Treatment of cavities with citric acid cavity cleanser, also used as an etchant, before restoration with zinc oxide-eugenol cement, was toxic to the human dental pulp in comparison to sham-treated controls. The cleanser caused a significantly (P less than .01) greater intensity and incidence (P less than .01) of inflammation. The added insult from cleanser pretreatment caused destruction of the odontoblast processes withnin the cut dentinal tubules, and an increase in diameter of the tubules. These effects on dentin and odontoblasts probably contributed to the observed increase in adverse pulp responses.