How to give Inferior alveolar nerve block efficiently?
The inferior alveolar nerve block is one of the main challenges that faces the dentist during the routine daily work, as it failures many times that makes you need to give more than one carpule of the anesthetic solution.
The Inferior alveolar nerve is a branch of mandibular nerve which is itself the third branch of trigeminal nerve (The Fifth cranial nerve).
We target in our injection the Inferior alveolar nerve just before it's entry to the mandibular canal in the mandibular foramen
In order to give the nerve block for the inferior alveolar nerve with high success rate, you have to follow these steps:
- Put your index finger of the non working hand on the external oblique ridge.
- Move upward until you reach the deepest concavity (this is the coronoid notch) and this determines the height of the injection.
- Identify the landmark pterygomandibular raphe which connects the upper and lower 8.
- pterygomandibular raphe and coronoid notch are your boundaries for the injection.
- The injection is in between an imaginary line joining the pterygomandibular raphe and coronoid notch.
- Inject the needle until you feel touch bone, that bony touch should be felt after injecting about 2/3 of the needle.
- The lingual nerve often gets anesthetized in the same block procedure due to close proximity of lingual nerve, producing anesthesia of the anterior 2/3 of the tongue as well as the lingual gingiva and musosa of floor of the mouth.
- Inferior alveolar nerve block produces anesthesia in all teeth in that half also the mucosa of all teeth in that half except the buccal mucosa for molars which is innervated by long buccal nerve.
Here is a video illustrates Inferior alveolar nerve block in Direct Technique
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