Arjun Hegde, Preethesh Shetty, Raksha Bhat. Insight on the Use and Abuse of Sodium Hypochlorite in Endodontics: A Review. Int J Dentistry Oral Sci. 2021;8(8):4028-4031. 4028 OPEN ACCESS https://scidoc.org/IJDOS.php Insight on the Use and Abuse of Sodium Hypochlorite in Endodontics: A Review Review Article International Journal of Dentistry and Oral Science (IJDOS) ISSN: 2377-8075 *Corresponding Author: Raksha Bhat, Lecturer, Nitte (Deemed to be University), AB Shetty Memorial Institute Of Dental Sciences(ABSMIDS), Department of Conservative Dentistry and Endodontics, Mangalore, Karnataka, India - 575018. E-mail: rkshabhat@gmail.com Received: May 22, 2021 Accepted: August 11, 2021 Published: August 19, 2021 Citation: Arjun Hegde, Preethesh Shetty, Raksha Bhat. Insight on the Use and Abuse of Sodium Hypochlorite in Endodontics: A Review. Int J Dentistry Oral Sci. 2021;8(8):4028-4031. doi: http://dx.doi.org/10.19070/2377-8075-21000822 Copyright: Raksha Bhat © 2021. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribu- tion and reproduction in any medium, provided the original author and source are credited. Arjun Hegde 1 , Preethesh Shetty 2 , Raksha Bhat 3* 1 Assistant Professor, Manipal Academy of Higher Education, Melaka Manipal Medical College, Manipal, Karnataka, India - 576104. 2 Lecturer, Nitte (Deemed to be University), AB Shetty Memorial Institute Of Dental Sciences(ABSMIDS), Department of Conservative Dentistry and Endodontics, Mangalore, Karnataka, India - 575018. 3 Lecturer, Nitte (Deemed to be University), AB Shetty Memorial Institute Of Dental Sciences(ABSMIDS), Department of Conservative Dentistry and Endodontics, Mangalore, , Karnataka, India - 575018. Introduction Irrigants perform both biological and physical roles during en- dodontic treatments. An irrigant ideally provides a mechani- cal fushing action and dissolve the remnants of organic tissues without damaging the periradicular tissues if extruded into the periodontium. Irrigation plays the main role in eradication of mi- crobes from the root canal system [1]. Untoward incidents with irrigating solutions such as sulfuric acid, hydrogen peroxide, and sodium hypochlorite have been reported previously [2]. The an- tibacterial properties, tissue dissolution and canal lubrication of sodium hypochlorite (NaOCl) make it the most commonly used irrigating solution in endodontics. Clinically, various concentra- tions of NaOCl (0.5,1,2.6 and 5.25 %) have been used in root canal therapy. Careful mechanical cleansing and irrigation are usu- ally suffcient to eliminate root canal infection. Spangberg et al reported that high concentration of NaOCl is very toxic. They recommended diluting the solution to 1% to keep its antibacterial property at the lowest toxic level [3]. Sodium hypochlorite has been used for many years and its tissue dissolution, antibacterial, and lubricating properties have been well described and investi- gated [4]. This article reviews potential complications and the se- quence of events that occurs while using sodium hypochlorite in clinical practice, discusses measures to be taken in order to mini- mize risks and provides details for appropriate management in case of suspected tissue damage. Properties Irrigating solutions are used in root canal treatment for the re- moval of the infected tissue which may still be present especially in the accessory canals [5]. Hypochlorites are the most frequently used root canal irrigants since their introduction as a successful root canal irrigant in 1936 by Walker. Hypochlorites include so- dium hypochlorite and natrium hypochlorite. Hypochlorite have a proteolytic effect [6]. Another important advantage which makes the use of NaOCl justifable is the absence of clinical toxicity Abstract The present article aims to provide the dental practitioner a review about the properties of sodium hypochlorite, its mecha- nism of action, antibacterial effciency, its toxicity, complications along with the sequence of events, prevention and also con- siders the appropriate management while facing a potentially adverse incident with the agent. The main objective of root canal treatment is to disinfect the root canal system which requires the elimination of the sources of infection and pulpal contents utilizing mechanical instrumentation, chemical irrigants with simultaneous use of intracanal medicaments. However, extrusion of these irrigants beyond and into the surrounding tissues always remains a risk factor which can pose some drastic complica- tions. The present article discusses the use of sodium hypochlorite with its inadvertent effects. Avoiding complications of sodium hypochlorite with the use of specialized needles, avoiding excessive pressure, not wedging the needle tip in the canal. Vitality for the patient's safety remains on early recognition and management of advertent effects of sodium hypochlorite. Keywords: Sodium Hypochlorite; Irrigants; Toxicity; Apical Extrusion; Disinfection.