Momma Volcano: Sodium Hypochlorite Accident

Sounds serious, doesn't it?

And, I suppose, it is, a little. At least, the reactions of the dentist and his assistants seemed to lend credence to the seriousness of the situation.

But I seem to be starting on the wrong end of the story. The story really begins with me, peacefully reclining in the dentist chair, passively enjoying a root canal. (In other words, I was cringing on the chair, trying to relax enough to make it through.) The roots in the tooth (#4, for anyone caring) were extra convoluted, and it took a good hour to get it all clean.

Now, I've had many many many root canals in my life, but I've never cared to know exactly what was happening. The experience itself was bad enough. But I gather that they go in, use little needles and picks to remove all the root material, and then pack it with good sterile stuff and put cement and things on and around it. It makes sense that, during the needle/pick part (shudder), they need to rinse out the root to get rid of everything. One of the rinse agents is a caustic chemical called sodium hypochlorite, or NaOCl. This stuff is nasty, but very good at dissolving any root material and biologic junk left. The use of NaOCl has allowed root canals to have excellent success rates.

Rare (very rarely, if the reaction of the dentist and google results indicate), NaOCl makes its way into the soft tissues above the tooth. When this happens, excruciating pain for 2-5 minutes, immediate, prolonged severe swelling, and subsequent bruising and temporary (I hope) nerve damage follow.

Doesn't it sound FUN?

I am a lucky one, because, strangely, I missed out on the excruciating pain. (Whew!) Near the end of the root canal process, I felt a rapid, but gentle, pushing sensation travel up my cheek and begin nudging my lower eyelid. It felt almost as if the dentist was resting his finger on my cheek. About a minute later, he removed his hands from my mouth and called for another X-ray, to make sure the root was cleaned. I took off my glasses and gestured at my eye, making a guttural sound.

The dentist looked at me and nearly jumped. "You are swelling! When did that start??"

I took the bite guard out and told him less than two minutes. In the meantime, he was calling for a ice pack, asking me if he could administer benedryl, asking if I was having any throat swelling, and rapidly doing all sorts of things. The ice pack went over my suddenly puffy and slightly shut eye--the rest of the cheek puffed up a moment later--the benedryl shot went in my upper arm, and the dental assistant gave me a massive ibuprofen pill.

"Are you in any pain at all?" Dr. H. asked.

"Nope," I answered thickly, around the numb mouth and puffy cheek and ice pack.

"I have NEVER seen anyone swell up like that, and I've been doing root canals for ten years! But I do know what happened--I was just reading about it in a journal last week, and thinking that I'd never had a patient experience that. It's called a sodium hypochlorite accident."

Dr. H then called his friend, a very experienced endodontist, and described the problem. When he got off the phone, he explained the situation to me, and told me what our next steps are. First, we couldn't finish the root canal, because of the swelling and the bleeding under the skin and all. So I have a temporary cap right now. Second, I am on a massive dose of prednisone (a steroid that has an unfortunate side effect in some people of extreme crabbiness--yeah, yeah, I know, how will they tell?) and a regular dose of antibiotics. Third, I am supposed to keep icing it. Fourth, Dr. H. would like me to send pictures of my face to him tonight and tomorrow.

The prednisone is for the swelling, the antibiotics (according to Dr. Google) are because some of my soft tissue IS NOW DEAD and could possibly become infected. Ugh. I could have done without reading the phrase "grossly necrotic tissue" in relation to MYSELF.

So. Now one side of my face is swollen, but strangely not very painful. It's more irritating, because it obstruction my vision and makes it hard to eat. It feels...tight. And a little tingly. Unfortunately, unless you know me well, it just looks like I gained a ton of weight (on one side of my face, ha) or I am retaining water. Lovely. I don't know if I'll bruise, but the pictures on Google aren't very promising.

And we're going out of town on Saturday, and visiting my sister's church, too! I'll just tell everyone I walked into a door. :)

The best part? There are two: One, my root canal tooth stopped hurting, what with the removal of the root and all; and Two, my friend A. dropped off dinner for us. Score! Maybe I'll arrange these little accidents more often!