I believe that the reason why Cetacaine cannot be used on large areas of denuded or inflamed tissue is to prevent excessive systemic absorption of the anesthetic.The good news is that Cetacaine isn’t used on large areas of denuded or inflamed tissue because it is applied drop by drop in periodontal pockets. The concern is, most likely, with the spray, as it is more difficult to control the quantity of Cetacaine being applied to the tissue which subsequently, could lead to large areas of denuded or inflamed tissue being affected which, could potentially, increase the likelihood of excessive systemic absorption.At the dose we recommend and using the delivery method we demonstrate(i.e. 0.4 ml syringe), Cetacaine is a safe topical anesthetic.