Sodium hypochlorite
Sodium hypochlorite is the medicament of choice due to its efficacy against pathogenic organisms and pulp digestion in endodontic therapy. Its concentration for use varies from 0.5% to 5.25%. At low concentrations it dissolves mainly necrotic tissue; at higher concentrations it also dissolves vital tissue and additional bacterial species. One study has shown that "Enterococcus faecalis" was still present in the dentin after 40 minutes of exposure of 1.3% and 2.5% sodium hypochlorite, whereas 40 minutes at a concentration of 5.25% was effective in "E. faecalis" removal. In addition to higher concentrations of sodium hypochlorite, longer time exposure and warming the solution (60 °C) also increases its effectiveness in removing soft tissue and bacteria within the root canal chamber. 2% is a common concentration as there is less risk of an iatrogenic hypochlorite incident. A hypochlorite incident is an immediate reaction of severe pain, followed by edema, haematoma, and ecchymosis as a consequence of the solution escaping the confines of the tooth and entering the periapical space. This may be caused by binding or excessive pressure on the irrigant syringe, or it may occur if the tooth has an unusually large apical foramen.