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John Neiberger
medicine forum beginner
Joined: 03 Jun 2006
Posts: 5
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 Posted: Sat Jun 03, 2006 9:46 pm Post subject:
Sodium hypochlorite, root canals, and bad sinuses
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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 sheet, 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 |
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Steven Bornfeld
medicine forum Guru
Joined: 28 Apr 2005
Posts: 492
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| Posted: Sun Jun 04, 2006 3:08 am Post subject:
Re: Sodium hypochlorite, root canals, and bad sinuses
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John Neiberger wrote:
| Quote: | 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 sheet, 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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John Neiberger
medicine forum beginner
Joined: 03 Jun 2006
Posts: 5
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| Posted: Sun Jun 04, 2006 4:22 am Post subject:
Re: Sodium hypochlorite, root canals, and bad sinuses
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| Quote: | 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.
|
That may well be true, but I lived through this rather uncomfortable
experience. It was not pleasant to sit in that chair while this guy
squirted fluids up into my sinuses through a hole in my gums and jaw.
| Quote: | 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.
|
Again, that may be true, but this tasted and smelled exactly like he'd
squirted clorox bleach into my sinuses. It never occurred to me that it
might actually have been sodium hypochlorite until yesterday when I
found out that it had a legitimate use in that sort of procedure.
| Quote: | 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.
|
It was pretty darn uncomfortable, I must say. It did burn and was quite
irritating. As soon as I mentioned it he put the "turkey baster" down
and started rinsing my sinuses quite thoroughly with water.
| Quote: | 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.
|
I'll defer to your experience. What else might be in an endodontist's
office that tastes and smells exactly like clorox bleach?
| Quote: | 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
|
That's been my assumption this entire time. We did every X-ray we could
think of and no one could ever find it. As I said before, he did
X-rays, my dentist did some, an oral surgeon did a panoramic X-ray, and
my doctor even did some. No one could find anything that looked like a
root tip in my sinuses. Knowing my luck, it actually is still in there
but hidden.
I've been meaning to see an ENT anyway about the constant congestion.
Maybe this would be a good opportunity to do some more exploration into
this matter and see if we can find something up there that shouldn't be
there.
Thanks,
John |
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Steven Bornfeld
medicine forum Guru
Joined: 28 Apr 2005
Posts: 492
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| Posted: Sun Jun 04, 2006 7:50 pm Post subject:
Re: Sodium hypochlorite, root canals, and bad sinuses
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John Neiberger wrote:
| Quote: | 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.
That may well be true, but I lived through this rather uncomfortable
experience. It was not pleasant to sit in that chair while this guy
squirted fluids up into my sinuses through a hole in my gums and jaw.
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.
Again, that may be true, but this tasted and smelled exactly like he'd
squirted clorox bleach into my sinuses. It never occurred to me that it
might actually have been sodium hypochlorite until yesterday when I
found out that it had a legitimate use in that sort of procedure.
|
Let me be clear--this is NOT a legitimate use of sodium hypochlorite
solution. What you may have smelled I don't know--sodium hypochlorite
is a commonly used surface disinfectant by some dentists, and the
instruments/syringes etc. may have had a residual odor. I can only
speculate.
Sodium hypochlorite solution should ONLY be used within the root canal
or pulp chamber--nowhere near soft tissues and certainly not near the sinus.
| Quote: |
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.
It was pretty darn uncomfortable, I must say. It did burn and was quite
irritating. As soon as I mentioned it he put the "turkey baster" down
and started rinsing my sinuses quite thoroughly with water.
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.
I'll defer to your experience. What else might be in an endodontist's
office that tastes and smells exactly like clorox bleach?
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
That's been my assumption this entire time. We did every X-ray we could
think of and no one could ever find it. As I said before, he did
X-rays, my dentist did some, an oral surgeon did a panoramic X-ray, and
my doctor even did some. No one could find anything that looked like a
root tip in my sinuses. Knowing my luck, it actually is still in there
but hidden.
I've been meaning to see an ENT anyway about the constant congestion.
Maybe this would be a good opportunity to do some more exploration into
this matter and see if we can find something up there that shouldn't be
there.
|
I agree.
Steve
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John Neiberger
medicine forum beginner
Joined: 03 Jun 2006
Posts: 5
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| Posted: Sun Jun 04, 2006 8:16 pm Post subject:
Re: Sodium hypochlorite, root canals, and bad sinuses
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| Quote: | Let me be clear--this is NOT a legitimate use of sodium hypochlorite
solution. What you may have smelled I don't know--sodium hypochlorite
is a commonly used surface disinfectant by some dentists, and the
instruments/syringes etc. may have had a residual odor. I can only
speculate.
Sodium hypochlorite solution should ONLY be used within the root canal
or pulp chamber--nowhere near soft tissues and certainly not near the sinus.
|
I'm sure you're right. I probably was only smelling and tasting
something residual, but it sure seemed like more than that at the time.
I just know that my sinuses, especially on that side, have never been
the same. However, they were probably just irritated by the procedure,
not by any significant amount of chemical being washed into them.
Thanks for your help!
John |
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Alexander Vasserman DDS
medicine forum Guru Wannabe
Joined: 06 May 2005
Posts: 204
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| Posted: Sun Jun 04, 2006 10:39 pm Post subject:
Re: Sodium hypochlorite, root canals, and bad sinuses
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Some periodontists such as J. Slotts at USC recommend rinsing with
bleach to control periodontal disease.
Unless this bleach came out of your nostril, the sinus can not have
been involved in the apicoectomy surgery.
Root tips often get sucked up without noticing it. If the x-rays did
not show it then the root tip is not inside you. Nobody I know does a
an apicoectomy through the sinus cavity.
If there was an inadvertant brief irrigation of bleach in the surgical
site, there would not be any lasting damage. On the other hand if the
bleach was left there for 1min or more then you could get
complications.
John Neiberger wrote:
| Quote: | Let me be clear--this is NOT a legitimate use of sodium hypochlorite
solution. What you may have smelled I don't know--sodium hypochlorite
is a commonly used surface disinfectant by some dentists, and the
instruments/syringes etc. may have had a residual odor. I can only
speculate.
Sodium hypochlorite solution should ONLY be used within the root canal
or pulp chamber--nowhere near soft tissues and certainly not near the sinus.
I'm sure you're right. I probably was only smelling and tasting
something residual, but it sure seemed like more than that at the time.
I just know that my sinuses, especially on that side, have never been
the same. However, they were probably just irritated by the procedure,
not by any significant amount of chemical being washed into them.
Thanks for your help!
John |
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John Neiberger
medicine forum beginner
Joined: 03 Jun 2006
Posts: 5
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| Posted: Sun Jun 04, 2006 11:27 pm Post subject:
Re: Sodium hypochlorite, root canals, and bad sinuses
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| Quote: | Unless this bleach came out of your nostril, the sinus can not have
been involved in the apicoectomy surgery.
|
The bleach--or whatever it was--did not come out of my nostril. I was
lying on my back in the chair and the specialist was squirting fluids
into my sinus through a hole in my maxilla. He drilled through the side
of my upper jaw to do the apicoectomy and it was into that hole that he
squirting fluids.
The fluids were washing through my sinuses and into my throat. The
nostrils were never involved. There had to be a hole from my upper jaw
into my sinuses for two reasons: (1) The specialist was worried that
the root tip fell into my sinus, hence all the X-rays, and (2) he
rinsed my sinuses quite thoroughly by squirting fluids through my
maxilla right into the sinus, which would have been difficult had there
been no opening. :-)
To make matters more interesting, I tend to have recurring sinus
infections that seem to reside primarily in my maxillary sinus. I have
no idea if one of the complications from an apicoectomy is sinusitis or
increased risk of sinus infections, though. One probably has nothing to
do with the other, but that's why I'm asking.
Thanks!
John |
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Alexander Vasserman DDS
medicine forum Guru Wannabe
Joined: 06 May 2005
Posts: 204
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| Posted: Mon Jun 05, 2006 6:10 am Post subject:
Re: Sodium hypochlorite, root canals, and bad sinuses
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Sounds like a typical apical surgery procedure.
Nobody drills a hole from the side into the sinus for apicoectomy. The
sinus is much above where they need to the drill that hole hence the
sinus is not involved.
The hole they drill is a window which exposes the root tip and
surrounding granulation (puss infected) tissue it is not in the sinus.
You may have been told of the sinus being involved as a complication
during the procedure, but from what you told me so far, that fluid was
nowhere near your sinus. If the sinus membrane was damaged through
perforation that window would still be there and even now if you drank
something it would drain from your nose.
It could have been some bleach/ hydrogen peroxide or chlorhexidine that
was used to help kill the surrounding tissue and minimize amount of
bacteria there for better healing but again a quick rinse of bleach is
not going to cause irreversable damage.
If you are having problems with your sinus you should have that
examined but from what you told us the apicoectomy did not trade an
infected tooth problem due to failing root canal for a sinus problem.
John Neiberger wrote:
| Quote: | Unless this bleach came out of your nostril, the sinus can not have
been involved in the apicoectomy surgery.
The bleach--or whatever it was--did not come out of my nostril. I was
lying on my back in the chair and the specialist was squirting fluids
into my sinus through a hole in my maxilla. He drilled through the side
of my upper jaw to do the apicoectomy and it was into that hole that he
squirting fluids.
The fluids were washing through my sinuses and into my throat. The
nostrils were never involved. There had to be a hole from my upper jaw
into my sinuses for two reasons: (1) The specialist was worried that
the root tip fell into my sinus, hence all the X-rays, and (2) he
rinsed my sinuses quite thoroughly by squirting fluids through my
maxilla right into the sinus, which would have been difficult had there
been no opening. :-)
To make matters more interesting, I tend to have recurring sinus
infections that seem to reside primarily in my maxillary sinus. I have
no idea if one of the complications from an apicoectomy is sinusitis or
increased risk of sinus infections, though. One probably has nothing to
do with the other, but that's why I'm asking.
Thanks!
John |
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Steven Bornfeld
medicine forum Guru
Joined: 28 Apr 2005
Posts: 492
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| Posted: Mon Jun 05, 2006 1:02 pm Post subject:
Re: Sodium hypochlorite, root canals, and bad sinuses
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Alexander Vasserman DDS wrote:
| Quote: | Sounds like a typical apical surgery procedure.
Nobody drills a hole from the side into the sinus for apicoectomy.
|
Not deliberately, in any case. But an oral surgeon recently refused to
do an apico on my wife's #14 on the grounds that he was concerned there
could be sinus involvement as a result. The tooth was later extracted
(fortunately, there was no detectable entry into the sinus.
Steve
The
| Quote: | sinus is much above where they need to the drill that hole hence the
sinus is not involved.
The hole they drill is a window which exposes the root tip and
surrounding granulation (puss infected) tissue it is not in the sinus.
You may have been told of the sinus being involved as a complication
during the procedure, but from what you told me so far, that fluid was
nowhere near your sinus. If the sinus membrane was damaged through
perforation that window would still be there and even now if you drank
something it would drain from your nose.
It could have been some bleach/ hydrogen peroxide or chlorhexidine that
was used to help kill the surrounding tissue and minimize amount of
bacteria there for better healing but again a quick rinse of bleach is
not going to cause irreversable damage.
If you are having problems with your sinus you should have that
examined but from what you told us the apicoectomy did not trade an
infected tooth problem due to failing root canal for a sinus problem.
John Neiberger wrote:
Unless this bleach came out of your nostril, the sinus can not have
been involved in the apicoectomy surgery.
The bleach--or whatever it was--did not come out of my nostril. I was
lying on my back in the chair and the specialist was squirting fluids
into my sinus through a hole in my maxilla. He drilled through the side
of my upper jaw to do the apicoectomy and it was into that hole that he
squirting fluids.
The fluids were washing through my sinuses and into my throat. The
nostrils were never involved. There had to be a hole from my upper jaw
into my sinuses for two reasons: (1) The specialist was worried that
the root tip fell into my sinus, hence all the X-rays, and (2) he
rinsed my sinuses quite thoroughly by squirting fluids through my
maxilla right into the sinus, which would have been difficult had there
been no opening. :-)
To make matters more interesting, I tend to have recurring sinus
infections that seem to reside primarily in my maxillary sinus. I have
no idea if one of the complications from an apicoectomy is sinusitis or
increased risk of sinus infections, though. One probably has nothing to
do with the other, but that's why I'm asking.
Thanks!
John
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John Neiberger
medicine forum beginner
Joined: 03 Jun 2006
Posts: 5
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| Posted: Tue Jun 06, 2006 4:36 am Post subject:
Re: Sodium hypochlorite, root canals, and bad sinuses
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Alexander Vasserman DDS wrote:
| Quote: | Sounds like a typical apical surgery procedure.
Nobody drills a hole from the side into the sinus for apicoectomy. The
sinus is much above where they need to the drill that hole hence the
sinus is not involved.
The hole they drill is a window which exposes the root tip and
surrounding granulation (puss infected) tissue it is not in the sinus.
You may have been told of the sinus being involved as a complication
during the procedure, but from what you told me so far, that fluid was
nowhere near your sinus.
|
I don't know how to be more clear about what happened. Regardless of
the actual location of the hole, it was the hole into which the spray
implement (whatever you call it) was placed. Water went into the hole
and up into my maxillary sinus. The specialist did this specifically
because he thought the root tip had fallen into the sinus. If there was
no hole into the sinus, that would have been rather silly of him to
worry over, don't you think?
It's a fairly unique sensation to have cold water squirted through the
gums and into the sinuses. I'm quite certain that this was what was
happening. I doubt that the hole itself led directly into the sinus,
but I'm 100% certain the sinus was perforated in some fashion. There
simply is no doubt in my mind. Even if this is an abnormal outcome of
this sort of procedure, it is in fact what happened. |
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