Dental Nerve Blocks
Basic Information 
Overview and Goal(s)
To provide analgesia to the relevant branches of the fifth cranial nerve (trigeminal nerve) for invasive dental and surgical techniques
Preparation: Imporant Checkpoints
The maxillary nerve block is the only perineural injection that the author treats as a joint injection. The site is aseptically prepared, sterile gloves are worn, and sterile technique is rigidly followed.
Possible Complications and Common Errors To Be Avoided
Anatomically, nerve tissues parallel vascular tissue, and the maxillary and mandibular nerves are no different. Therefore hemorrhage may occur due to inadvertent puncture of these large vessels. Because of the position of these structures, it is unlikely that significant external blood loss will be appreciated; however, in the case of the maxillary nerve, hemorrhage may lead to exophthalmos and possibly a retrobulbar abscess. Therefore clients should be forewarned of the risk and aseptic technique should be adhered to during the procedure.
Procedure
• Block: Maxillary nerve (Figure 1)
Desensitized region: All sensation to maxillary teeth (including incisors), sinuses, and skin of muzzle
Anatomic landmarks: Rostral limit of the caudal third of the palpebral fissure, under the zygomatic arch, angle slightly up
Note: The needle depth should be at least 3 inches, and the sharp end of the needle should be against bone for correct positioning. If the end of the needle is not on bone, the needle position is incorrect.
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