View source for Nerve block: lingual

==Overview==
[[File:Grant 1962 656b.png|thumb|Distribution of lingual nerve.]]
[[File:Gray778.png|thumb|Lingual nerve anatomy branching off V<sub>3</sub>  mandibular division of the trigeminal nerve.]]
[[File:Gray782 updated.png|thumb|Intra oral anatomy of lingual nerve.]]
[[File:Gray1202.png|thumb|Lingual anatomy.]]
* The lingual nerve is a branch of the mandibular (V<sub>3</sub>) division of the trigeminal nerve
* Provides sensation to the anterior two-thirds of the tongue, the floor of the mouth, and the lingual mucous membrane
* Lingual nerve block is an effective means of anesthesia for tongue lacerations and avoids the anesthesia of the lip, chin, and teeth that [[Nerve Block: Inferior Alveolar|inferior alveolar nerve block]] causes<ref>Balasubramanian S et al. Efficacy of Exclusive Lingual Nerve Block versus Conventional Inferior Alveolar Nerve Block in Achieving Lingual Soft-tissue Anesthesia. Ann Maxillofac Surg. 2017; 7(2): 250-255.
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* No chance of accidental carotid artery puncture compared to IANB
** Studies have shown lower rates of nerve injury and trismus compared to IANB as well as greater success rates<ref>Balasubramanian S et al. Efficacy of Exclusive Lingual Nerve Block versus Conventional Inferior Alveolar Nerve Block in Achieving Lingual Soft-tissue Anesthesia. Ann Maxillofac Surg. 2017; 7(2): 250-255.
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==Indications==
* [[Tongue laceration]]
* Sublingual abscess drainage
* Foreign body removal
* Sialolith removal
* Periodontal surgery
* Glossodynia

==Contraindications==
* Lingual soft tissue infection
* Local anesthetic allergy

==Equipment Needed==
* Gloves
* Aseptic mouth rinse
* 4x4 gauze
* Suction
* Syringe
* 25-27 gauge needle
* Topical anesthetic
* Local anesthetic

==Procedure<ref>Reichman EF. Dental Anesthesia and Analgesia. In: Reichman EF. Emergency Medicine Procedures. 2nd ed. McGraw-Hill; 2013.</ref>==
# Have the patient rinse their mouth with an aseptic mouth rinse.
# Apply soaked gauze with topical anesthetic.
# Place patient reclining or upright and have them open their mouth.
# Identify site of injection: 1 cm medial to the second mandibular molar.
# Have the patient move their tongue to the side or use a tongue blade.
# From the contralateral side, approach with your needle and insert 1 cm posteriorly directed.
# Aspirate to confirm location is not intravascular.
# Inject 1.0 - 1.5 ml local anesthetic.

==Complications==
* Hematoma 
* Infection
* Failure to anesthetize 

==See Also==
*[[Tongue laceration]]
*[[Nerve Block: Inferior Alveolar]]
*[[Nerve blocks (main)]]
*[[LAST]]

==References==
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[[Category:Procedures]]