II. Indications
- Anesthesia of lower teeth (mandibular teeth) to the midline on the affected side
- Tongue Sensation (anterior two thirds)
- Oral cavity floor
III. Physiology
- Inferior alveolar nerve and lingual nerves pass through the pterygomandibular space, the target of this injection
IV. Preparations
- Typical: 0.5% Bupivacaine (Marcaine or Sensorcaine) with Epinephrine 2 ml
V. Images
- Inferior Alveolar Nerve Block
VI. Technique
- Apply topical benzocaine gel to area of planned injection
- Examiner holds patient's angle of the jaw with one hand between thumb and index finger
- Place thumb inside mouth at coronoid notch
- Place index finger on the outside of the jaw at posterior aspect of the mandibular ramus
- Direct the syringe
- Barrel should be over the top of the opposite premolar
- Needle should be inserted posterior to the coronoid notch, toward the mandibular ramus
- Insert the syringe
- Needle should enter mucosa and strike the Mandible bone at 2-3 cm
- Do not continue if bone is not struck (withdraw and redirect)
- Withdraw the needle slightly away from the bone
- Aspirate to confirm no blood from inferior alveolar artery or vein
- Deposit the Anesthetic
- Needle should enter mucosa and strike the Mandible bone at 2-3 cm