Re: Sodium hypochlorite, root canals, and bad sinuses



John Neiberger wrote:
A little over tens years ago, I went to a dentist for a root canal on
an upper molar. She broke a file off in the tooth and recommended that
I see an endodontist, which I did. The endodontist performed an apico
and then finished up whatever work was left to complete on the root
canal.

During the apico, the endodontist cut the tip off of the root of my
molar. He then grabbed the little suction straw to draw away some
fluids. When he was done, the root tip was gone and he didn't know
where it went. He felt that it was too big to fit into the suction
straw and he thought that it might have fallen into my sinus.

In an attempt to flush it out, assuming that's where it went, he
grabbed something that resembled a turkey baster and started squirting
a fluid directly into my sinuses through the hole in the root. This was
a horribly foul tasting fluid and I commented at the time that it
tasted like bleach. He said, and I quote, "Hmm...that's weird." Then he
put the turkey baster away and grabbed the tool that sprays both air
and water, and he started flushing out my sinuses with water. He didn't
ever say another word about the other fluid.

We never did find the root tip. I had regular dental x-rays done, as
well as a panoramic x-ray at an oral surgery office and a regular
medical x-ray at my doctor's office. No luck, so we just assumed that
it had actually been suctioned up.

I have always had allergies and sinus problems but they seemed to get
dramatically worse after this ordeal, particularly on the same side as
the apico. Just last night, purely by accident, I stumbled across a
link to a page about bleach (sodium hypochlorite). According to that
information ***, sodium hypochlorite is used during root canals to
disinfect the canal and to dissolve any remaining pulp. So, now I'm
thinking that that fluid tasted like bleach because it *was* bleach!

If he happened to be using a strong solution, let's say 5% or so, is it
possible that he damaged my sinuses by initially flushing them with
bleach? Or, do you think that is dilute enough that it probably didn't
have any lasting effect?

My sinuses are always congested and, as I mentioned, this worsened
after the visit to the endodontist. I've only had a little luck with
the usual remedies like nasal steroid sprays. If I could trace at least
a portion of my problem back to damage from the sodium hypochlorite
then perhaps we could treat it differently and have different results.

What do you think?

Regards,
John



I think it would be a rare endodontist that would attempt an apicoectomy where there is a likelihood the sinus would be involved. It is possible an oral surgeon might if the tooth was considered important enough to risk it.
Yes, sodium hypochlorite is used within the root canal system as an irrigant. It would be an exceptional error to use this to irrigate an apicoectomy, and I find it difficult to believe this error could be made by a conscious surgeon, let alone a conscientious one. Furthermore, using a sodium hypochlorite solution in the sinus wouldn't merely result in a "worsening" of a pre-existing sinus condition. It would create an immediate emergency, with extensive burning and tissue damage. In fact, merely forcing a bit out the tip of the root can cause major problems. I think the chances that this happened are slim.
HOWEVER--it is not out of the question that the surgery itself, if it did in fact involve the sinus, could have exacerbated any sinus problems, esp. if there was a root fragment that was never recovered.

Steve

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