Mental (infraoral) nerve block

The mental nerve block anesthetizes the lower lip, skin below the lip, and chin as shown in A above. To perform, locate the mental nerve foramen by palpation of the mandible in line with the infraorbital and supraorbital foramen as shown in B above. After cleansing, insert a small needle (eg, 25 or 27 gauge) through the skin just medial and directed towards the foramen (see A above). Insert the needle to a depth of approximately 0.5 cm and inject one to two mL of local anesthetic (eg, buffered lidocaine 1 percent with epinephrine). In older children and adolescents, who report paresthesias, withdraw the needle until paresthesias resolve prior to injection of anesthetic.