Which nerve would need to be anaesthetised to numb the upper 5 buccal gum and tooth?

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

Answer: (D)

Understanding which nerves supply sensation to the maxillary teeth and their buccal gingiva helps identify the right nerve block. The middle superior alveolar nerve provides sensation to the maxillary first and second premolars and their overlying buccal gingiva (and may include the mesiobuccal root of the first molar). To numb the upper premolar region’s buccal gum and tooth, anaesthetising this nerve is the most direct choice.

The anterior superior alveolar nerve serves the incisors and canines and their buccal gingiva, not the premolars. The nasopalatine nerve supplies palatal tissues behind the anterior palate. The infraorbital nerve is a larger trunk giving rise to ASA and MSA branches and would numb a broader region, not as specifically targeted to the premolar buccal area.