Nerve Block: Mental

Background

• Mental nerve innervates the skin of the chin and mucous membranes of the lower lip (from lip anteriorly to alveolar process and to the mid body of the mandible) - by blocking this nerve you can have adequate anesthesia for complicated laceration closures
• NOTE: this block does NOT anesthetize the teeth or mandibular soft tissue (see Nerve Block: Inferior Alveolar)

Indications

• Trauma or need to perform painful procedure on area innervated by mental nerve

Contraindications

• Infection overlying injection site
• Previous allergic reaction to local anesthesic used
• Distortion of anatomic landmarks

Equipment Needed

• Local anesthesic
• Chloraprep
• Syringe with blunt fill needle and 27ga needle

Procedure

• Obtain informed consent
• Place patient in semi-recumbent position
• Draw up 2-5cc of anesthetic into syringe
• Locate the mental foramen by retracting the cheek laterally and palpating between the 2 lower premolar teeth
• Insert the needle along the lower gum into the buccal fold between the premolar teeth without placing the needle directly into the foramen
• Aspirate; if no blood, inject a few cc's of anesthetic slowly (avoid injecting directly into the foramen as to prevent damage to the neurovascular bundle)

Complications

• Bleeding
• Infection
• Pain
• Needle fracture
• Neurapraxia

See Also

• Nerve blocks (main)
• Local anesthetic systemic toxicity