by | Jun 18, 2021


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


  • Infection overlying injection site
  • Allergy to local anesthetic
  • Distortion of anatomical landmarks


  • 2-5cc of local anesthetic of choice
  • Syringe
  • Cleansing solution
  • 1.5 inch small gauge needle (25 or greater)


  1. Place patient in semi-recumbent position
  2. Draw up 2-5cc of anesthetic into syringe
  3. Locate the mental foramen by retracting the cheek laterally and palpating between the 2 lower premolar teeth
  4. Insert the needle along the lower gum into the buccal fold between the premolar teeth without placing the needle directly into the foramen
  5. 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)
  6. For lacerations over the midline, block the mental nerve on each side of the face to anesthetize crossover fibers
  7. Block may also be performed extraorally by palpating and approaching the mandible slightly laterally to make contact just outside the mental foramen


  1. WikEM