Caries, pulp and periodontal disease: sodium hypochlorite accident: practice question

A Dentistry question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

Try it

Dentistry · Caries, pulp and periodontal disease: sodium hypochlorite accident

Sample item

During irrigation of a maxillary premolar with sodium hypochlorite, the patient suddenly complains of severe pain, rapid facial swelling and bruising. Bleeding comes from the canal. What has most likely occurred?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Extrusion of hypochlorite beyond the apex into the periapical tissues

Forcing hypochlorite through the apex causes chemical tissue injury with immediate severe pain, swelling, ecchymosis and haemorrhage. The irrigant should be stopped, the canal rinsed, analgesia given and the patient observed. Needle binding and excess pressure are the main causes.

Option by option

  • A. Anaphylaxis to latex

    Latex allergy gives urticaria or wheeze and not localised bruising with bleeding from the canal.

  • B. Extrusion of hypochlorite beyond the apex into the periapical tissues (correct)

    Correct. Rapid swelling with bruising and pain after irrigation indicates apical extrusion.

  • C. Vasovagal syncope

    Syncope causes pallor and faintness without local swelling.

  • D. Inferior alveolar nerve injury

    Nerve injury causes numbness and not swelling with bruising.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More Dentistry questions

Questions about this Dentistry question

What is the answer to this Dentistry question?

The best answer is B, Extrusion of hypochlorite beyond the apex into the periapical tissues. Forcing hypochlorite through the apex causes chemical tissue injury with immediate severe pain, swelling, ecchymosis and haemorrhage.

Why is "Anaphylaxis to latex" not the answer?

Latex allergy gives urticaria or wheeze and not localised bruising with bleeding from the canal.

Why is "Vasovagal syncope" not the answer?

Syncope causes pallor and faintness without local swelling.

Why is "Inferior alveolar nerve injury" not the answer?

Nerve injury causes numbness and not swelling with bruising.

What concept does this question test?

It tests Caries, pulp and periodontal disease: sodium hypochlorite accident in Dentistry. The irrigant should be stopped, the canal rinsed, analgesia given and the patient observed. Needle binding and excess pressure are the main causes.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Caries, pulp and periodontal disease: sodium hypochlorite accident?

Learn the dental formula, eruption ages and tooth structure once, as tables. Then use the flashcards and the other Dentistry questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.