NaOCl Accident — NDEB AFK MCQ
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Correct answer: D — Immediate severe pain, rapid swelling, ecchymosis, and possible paraesthesia
NaOCl extrusion beyond the apex causes immediate severe pain (out of proportion to the procedure), rapid tissue swelling (oedema and haemorrhage), ecchymosis (bruising) of overlying skin/mucosa, possible haemorrhage from the canal, and occasionally paraesthesia if the nerve is involved. It is a chemical burn caused by the oxidising and proteolytic properties of NaOCl. Management includes analgesia, antibiotics, corticosteroids, warm compresses, and monitoring. Most cases resolve within weeks but can cause permanent nerve damage.
Reference: Torabinejad – Endodontics: Principles and Practice, 6th ed., 2021