Abstract
Aim: Anxiety and intolerance to dental local anesthetic injections are common in patients undergoing dental procedures. This work was designed to study cytotoxicity of selected flavors in primary gingival keratinocytes (PGK), to acquire information on their suitability for use in dental lidocaine hydrochloride (LID) injection. We also evaluated the bio-mimetic taste of LID dental injection in the presence of selected flavors and sweetener using an Astree electronic tongue (ETongue). Methods: The cytotoxicity of chocolate natural and artificial flavor (CTE), raspberry flavor artificial (RAS), cherry flavor (CHR), bitterness suppressor flavor (BSF) and lemon flavor extract (LFE) at various dilutions (0.16–10% v/v) was carried out in PGK using the live cell morphological analysis and MTT cell cytotoxicity assay. Based on the cytotoxicity data, CTE and RAS were added to Xylocaine® (2%) along with 0.09% sodium saccharin and taste was assessed using an ETongue. Results: After three hours of treatment, a dose-dependent cell death was induced by all flavors compared to the untreated control. BSF was found to be more toxic when compared to other flavors. CTE was found to be less toxic. The mean IC50 values of CTE, RAS, CHR, BSF and LFE in PGK were found to be 9.54, 8.43, 2.21, 0.38 and 4.01 mg/mL. Taste analysis with the ETongue showed a clear taste difference between the control and test formulations containing CTE and RAS flavors along with sodium saccharin. Conclusion: CTE and RAS flavors in combination with 0.09% sodium saccharin can achieve a significant taste-masking effect in the dental LID injection.
Highlights
In the literature, a wide variety of techniques such as the addition of sweeteners, complexing with cyclodextrins, coating with insoluble polymers [9], the use of ion-exchange resins [10], the addition of flavors [11] and the use of prodrugs [12] are reported for reducing bitter and unacceptable tastes of orally administered drugs [13]
This study aims to assess the ability of a range of flavors along with a sweetener to mask the bitter taste of dental lidocaine hydrochloride (LID) injection
We used a combination of flavor and sweetener to improve the taste of LID dental injection
Summary
A wide variety of techniques such as the addition of sweeteners, complexing with cyclodextrins, coating with insoluble polymers [9], the use of ion-exchange resins [10], the addition of flavors [11] and the use of prodrugs [12] are reported for reducing bitter and unacceptable tastes of orally administered drugs [13]. These techniques are not accepted in an injectable formulation due to stringent requirements by the FDA. Based on the popularity of LID injection in dental procedures, it is expected that the resulting anesthetics will have a huge potential in dental practices worldwide
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