Sodium hypochlorite (bleach) is advocated as an irrigant for use in endodontic therapy for its bacteriocidal and tissue dissolving properties. Extrusion of hypochlorite into the surrounding soft and hard tissues, however, can lead to severe complications, as illustrated in our four case reports. This article considers the risk benefit ratio of the different materials available and advises dental practitioners to ensure patients are aware of the potential risks of the materials used when seeking informed consent. It also aims to provide some guidance on prevention, identification and management of incidents.