Local anaesthetics routinely given to children undergoing dental treatment may affect tooth cell growth and development, according to research published in Cell Death Discovery
 on 7 September 2015.
It is the first time that researchers have identified a possible link between child tooth development and the use of a local anaesthetic. But researchers warn further studies are needed before clinical guidelines are revised.
The researchers used a five-month old pig that had deciduous teeth, young permanent teeth, and a developing third permanent molar tooth, similar to adolescent children. They also used in vitro human cell culture and systematically tested the local concentrations of the agents and the cellular effects and molecular interactions of five commercial local anaesthetics routinely used in clinics at four dental schools.
Fluorescein-labelled local anaesthetics were injected either around mandibular foramen for nerve block or under the mucosa of the mesial buccal and lingual periapical regions of the first molar for infiltration, exactly simulating clinical situations.
The researchers found that longer duration of exposure to high concentrations of local anaesthetic was most harmful because it interferes with the function of mitochondria – the “batteries of the cell” and induces a cell death mechanism called “autophagy”.
“Our findings that local anaesthetics can induce autophagy in tooth pulp cells have clinical implications, due to their potential impacts on tooth development as well as root formation and apical foramen closure,” the researchers write.
“Future in vivo validation of our findings will be plausible to further enhance our knowledge about the clinical impacts of these local anaesthetic drugs.”