I recently finished the 2nd stage of LL6 RCT to a patient, there was slight tear of rubber dam underneath the metal clamp, which resulted leaking of sodium hypochlorite solution through the rubber dam. I accidentally noticed it because it was blocked by the metal clamp, which made me difficult to detect.
I confirmed if pt noticed a bad taste, pt agreed, I stopped and adjusted the rubber dam position and rinsed pt mouth with 3 in 1 tip to ensure no more bad taste. I confirmed rubber dam leaking by placing some extra water creating a water puddle over rubber dam to confirm good seal before continue finishing rct. Upon hindsight after seeing the pt post operative pictures the next day, it probably at that time the hypochlorite had been in contact with the mucosa for a long time and resulted ulcer over lateral surface of tongue of left hand side and upper palate, which had resulted difficulty swallowing and pain to pt for the next few days. we recommended pt to A&E and GP asap to assess and advised painkiller and difflam, Pt reported a few days severe pain and difficulty swallowing but started to get slight better yesterday.
I am still surprised to see some ulcer on the tongue and hard palate, as in the past I have had similar situations and the pt did not report any ulcer or pain afterwards even having with exposed to leaked hypochlorite for a while. Not sure if it is due to different people reacting to hypochlorite exposure differently ? I probably should have asked pt to rinse mouth with cups of water in the future should similar leakage occurred