66 - Effects of Compound Topical Anesthetic on Oral Soft Tissue

Abstract: Effects of Compound Topical Anesthetic on Oral Soft Tissue

Boraski, V., Lallier, T., Roberts, SM.

Louisiana State University Health Sciences Center School of Dentistry, New Orleans, LA


Purpose: Compounded topical anesthetics are frequently used in pediatric dentistry, in contrast to the single-agent topical anesthetics more commonly used in adult populations. The aim of this study is to evaluate the cytotoxic effects of commonly used compounded topical anesthetics on oral soft tissue and to compare these effects with those of single-agent topical anesthetics. Specifically, this study evaluates cytotoxicity in gingival fibroblasts, assessing cell survivability, proliferation, and motility.

Methods: The compounded topical anesthetics evaluated will include commonly combined concentrations of lidocaine, tetracaine, prilocaine, phenylephrine, and benzocaine. Gingival fibroblasts will be cultured in vitro. Cytotoxicity and cell proliferation will be measured fluorometrically using Calcein-AM to assess viable cells and CyQUANT fluorescent dye to quantify total cellular DNA. Cell motility will be evaluated using an in vitro wound healing assay with visualization via inverted fluorescence microscopy and Calcein-AM staining.

Results: Compounded topical anesthetics demonstrated concentration-dependent cytotoxicity in human gingival fibroblasts. Significant reductions in cell viability were observed at concentrations as low as 0.5% in multi-drug formulations, with complete cell death at 5% across all groups. At 0.2%, select formulations induced cell death or inhibited proliferation, while others had minimal effects. At 1%, proliferation was further reduced, with some formulations causing complete growth arrest. Benzocaine alone significantly impaired both cell proliferation and migration. In contrast, lower-concentration formulations, as well as lidocaine alone, inhibited proliferation but did not impair cell migration.

Conclusions: Compounded topical anesthetics exhibit concentration and formulation dependent cytotoxic effects on gingival fibroblasts, with multi-drug and higher concentration formulations demonstrating the greatest impact on cell viability and function. Benzocaine significantly impairs both proliferation and migration, whereas lower-concentration and simpler formulations show reduced cytotoxicity. These findings suggest that minimizing anesthetic concentration and limiting the number of active agents may improve biocompatibility and support safer clinical use in pediatric dentistry.

Identify Supporting Agency and Grant Number: