Stojicic S, Zivkovic S, Qian W, Zhang H, Haapasalo M . Tissue dissolution by sodium hypochlorite: effect of concentration, temperature, agitation, and surfactant. J Endod 2010; 36: 1558–1562. Haapasalo M, Qian W, Shen Y . Irrigation: beyond the smear layer. Endodontic Topics 2012; 27: 35–53. A beautiful smile with sparkling white teeth is something we all wish for. Boots has a wide variety of gels, toothpastes for whiter teeth and mouthwashes which aim to restore your teeth’s natural whiteness. From kits by Rapid White to whitening treatments by Blanx, there’s something for every budget. Gu L S, Kim J R, Ling J, Choi K K, Pashley D H, Tay F R . Review of contemporary irrigant agitation techniques and devices. J Endod 2009; 35: 791–804.

Basrani B R, Manek S, Sodhi R N, Fillery E, Manzur A . Interaction between sodium hypochlorite and chlorhexidine gluconate. J Endod 2007; 33: 966–969. Baumgartner J C, Brown C M, Mader C L, Peters D D, Shulman J D . A scanning electron microscopic evaluation of root canal debridement using saline, sodium hypochlorite, and citric acid. J Endod 1984; 10: 525–531.

How Do You Use A Wisdom Teeth Syringe Hole?

Johnson M, Sidow S J, Looney S W, Lindsey K, Niu L N, Tay F R . Canal and isthmus debridement efficacy using a sonic irrigation technique in a closed-canal system. J Endod 2012; 38: 1265–1268. Choose from a huge range of anti-bacterial and alcohol-free mouthwashes to give you fresher breath and aid with general dental health. Ranges available include Corsodyl, Colgate, Listerine, Dentyl and CB12, so Boots are sure to meet all of your dental needs. Barrette WC Jr, Hannum D M, Wheeler W D et al. General mechanism for the bacterial toxicity of hypochlorous acid: abolition of ATP production. Biochemistry 1989; 28: 9172–9178. Harrison J W, Hand R E . The effect of dilution and organic matter on the anti-bacterial property of 5.25% sodium hypochlorite. J Endod 1981; 7: 128–132.

Citric acid has a long history of use in root canal irrigation. It can be used instead of EDTA as the final rinse to remove the smear layer after use of NaOCl. One to ten percent solutions have been used. Citric acid is somewhat more aggressive than EDTA, and if NaOCl is used after citric acid (not recommended), the root canal wall erosion is more pronounced than in the EDTA–NaOCl sequence. 35 Citric acid is used as a component in MTAD and Tetraclean, the combination products for smear layer removal. 49, 50 Pappen F G, Shen Y, Qian W, Leonardo M R, Giardino L, Haapasalo M . In vitro antibacterial action of Tetraclean, MTAD and five experimental irrigation solutions. Int Endod J 2010; 43: 528–535. Cleaning efficacy of EDDY versus ultrasonically-activated irrigation in root canals: a systematic review and meta-analysis

Williamson A E, Cardon J W, Drake D R . Antimicrobial susceptibility of monoculture biofilms of a clinical isolate of Enterococcus faecalis. J Endod 2009; 35: 95–97. Haapasalo M, Shen Y, Qian W, Gao Y . Irrigation in endodontics. Dent Clin North Am 2010; 54: 291–312.

Sarno M U, Sidow S J, Looney S W, Lindsey K W, Niu L N, Tay F R . Canal and isthmus debridement efficacy of the VPro EndoSafe negative-pressure irrigation technique. J Endod 2012; 38: 1631–1634. Jeansonne M J, White R R . A comparison of 2.0% chlorhexidine gluconate and 5.25% sodium hypochlorite as antimicrobial endodontic irrigants. J Endod 1994; 20: 276–278. Siqueira JF Jr, Rôças I N, Favieri A, Lima K C . Chemomechanical reduction of the bacterial population in the root canal after instrumentation and irrigation with 1%, 2.5%, and 5.25% sodium hypochlorite. J Endod 2000; 26: 331–334. Although many bacteria may be killed by CHX, it cannot dissolve the biofilm or other organic debris. Residual organic tissue is likely to weaken the quality of the seal by the permanent root filling, necessitating the use of NaOCl as the main irrigant during instrumentation. On the positive side, CHX as the final rinse after EDTA does not cause erosion of dentine as NaOCl does; therefore 2% CHX may be considered for irrigation after the smear layer is removed. 58 Mancini M, Cerroni L, Iorio L, Armellin E, Conte G, Cianconi L . Smear layer removal and canal cleanliness using different irrigation systems (EndoActivator, EndoVac, and Passive Ultrasonic Irrigation): Field emission scanning electron microscopic evaluation in an in vitro study. J Endod 2013; 39: 1456–1460.Schoeffel G J . The EndoVac method of endodontic irrigation: part 2—efficacy. Dent Today 2008; 27: 82, 84, 86–87.

Several earlier studies that compared the antibacterial effect of NaOCl and 2% CHX against intracanal infection have shown little or no difference between their antimicrobial effectiveness. 54, 55, 56, 57 However, recent studies using viability staining and more advanced biofilm models including a dentine biofilm model have shown that 6% NaOCl has a much stronger antibiofilm effect than 2% CHX, which is comparable or weaker than 1 and 2% NaOCl. 32, 33 Malentacca A, Uccioli U, Zangari D, Lajolo C, Fabiani C . Efficacy and safety of various active irrigation devices when used with either positive or negative pressure: an in vitro study. J Endod 2012; 38: 1622–1626.Clarkson R M, Kidd B, Evans G E, Moule A J . The effect of surfactant on the dissolution of porcine pulpal tissue by sodium hypochlorite solutions. J Endod 2012; 38: 1257–1260.