Accidental injection of 2% chlorhexidine gluconate instead of an anesthetic agent: A case report

Abstract

We report a case where 2% chlorhexidine (CHX) gluconate was mistaken for an anesthetic solution and infiltrated into the buccal vestibule during routine root canal treatment. Accidentally, 2% CHX gluconate solution was injected in the right upper buccal vestibule (16) of a 23-year-old male during routine root canal treatment. The patient experienced pain and a burning sensation over the injected area shortly after injection. Swelling with mild extraoral redness over the right cheek area was observed clinically. The patient was immediately administered dexamethasone intramuscularly, and was prescribed antibiotics, analgesics, and antihistamines. The patient complained of a loss of sensation over the right cheek by the 15th day. The swelling reduced gradually over a period of 15 days. Reversal of sensation was attained after 35 days.

Dental Negligence: Accidental Administration of Formalin Instead of Local Anesthetic

“…Dental literature search shows articles on accidental injection of solutions like xylene, cholorohexidine, benzalkonium chloride, EDTA, sodium hypochlorite, formocresol, adrenalin, chloroform and even lighter fuel instead of local anesthetic agent. [5][6][7][8][9][10][11][12][13][14][15][16] The search also shows up to 9 articles on the accidental injection of formalin as an anesthetic agent during dental treatment procedures. [17][18][19][20][21][22][23][24][25] Formalin accidentally being used as an irrigant for rotary bur during bilateral surgical removal of 3 rd molar has also been documented.…”

Mucosal Fenestration After 2% Chlorhexidine Extrusion Used in Substitution of Sodium Hypochlorite: A Case Report

“…8 Besides, similar treatment was adopted in one case of accidental injection of 2% chlorhexidine gluconate instead of an anesthetic agent, which caused tissue necrosis. 19 Ideally, root canal irrigants should be highly toxic for microorganism cells but not toxic for human cells. However, this is a form of utopia for NaOCl and CHX.…”

“… 8 Besides, similar treatment was adopted in one case of accidental injection of 2% chlorhexidine gluconate instead of an anesthetic agent, which caused tissue necrosis. 19 …”

“…16,17 Additionally, some previous studies reported serious complications after accidental injection of CHX into soft tissues or blood vessels. [18][19][20] This report describes a case in which NaOCl was extruded through the apical foramen, causing acute pain and swelling. In the next session, CHX was used as alternative irrigant but produced an accident even more severe, with the occurrence of mucosal fenestration.…”

“… 16 17 Additionally, some previous studies reported serious complications after accidental injection of CHX into soft tissues or blood vessels. 18 19 20…”