Which nerve is commonly targeted for numbing the upper teeth in a regional block that supplies the maxillary anterior and premolar teeth?

• A. Infraorbital nerve
• B. Middle superior dental nerve
• C. Anterior superior alveolar nerve
• D. Posterior superior alveolar nerve

Answer: (B)

In upper-mouth regional anesthesia, you target the branches of the maxillary nerve that feed groups of teeth. The middle superior dental nerve is the one commonly targeted when the goal is to numb the premolar area, because its distribution covers the maxillary premolars (and is associated with the mesiobuccal root of the first molar in some people). Targeting this nerve in a regional block gives focused anesthesia to the premolars and adjacent gingiva, which is what the question is aiming at.

The other nerves serve different zones: the anterior superior alveolar nerve mainly supplies the anterior teeth, the posterior superior alveolar nerve supplies the molars, and the infraorbital approach is a broader route that can affect both anterior and premolar regions but isn’t the distinct middle branch used for the premolars in isolation.