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The Shelf-Life of Sodium Hypochlorite Irrigating Solutions: Adrf Report

This study examined the shelf life of sodium hypochlorite solutions commonly used as endodontic irrigants under various storage conditions. The available chlorine concentration of undiluted and diluted domestic bleach, as well as Milton sanitizer, were measured initially and after periods of storage while exposed to factors like light, air, temperature, and container opening. Results showed that solutions deteriorated most rapidly when exposed to sunlight in syringes. Undiluted domestic bleach was the most stable, while Milton was the least stable. Constant opening of containers also increased loss of chlorine in diluted bleach solutions over time. Proper storage in closed, opaque containers away from light is recommended to maximize shelf life.

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0% found this document useful (0 votes)
24 views8 pages

The Shelf-Life of Sodium Hypochlorite Irrigating Solutions: Adrf Report

This study examined the shelf life of sodium hypochlorite solutions commonly used as endodontic irrigants under various storage conditions. The available chlorine concentration of undiluted and diluted domestic bleach, as well as Milton sanitizer, were measured initially and after periods of storage while exposed to factors like light, air, temperature, and container opening. Results showed that solutions deteriorated most rapidly when exposed to sunlight in syringes. Undiluted domestic bleach was the most stable, while Milton was the least stable. Constant opening of containers also increased loss of chlorine in diluted bleach solutions over time. Proper storage in closed, opaque containers away from light is recommended to maximize shelf life.

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EmanuelMuruaga
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© © All Rights Reserved
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ADRF REPORT

Australian Dental Journal 2001;46:(4):269-276

The shelf-life of sodium hypochlorite irrigating solutions


RM Clarkson,* AJ Moule,† HM Podlich‡

Abstract INTRODUCTION
Background: Sodium hypochlorite (bleach) Biomechanical instrumentation and cleaning of root
solutions are widely used as irrigants in endodontics. canals require the use of an irrigant to suspend and
Their tendency to deteriorate is worsened by flush pulpal and dentinal debris from root canals.1
environmental influences which could cause loss of Ideally, an endodontic irrigant should be sterile and
available chlorine content.
Methods: This study measured the loss of available should also be capable of destroying the micro-
chlorine concentration in a range of sodium organisms found in a necrotic pulp, as well as
hypochlorite solutions under conditions which dissolving both vital and necrotic pulpal tissue.2-4
mimic clinical usage and storage. Domestic bleach, Sodium hypochlorite solutions, which are bactericidal,
both undiluted and diluted with demineralised water virucidal and which dissolve protein, have been widely
or hard water, was tested, along with Milton, for
used for this purpose.5-7 The concentration of sodium
initial concentration of available chlorine, and then
retested after varying periods and modes of storage hypochlorite solutions used in endodontics may vary
to measure loss of chlorine concentration. The types from 0.5-5.25 per cent available chlorine.8 While
of storage were: (1) in closed plastic bottles which sodium hypochlorite may be prepared and packaged
were opened daily and agitated; (2) in open plastic commercially for therapeutic use,1 it is common in
bottles; (3) in syringes exposed to sunlight; (4) in many countries for domestic bleach (diluted or
syringes kept in the dark; (5) in open stainless steel
undiluted) to be used as an endodontic irrigant.8
bowls; (6) in closed stainless steel bowls; and (7)
when heated to 50°C. Not all solutions were tested Sodium hypochlorite is a strong oxidising agent.9 The
under all storage conditions. level of available chlorine is the critical factor affecting
Results: Of the solutions opened daily, undiluted the activity of sodium hypochlorite solutions.5,10 These
domestic bleach was the most stable and Milton was solutions are unstable.11 Available chlorine
the least stable. Initially, diluted bleach left open
concentration deteriorates with time, exposure to
deteriorated rapidly but deterioration slowed with
time. Solutions in syringes exposed to sunlight light5,12 and heat8,13 and on contact with air,5,12 metals,
showed the most rapid loss of chlorine content. metallic ions10 and organic materials.1 While Velvart14
Heated bleach lost nearly 5 per cent of its strength in concluded that cold storage did not appear to improve
six hours. Diluted bleach surprisingly, increased its the shelf-life of two per cent solutions, other authors8,11
chlorine concentration in open bowls probably due demonstrated much better shelf-life under refrigeration,
to evaporation of water. Dilution of bleach with
and concluded dilute solutions were more stable than
hard tap water did not significantly affect shelf-life.
Preloading of diluted bleach into syringes appears to more concentrated solutions. While the bactericidal
be a sound technique if the syringes are stored away activity is greater at pH values as low as 6, high pH
from light. levels are necessary for effective shelf-life.6,11 Sodium
Conclusions: This study reinforces the need for hydroxide is usually present in the solutions to
sodium hypochlorite to be stored in closed opaque enhance alkalinity.
containers. Constant opening of containers appears
to cause greater loss in chlorine concentration of While the individual influences of environmental
diluted bleach solutions, perhaps because a lower factors on the stability of sodium hypochlorite have
concentration of sodium hydroxide allows the pH to been well documented, the influence of many of the
drop more rapidly. factors which are likely to be encountered in clinical
Key words: Sodium hypochlorite, domestic bleach, endodontic practice in combination have not been
endodontics, shelf-life, clinical usage, open containers, examined. The most pertinent of these influences are
syringes. combinations of time, temperature and exposure to
(Received for publication October 2000. Revised November light and air. In view of the recorded instability of
2000. Accepted for publication December 2000.) sodium hypochlorite solutions and of the wide range of
potential storage conditions and methods of dispensing
*General practitioner, Kingaroy.
†Specialist endodontist, Brisbane.
these solutions in different dental practices, further
‡Statistical consultant, The University of Queensland. examination of shelf-life under combinations of storage
Australian Dental Journal 2001;46:4. 269
and dispensing conditions which could accelerate the Table 1. Analysis of water from Kingaroy domestic
loss of available chlorine concentration was considered supply used to dilute domestic bleach.*
warranted. Contents Concentration mg/L
The activity of sodium hypochlorite solutions can be Cations
assessed by determining the amount of available Sodium 335
Potassium 12
chlorine in each solution. There are a number of Calcium 105
methods to measure available chlorine, including tissue Magnesium 130
solubility;10 N-diethyl-p-phenylenediamine ferrous Hydrogen 0
ammonium sulphate analysis;5 titration against sodium Anions
arsenite;11 and iodometric titration with a variety of Bicarbonate 125
end-point detection procedures, which include titration Carbonate 1.6
Hydroxide 0
against sodium thiosulphate and amperometric Chloride 980
titration against phenylarsine.15 While the accuracy of Fluoride 0.1
iodometric titration against sodium thiosulphate has Nitrate 3.7
Sulphate 46
been questioned,11 because breakdown products such as
chlorates and chlorites could potentially give artificially Other dissolved elements
high readings, it is the simplest and most widely used Iron <0.02
Manganese 0.06
test for available chlorine; does not have the disposal Zinc <0.02
problems or toxicity of arsenic compounds;15 and was Aluminium <0.05
used in this study. Boron 0.1
Copper <0.05
This study examined hypochlorite solutions
*Collected 28th August 1995 – tested April 1997 by Scientific
commonly used for endodontic irrigation in Australia. Services section of Queensland Health.
Solutions assessed included an infant sanitiser and a
common brand of domestic bleach, both undiluted and
diluted. Changes in available chlorine concentrations period. The solutions in syringes were treated
were investigated when the solutions were exposed to differently – the contents of six syringes were combined
combinations of environmental and storage variables and stirred to make a solution from which three
commonly found in dental practices. titrations were carried out at each test period. Solutions
in syringes exposed to sunlight were titrated by a single
M AT E R I A L S A N D M E T H O D S operator and all other titrations were carried out by
Sodium hypochlorite solutions teams of two operators, each making independent
Milton (Proctor & Gamble Australia, Parramatta, readings of the titration results. The 10 solutions were
NSW) (1 per cent w/v) and Sno-Wite (Kiwi Australia, tested immediately upon preparation and at varying
Clayton South, Vic) (4 per cent w/v) were used as the intervals depending on the storage conditions.
sources of sodium hypochlorite for this study. Milton
was used in the undiluted form only and Sno-Wite was Available chlorine
also used undiluted or diluted to 1 per cent w/v. To test the effect of storage conditions on shelf-life,
Sno-Wite solutions were diluted to one per cent w/v
Titrations with both demineralised water and hard tapwater, then
The level of available chlorine was assessed initially stored in the following manner:
and at each test period, using Australian Standard
1087.16 This test was developed for sodium (1) In one-litre bottles which were opened daily
hypochlorite solutions used in the dairy industry and Plastic one-litre bottles were half-filled with dilute
involved addition of potassium iodide to a prepared Sno-Wite, then tightly capped, wrapped in aluminium
sodium hypochlorite solution, with subsequent foil to help exclude light and placed in a lightproof box.
addition of acetic acid. Available chlorine oxidised the Each bottle was opened daily five days a week, agitated
iodide ions to produce iodine which turned the solution briefly then recapped after 10 minutes. Available
brown. The resulting solution was then titrated against chlorine levels were tested at varying intervals over
a standard sodium thiosulphate solution (0.1 eight months. The one per cent w/v solutions were
mole/litre) until the colour just disappeared. The stored in numbered containers. The titrating staff were
concentration of available chlorine was given by the not aware of the identity of solutions being tested.
following equation: per cent available chlorine equals
VC3.546, where V equals the volume of sodium (2) In open containers
thiosulphate used in millilitres and C equals the In this segment of the study, an identical solution to
concentration of the standard sodium thiosulphate that prepared in (1) above was prepared and placed in
solution in moles/litre. individual one-litre bottles which were wrapped in
For all solutions except those in syringes, three aluminium foil and stored in a lightproof, ventilated
samples were prepared and three titrations were box in a photographic darkroom, with the bottles
performed on each sample at the end of each storage remaining uncapped.
270 Australian Dental Journal 2001;46:4.
Table 2. Sodium hypochlorite test solutions and details of conditions of storage and container type.
Parent Diluent Nominal concentration of Storage Container Opened Light Container
solution used test solution* temperature capped daily exposure type
Milton Nil 1 Air conditioned Yes Yes Dark 1L plastic
Sno-Wite Nil 4 Air conditioned Yes Yes Dark 1L plastic
Sno-Wite Nil 4 50°C No Open Ambient 100ml glass
Sno-Wite Demin 1 Air conditioned Yes No Sunlight 5ml syringe
Sno-Wite Demin 1 Air conditioned Yes No Dark 5ml syringe
Sno-Wite Demin 1 Air conditioned No Open Dark 1L plastic
Sno-Wite Demin 1 Air conditioned No Open Ambient Stainless bowl
Sno-Wite Demin 1 Air conditioned Yes No Ambient Stainless bowl
Sno-Wite Hard 1 Air conditioned Yes Yes Dark 1L plastic
Sno-Wite Demin 1 Air conditioned Yes Yes Dark 1L plastic
*Per cent available chlorine. Demin – demineralised water. Hard – hard water from Table 1. Sunlight – indirect sunlight. Ambient – sunlight from
windows plus fluorescent lights.

(3) Using hard tapwater for dilution tested were tabulated according to the parent
These solutions were prepared and stored as in (1) hypochlorite solution; type of water used for dilution
above, but the Sno-Wite was diluted with tapwater (if any); storage temperature; whether the container
obtained from the Kingaroy reticulated supply during a was left open, covered or opened daily; the nature of
period of prolonged drought. Detailed analysis of this exposure to light; and the type of container used (Table
water is provided in Table 1. 2). Changes in chlorine concentration over time were
graphed for all solutions, with chlorine content
(4) In syringes exposed to sunlight expressed as a percentage of the initial available chlo-
Diluted Sno-Wite was pre-loaded into 5mL disposable rine concentration.
syringes (Becton Dickinson Medical, Singapore) with
one inch 30 gauge needles attached. The syringes were pH of solutions stored for eight months
stored on a window ledge in indirect sunlight. Solutions The pH of all solutions tested over eight months was
were tested after 6, 15, 23 and 30 days. measured on the same day as the final titrations, using
an appropriately calibrated Activon (Activon,
(5) In syringes stored in the dark Gladesville, NSW) model 109 pH meter, and tabulated
Syringes and solution identical to (4) above, were to compare them statistically with the final
stored in a closed cardboard box, in air-conditioned concentrations of these solutions (Table 3).
premises, and tested after 42 and 98 days.
Statistics
(6) In stainless steel bowls Statistical methods used to analyse the data varied
In this part of the study, solutions of diluted Sno- for different segments of the study. These are specified
Wite were placed into stainless steel bowls, both open in reporting the results. For clarity in detailing the
to the atmosphere and covered with polythene cling- preparation and storage of test solutions, textual
wrap to exclude air. The solutions were stirred prior to divisions used in the results section vary slightly from
sampling and testing, which was carried out after six those used in (1) to (8) above.
and five hours respectively.
R E S U LT S
Undiluted Milton and Sno-Wite were also tested in Solutions stored for eight months
the following manner: Changes in mean concentration of the five solutions
stored over approximately eight months are illustrated
(7) In containers which were opened and agitated daily in Fig 1. Undiluted Sno-Wite was the most stable
The parent solutions of these two products were solution (p<0.05), losing just over 10 per cent of its
stored in identical one-litre plastic bottles, in the same original strength over the experimental period.
lightproof box and subjected to the same regime of However, the stability of Sno-Wite was not significantly
daily opening and agitation as in (1) above, and also different from the other solutions opened and agitated
tested over eight months. daily at the end of the first and third months (p>0.05).
Milton was the least stable solution, deteriorating over
(8) After storage at 50°C the eight month period to just over 11 per cent of its
Four per cent w/v Sno-Wite was placed in 100mL initial concentration (mean concentration in nine
measuring cylinders immersed in water at a constant samples 11.043 per cent with a standard error of
50°C. The cylinders were loosely covered to prevent 0.530). The other three solutions were not significantly
dilution by splash from the water bath and the contents different in mean concentration percentage after eight
evaluated after five hours. months (p>0.05), their mean values ranging between
The five test solutions in (1), (2), (3), and (7) above, 41.8 (standard error 3.906) and 47.8 per cent (standard
were analysed at 35, 98 and 238 days. All solutions error 9.463). The Sno-Wite diluted with hard water
Australian Dental Journal 2001;46:4. 271
Table 3. pH and concentration of sodium
hypochlorite solutions after storage for eight months
while opened daily or left permanently open.
Solutions Average concentrations % Average pH
Milton 0.125 8.533
Hard 0.415 9.363
Demin 0.474 9.507
Sno-Wite 3.554 12.517
Open 0.465 9.657
Hard – Sno-Wite diluted with hard water. Demin – Sno-Wite diluted
with demineralised water. Open – Sno-Wite diluted with
demineralised water and left permanently open.

produced a fine white precipitate in the bottom of the


containers of all three samples.
The solution stored in open containers initially had a
much greater loss of activity, with its concentration
being significantly different from the other solutions at
the first and third months (p<0.05), the loss of active
chlorine concentration decreasing between the third
and eighth month. Statistical comparisons of the
solutions were based on an approximate test of
equality of means when variances are heterogeneous,
with the Games and Howell method17 being used to
make pair-wise comparisons. At three months, the data
were transformed using the arcsin transformation to
achieve approximate normality of the samples and Fig 2. Change in percentage concentration with time of available
comparisons made on this transformed scale. chlorine in Sno-Wite diluted to 1 per cent when stored in translucent
syringes exposed to indirect sunlight.
Solutions stored in syringes exposed to sunlight
The one per cent w/v solutions stored in syringes deterioration in concentration. After six days, the
exposed to indirect sunlight showed the most dramatic solutions had lost more than 25 per cent of their
available chlorine (mean concentration in the three
samples 73.7 per cent with a standard error of 0.207)
and after 23 days their concentration was less than
20 per cent of that at the start of the experiment
(mean concentration in the three samples 18.2 per cent
with a standard error of 0.095). Figure 2 displays
mean concentrations of solutions exposed to
sunlight. Standard error bars are included, though
they are particularly small here because of the low
standard error.

Solutions stored in syringes kept in the dark


One per cent bleach solutions stored in the dark in
syringes identical to those used for solutions exposed to
sunlight deteriorated at a much slower rate than the
solutions described above (Fig 3). After three months,
these solutions still retained more of the original
available chlorine content than solutions in syringes
———1%
• • • Sno-Wite permanently open
exposed to sunlight after 30 days. After six days, mean
––––– Sno-Wite diluted to 1% with demineralised water
...........Sno-Wite diluted to 1% with hard water
concentration of the nine samples was 78.7 per cent
– – – –Milton with a standard error of 0.345, giving 95 per cent
------- - Undiluted Sno-Wite confidence that the mean loss in concentration would
fall between 20.460 and 22.052 per cent. This and
subsequent confidence intervals are constructed
assuming normality of the nine samples, where
standard statistical tests indicate this assumption is
Fig 1. Change in percentage concentration of available chlorine in
sodium hypochlorite solutions stored over eight months while opened reasonable. The plungers of the syringes showed
and agitated daily or left permanently open. marked adhesion to the barrel wall and, by the end of
272 Australian Dental Journal 2001;46:4.
a

Fig 4. Rust formation after seven days in syringes loaded with Milton
and stored in the dark. Fig 4a shows demonstrable rust formation in
drops of Milton trapped in needle sheath of syringe. In Fig 4b, the
lumen of the 30 gauge needle appears completely occluded by rust.

Solutions stored in stainless steel bowls


The only solutions to show a significant increase in
concentration during the study were those stored in
open stainless steel bowls. The mean increase in
concentration over a period of six hours was 3.5 per
cent, with a standard error of 0.150 per cent, giving 95
per cent confidence that the value of the mean increase
Fig 3. Change in percentage concentration with time of available in concentration percentage would fall between 3.154
chlorine in Sno-Wite diluted to 1 per cent when stored in translucent and 3.846 per cent. Similar solutions stored in identical
syringes stored in the dark. bowls tightly covered with clingwrap showed a
reduction in available chlorine of the original
concentration over a slightly shorter period (five
the experiment, a black coloration of the hypochlorite
solution was apparent adjacent to the plunger. This
coloration disappeared rapidly when the solutions were
pooled in a beaker ready for testing. When Milton was
stored in syringes in the dark, as demonstrated in Fig 4,
rust was also apparent by day seven. Obvious rust in
droplets in the needle sheath is demonstrated in Fig 4a,
and in Fig 4b the lumen of the needle at the bevel end
appears totally occluded by rust. For this reason, this
section of the study was abandoned.

Sno Wite heated to 50°C


Undiluted Sno-Wite stored at 50°C deteriorated to a
mean of only 94.7 per cent of its original concentration
after five hours, with a standard error of 0.135, giving
95 per cent confidence that the mean loss in percentage
concentration would fall between 4.935 and 5.560 per
cent. These changes are graphed in Fig 5 along with
those for all solutions stored for less than a day,
---------- 1% Sno-Wite in open stainless steel bowls
comparing average percentage concentrations and – – – – Undiluted Sno-Wite heated
showing standard error bars for these means. One of 1% Sno-Wite in covered stainless steel bowls

the 100mL measuring cylinders used for this section of


the study had previously suffered noticeable etching of
its inner surface and the solution it contained showed
continuous ‘gassing’ during the entire test period while
the other solutions did not. The results reported earlier
therefore exclude this cylinder, with its final available Fig 5. Change in percentage concentration with time of
available chlorine of undiluted Sno-Wite heated to 50oC and diluted
mean chlorine concentration being 92 per cent, Sno-Wite stored in open and closed stainless steel bowls for periods
compared to 97.8 per cent for the other cylinders. up to six hours.
Australian Dental Journal 2001;46:4. 273
hours). The mean decrease of the percentage remaining after 30 days for the syringes exposed to
concentration was 4.4, with a standard error of 0.948, sunlight in this study.
giving 95 per cent confidence the mean loss would be In comparing the results of this study to previous
between 2.168 and 6.542 per cent. When Milton was studies, consideration should be given to the different
stored in stainless steel bowls for six hours, there was storage conditions – syringes rather than translucent
visible rust formation with marked pitting of the metal bottles. Difficulties in quantifying exposure to light,
surface. For this reason, the result was not reported. variations in container volume and variations in trans-
parency of containers make cross-study comparisons
pH of solutions stored for eight months unreliable. From a chlorine concentration point of
The pH of each long term solution is listed in Table 3, view, when the syringes are stored away from ambient
along with the final mean concentration of available light, preloading of bleach into capped syringes appears
chlorine. Solutions which deteriorated more had to be an acceptable practice.
lower pH readings – Milton, at 8.6 (standard error Use of an open container, such as a stainless steel or
0.052), having the lowest mean pH of the three samples plastic bowl from which syringes can be regularly
tested. At 12.6 (standard error 0.034), undiluted refilled during the course of an appointment, would not
Sno-Wite showed the highest mean pH in the three appear to result in a noticeably weakened solution over
samples tested. the course of a few hours. Similarly, the results of this
To establish and compare time frames within which study suggest heating four per cent w/v solutions to
the loss of concentration did not exceed 10 per cent, 50°C for use during a single endodontic appointment
some further comparisons were made and confidence would not appear to cause significant loss of available
intervals constructed. Capped syringes stored in the chlorine content. Gambarini et al13 also reported
dark and the 1 per cent w/v solutions opened and minimal loss of available chlorine concentration when
agitated daily were compared after three months. The five per cent solutions were heated intermittently.
best performing solution after this time was the However, it must be appreciated that accidental spillage
solution diluted using hard water, with 95 per cent from an open container may present a hazard to the
confidence that the mean loss in percentage clothing and eyes of operator, staff and patients, so care
concentration would give a value between 7.513 and should be taken if this method of delivery is to be used
10.817. This solution was significantly different from clinically. The increase in concentration of the solution
Milton (p<0.05), where there was 95 per cent in an open (uncovered) bowl was surprising, and was
confidence that the value would fall between 17.738 presumably due to evaporation of water as a result of
and 22.131 for the mean loss in percentage the large surface area of the solution in relation to its
concentration, but the loss was not significantly volume and the low relative humidity of the air-
different from the solution diluted with demineralised conditioned environment. A similar experiment with a
water, where there was 95 per cent confidence that the covered bowl predictably showed loss of available
loss of available chlorine concentration lay between chlorine due to air exposure and contact with metal.
7.287 and 16.462. Solutions in capped syringes stored It does not appear that other researchers have studied
in the dark had the greatest loss in mean concentration the effect of daily opening and agitation of bleach
after a period of three months, with 95 per cent solutions for the purpose of decanting small quantities
confidence limits for these values of 20.572 and 22.052 into syringes. Such procedures result in only modest
per cent loss of original concentration, but was only loss of available chlorine. If a loss of 10 per cent of
significantly different from the best performing solution available chlorine is regarded as acceptable, then
diluted with hard water. The comparisons were made domestic bleach diluted to one per cent w/v should have
on the arcsin scale, using the approximate test of a shelf-life well in excess of one month and perhaps as
equality of means. The confidence intervals reported much as three months. Capped syringes of diluted
have been back-transformed to the original scale. After bleach stored in the dark should have a similar storage
the shorter one-month period, none of the solutions life. Undiluted Sno-Wite would appear to have a shelf-
had measurements with a concentration loss exceeding life approaching eight months. This latter result is
10 per cent. surprising, as more dilute solutions normally have a
longer shelf-life, but it is likely the greater content of
DISCUSSION sodium hydroxide in the undiluted samples may
In this study, loss of available chlorine concentration counter the drop in pH associated with exposure of
due to exposure of bleach solutions to light was much these solutions to carbon dioxide in air. Reduction in
greater than previously reported. One per cent w/v pH has a dramatic effect on storage life for sodium
solutions examined by Rutala et al5 deteriorated to 83 hypochlorite solutions.11 As would be expected, in this
per cent at 30 days when exposed to direct and indirect study solutions with the lowest end concentrations had
sunlight, while Aparecida et al12 reported 2.6 per cent the lowest pH (Table 3). In this study, the poor
w/v solutions deteriorated to a similar level in performance of Milton may be explained by differences
continuous artificial light over the same period. This in the relative content of sodium hydroxide compared
contrasts with less than 10 per cent available chlorine to diluted bleach, although Milton does have sodium
274 Australian Dental Journal 2001;46:4.
chloride added as a buffer to reduce its rate of chlorine content. Initially, diluted bleach left open
decomposition. deteriorated rapidly, but this rate slowed over time.
Solutions diluted with hard tapwater might have The contents of syringes exposed to sunlight showed
been expected to deteriorate more rapidly given the the most rapid loss of chlorine content. If a 10 per cent
presence of metallic ions in such water. It should be loss of available chlorine concentration is regarded as
stressed that the water used here was very high in salt the maximum acceptable, then domestic bleach diluted
content and failed to meet National Health and to one per cent w/v with demineralised water should
Medical Research Council standards for drinking not be stored for more than three months.
water. The high sodium content of this water sample Heated bleach lost nearly five per cent of its strength
may also have had a buffering effect, counteracting the in six hours. Diluted bleach increased its chlorine
potential reduction in available chlorine content in the concentration in open bowls by more than three per
solution. Reticulated water from other supplies may cent over five hours.
not behave as this sample did. The nature of the Containers of Milton or bleach solutions should be
precipitate in the hard water solutions is not known but tightly closed at all times and stored away from light.
may be calcium or magnesium salts precipitated by the The results of this study suggest that, from the point of
high pH of the bleach solutions. Despite its good view of available chlorine concentration, preloading of
performance in these tests, water from reticulated
one per cent bleach solutions into capped, disposable
supplies cannot be recommended for dilution of bleach
plastic syringes which are prominently labelled is
because variations in dissolved salts could vary the
acceptable provided they are stored away from light
results and the unknown nature of precipitates may
and discarded after about two months. Under no
present a hazard.
circumstances should local anaesthetic cartridges be
Initially, diluted bleach solutions stored in open refilled for dispensing sodium hypochlorite.
containers showed rapid deterioration but after eight Practitioners should discard any batch of syringes
months had similar concentrations to those of identical which shows deterioration of the rubber seal, due to
solutions opened daily. This result is at variance with risk of the seal sticking to the syringe barrel with
the findings of Aparecida et al,12 who reported that 2.6 forceful injection into the canal and because of the
per cent solutions stored in open containers, while also unknown nature of breakdown products.
giving a 40 per cent residual chlorine concentration at
eight months, showed less initial deterioration. This AC K N OW L E D G E M E N T S
result is perplexing but may be explained by the fact
The assistance of the general practitioner members of
that solutions in the current study were stored in a
the Brisbane Endodontic Research Group, the
photographic darkroom. Vapour from acetic acid stop
chemistry section of Tarong Energy and Dr Peter
baths used for photography could theoretically result in
Brockhurst of the University of Queensland is
a drop in pH, causing accelerated reduction in chlorine
acknowledged. This research was financed by a grant
concentration in the early stages.
from the Australian Dental Research Foundation.
The results of this study have caused the authors to
review their previous endorsement of Milton for REFERENCES
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