Area of desensitization following mental nerve block in dogs

Regional nerve blocks are commonly used to provide analgesia for dental and oral surgical procedures. The purpose of this study was to demarcate the areas of the mandible that would be desensitized by application of the mental nerve block. Seven healthy mixed-breed dogs were anesthetized for an annual dental examination and professional teeth cleaning procedure. Bupivacaine HCl (0.4 ml/ m2) was administered at one middle mental foramen based on previously described techniques for the mental nerve block. A noxious stimulus was applied at 23 predetermined ipsilateral mandibular locations using pressure from a mosquito hemostat on the mucocutaneous junction (MCJ) and a dental curette on the vestibular mucogingival line (MGL) at the incisor canine, and premolar teeth; and, the mesial and distal aspects of the first molar tooth. A thermal stimulus using a refrigerant spray on a cotton ball was applied to the ipsilateral canine, third premolar and fourth premolar teeth; and, the mesial and distal aspects of the first molar tooth. Demonstration of nociception or anesthesia was noted and the responses tabulated. The area of desensitized tissues was smaller than expected and highly variable within the study group. In conclusion, the unilateral mental nerve block does not reliably provide generalized desensitization to tissues of the incisive and rostral regions of the mandible. Although the mental nerve block is recommended, other modes of analgesia should be emphasized for surgical and dental procedures involving these areas.