Sodium hypochlorite (NaOCl) is a very strong irrigation solution (medical bleach) used in root canal treatment to dissolve bacteria and organic tissue inside the canals. If the root apex is very wide, if there is a hidden crack in the root, or if the irrigation needle gets stuck in the canal and the solution is sprayed under high pressure, NaOCl can leak out of the root apex and spurt directly into the jawbone and surrounding soft tissues; this is called “sodium hypochlorite leakage”. Severe chemical burns and necrosis begin immediately in the tissues. The patient lets out a sudden, terrifying scream of pain, their face swells up like a balloon within seconds, and bleeding (ecchymosis) begins under the skin. In emergency management, the canal is immediately rinsed with saline to dilute the solution, the patient is given high doses of cortisone and analgesics, ice compresses are started, and the patient is closely monitored under antibiotic pressure to prevent tissue necrosis and secondary infection.
