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Which Nerves Are Used for Dental Anesthesia?

Published in Dental Anesthesia 3 mins read

The nerves used for dental anesthesia vary depending on which teeth and oral structures need to be anesthetized.

Here's a breakdown of the key nerves involved:

  • Trigeminal Nerve (Cranial Nerve V): This is the primary nerve responsible for sensation in the face and oral cavity, and its branches are targeted for dental anesthesia.

    • Maxillary Nerve (V2): This branch innervates the upper teeth, palate, and surrounding tissues.

      • Posterior Superior Alveolar Nerve (PSA): Anesthetizes the maxillary molars (except sometimes the mesiobuccal root of the first molar) and the buccal gingiva in that region.
      • Middle Superior Alveolar Nerve (MSA): Anesthetizes the maxillary premolars and mesiobuccal root of the first molar, as well as the buccal gingiva in that region. Often absent.
      • Anterior Superior Alveolar Nerve (ASA): Anesthetizes the maxillary central and lateral incisors, canine, and associated periodontal tissues and labial gingiva.
      • Infraorbital Nerve: A terminal branch of the maxillary nerve, it can be blocked to anesthetize the ASA and MSA nerve regions.
      • Greater Palatine Nerve: Anesthetizes the posterior hard palate.
      • Nasopalatine Nerve: Anesthetizes the anterior hard palate.

    • Mandibular Nerve (V3): This branch innervates the lower teeth, tongue, and surrounding tissues.

      • Inferior Alveolar Nerve (IAN): This is a major nerve block used to anesthetize all teeth on one side of the mandible. It also affects the ipsilateral lip and chin via its terminal branch, the mental nerve.
      • Mental Nerve: A branch of the inferior alveolar nerve that provides sensation to the chin and lower lip. Blocked for procedures in that area.
      • Incisive Nerve: A continuation of the inferior alveolar nerve anterior to the mental foramen, providing sensation to the anterior teeth (incisors and canines).
      • Lingual Nerve: Provides sensation to the anterior 2/3 of the tongue. Often anesthetized during an inferior alveolar nerve block.
      • Buccal Nerve (Long Buccal Nerve): Provides sensation to the buccal gingiva of the mandibular molars. Often requires separate anesthesia from the IAN block.

Therefore, depending on the tooth or area that needs to be anesthetized, different branches of the trigeminal nerve are targeted with local anesthetics. The inferior alveolar nerve block is a common technique for lower teeth, while different branches of the maxillary nerve are targeted for upper teeth.

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