is a very toxic substance, that dissolves tissue. Touch a little with your fingers - you will feel them getting slippery. That slipperiness is not because the sodium hypochlorite is oily, it is because it is dissolving your skin. So, you can imagine what it does to your bone.

    I have lectured for years and years to countless dental audiences that they should stop using sodium hypochlorite, but few listen. Most believe (mistakenly in my opinion) that they need it to "sterilize" the root canal. If it really did that, it might be worth the risk, but it doesn't. Nevertheless, it is used by the vast majority of endodontists, so from the point of view of the majority of folks, your dentist was not wrong in using it. I personally would disagree, and I am sure you would, too.

    As for your symptoms, as I said, there is nothing but palliative care, i.e. pain medication and so forth that can be done. Warm compresses might make you feel a little better. You will heal in time; it usually takes about two weeks. Any further treatment will cause more harm than good, just adding insult to injury. The problem is the damage that the bleach did; you just have to wait until you heal.