Exam 2, DLA 1210

1. Innervation of Teeth
and Tissues
FACIAL NERVE, GLOSSOPHARYNGEAL NERVE, HYPOGLOSSAL NERVE,

3. Innervation of Maxillary Teeth and Tissues
NERVE TEETH TISSUES
Anterior Superior Alveolar
(ASA)
Centrals, Laterals, Canines Facial gingiva and PDL of anterior
teeth
Middle Superior Alveolar
(MSA)
First and Second Premolars, Mesiobuccal root
of first molar
Facial gingiva and PDL of premolar
area
Posterior Superior Alveolar
(PSA)
First Molars, distobuccal and lingual roots
only
Second and third molars (all roots)
Facial gingiva and PDL of molar area
Nasopalatine NONE Anterior palatal mucosa tissues
Palatal mucoperiosteum from lateral
incisor to lateral incisor
Greater Palatine NONE Molar and Premolar palatal mucosal
tissues
Palatal mucoperiosteum from
posterior of molars to canine teeth

4. Innervation of Mandibular Teeth and Tissues
NERVE TEETH TISSUES
Inferior Alveolar (the
lingual nerve is
usually involved,
because they run
parallel to each
other)
All mandibular posterior
teeth (premolars and molars)
Labial mucosa around lower lip
Anterior two-thirds of the tongue (lingual nerve)
Floor of the mouth (lingual)
Lingual mucosa of all teeth (lingual)
Incisive Anterior Teeth Chin and lower lip anterior to the mental foramen
Mental NONE Chin and lower lip anterior to the mental foramen
Buccal NONE Buccal mucous membrane of the cheek and gingiva of
premolars and molars
Lingual NONE Lingual mucosa of all teeth
Anterior two-thirds surface of the tongue
Floor of the mouth

5. Anterior Superior Alveolar
Nerve (ASA)
Facial tissue and pulp
AKA- Infraorbital Nerve
Height of muccobuccal fold at the maxillary first premolar
Numbs maxillary centrals, laterals and canines
Topical is placed at the apex of tooth to be numbed
6,7,8,9,10,11

6. Middle Superior Alveolar
Nerve (MSA)
Buccal tissue and pulp
Height of muccobuccal fold at the maxillary 2nd
premolar
Numbs mesial half of maxillary 1st molar and both
premolars
Topical is placed at the apex of the root of the 2nd
premolar
5,4,3:M and 12,13,14:M

7. Posterior Superior Alveolar (PSA)
Buccal tissue and pulp
Numbs distal half of the maxillary 1st and all
of 2nd and 3rd molar
Topical is placed at the apex of the
distobuccal root of the 2nd molar.
1,2,3:D and 16,15,14:D

8. Greater Palatine Nerve
Lingual tissue
Anterior to the greater palatine foramen
Middle of the maxillary second molar on the
palate
Numbs hard palate and soft tissues covering
hard palate from the distal of the canine
posteriorly
6:D,5,4,3,2,1 and 11:D,12,13,14,15,16

9. Nasopalatine
Lingual tissue
Incisive papilla
Numbs the anterior 1/3 of the hard
palate from canine to canine
6-11

10. Maxillary Nerve
Buccal, lingual tissue and pulp
Height of muccobuccal fold above distal of
maxillary 2nd molar
Numbs the buccal, palatal, and pulpal tissues in
one quadrant
Skin of the lower eyelid, side of nose, cheek and
upper lip
1-8 and 9-16

11. Inferior Alveolar (IA)
Block Injection
 Lingual, Buccal tissue and pulp
 AKA- Mandibular Block
 Inside of mandibular ramus, posterior to retromolar pad
 Numbs the whole quadrant from mandibular 3rd to central
incisor
 Topical is placed just posterior to the retromolar pad at the
ascending ramus
 25-32 and 17-24

12. Buccal Nerve
Buccal tissue
Numbs buccal tissue adjacent to the
mandibular molars only
Topical placed mucous membrane to the distal
and toward the buccal of the last mandibular
molar tooth in the arch
30,31,32 and 17,18,19

13. Lingual Nerve
Numbs lingual tissues and side of tongue,
mandibular teeth to the midline
Topical placed Lingual to mandibular ramus and
adjacent to maxillary tuberosity
17-24L and 25-32L

14. Mental Nerve
Facial/buccal tissues
Numbs mandibular premolars, canines and facial tissues
adjacent to those teeth
Topical placed anterior to the mental foramen, between
the apices off the roots of the mandibular premolars
27,28,29 and 22,21,20

15. Incisive Nerve
Facial tissue and pulp
Numbs premolars, canine, lateral and central incisors
Buccal mucous membrane from the mandibular
second premolar, lips and chin
Topical placed at the height of muccobuccal fold,
anterior to mental foramen
22-27

16. I want to numb……
#20 for a crown prep
Lingual foramen, Incisive Nerve
Muccobuccal fold, anterior to
mental foramen

17. I want to numb……
22, 20, & 18 for large amalgam
restoration
Inferior Alveolar (IA) (mandibular
block)
Just posterior to the retromolar pad
at the ascending ramus

18. I want to numb……
The lingual tissue of #7 for a
excisional biopsy
Nasopalatine Nerve, Incisive
Foramen
Incisive papilla

19. I want to numb……
#7 for a MIDF composite, the
restoration needs to extend below
tissue on facial.
ASA- infraorbital nerve
Placed at apex of tooth needing to
be numbed

20. I want to numb……
#4 for a MOB composite restoration, will
need to pack cord at buccal margin
MSA
At the apex of the root of the 2nd premolar
What teeth are numbed?
3:M, 4 and 5

21. I want to numb……
#2 for an excisional biopsy on lingual
Greater palatine Nerve
What is numbed?
Hard palate and soft tissues on lingual
distal to canine posteriorly
(i.e. 1,2,3,4,5,6:D)

22. I want to numb……
#2 for MOB amalgam restoration, decay
subgingival on buccal
PSA
Topical placed at apex of distobuccal root of 2nd
molar.
What teeth/tissues are numbed?
1,2,3:D

23. I want to numb……
Abscess on buccal tissues of 18
Buccal Nerve
Topical is placed mucous membrane to the
distal and toward the buccal of the last
mandibular molar tooth in arch
17,18,19 buccal tissues only

24. Facial Nerve (VII)

25. Facial Nerve (VII)
 Both afferent and efferent
 Provides innervation to:
All muscles of facial expression
Posterior belly of digastric muscle
Stylohyoid
Stapedius muscle of middle ear
 Provides taste sensation to anterior two-thirds of tongue
and innervation to nose and salivary glands

26. Facial Nerve (VII)
 Enters the infernal acoustic meatus and travels through the temporal
bone.
 It encounters its sensory ganglion, the geniculate ganglion, in the
temporal bone.
 While traveling through the temporal bone, the following branches are
found:
 Greater petrosal nerve supplies the glands of nose and mouth and lacrimal
gland
 Nerve to the stapedius muscle supplies the inner ear
 Chorda tympani nerve joins together with the lingual nerve and carries taste
fibers to anterior two-thirds of the tongue

27. Facial Nerve (VII)
The facial nerve then exits the skull through the
stylomastoid foramen and gives off the following
branches:
Posterior auricular nerve that supplies the posterior
auricular and occipital muscles
Digastric nerve provides innervation to the posterior belly
of the digastric muscle
Stylohyoid nerve that innervates the stylohyoid muscle

28. Facial Nerve (VII)

29. Facial Nerve (VII) (cont’d.)
The facial nerve then enters the parotid gland
and bifurcates into two divisions
Superior temporofacial
Temporal, zygomatic and buccal branches
Inferior cervicofacial
Mandibular and cervical branches

30. Facial Nerve (VII)
 The temporal division gives rise to the
following:
Temporal branches that supply the anterior
and superior auricular muscles, frontal
muscle, corrugator muscle of the eyebrow,
and the orbicularis oculi
Zygomatic branches that also provide
innervation to the orbicularis oculi
Buccal branches that supply the Procerus,
zygomatic, quadratis labii superioris,
nasalis, buccinator, orbicularis oris, and
Risorius muscles

31. Facial Nerve (VII)
The cervicofacial trunk gives
rise to the following:
Mandibular branch that
provides innervation to the
muscles of the lower lip and
chin
Cervical branch that supplies
the platysma muscle

33. Facial Nerve (VII)

34. Glossopharyngeal Nerve (IX)
 Both efferent and afferent
 Exits skull through jugular foramen and branches to tongue
and pharynx
 The glossopharyngeal nerve branches include:
Tympanic nerve provides parasympathetic to parotid gland and
sensory to middle ear
Carotid sinus nerve supplies carotid sinus for its blood pressure
regulators
Stylopharyngeal nerve supplies the stylopharyngeal muscle

35. Glossopharyngeal Nerve (IX)
 The pharyngeal branches join with the spinal accessory (XI) and
vagus (X) nerves to create the pharyngeal plexus.
 The plexus supplies the muscle of the soft palate and pharynx,
except for the Stylopharyngeal supplied by the IX, and the tensor veli
palatini supplies by V.
 It also innervates the mucosa of the soft palate, pharynx, and tonsils.
 The glossopharyngeal nerve also supplies the posterior one-third of
the tongue with taste sensation.

37. Hypoglossal Nerve (XII)
 Motor supply of the tongue and exits skull through
hypoglossal canal
Entirely efferent
Supply geniohyoid muscle and intrinsic and extrinsic muscles of
tongue, with the exception of the palatoglossal muscle, which is
innervated by the pharyngeal plexus.
Damage to this nerve causes paralysis of the tongue and
deviation toward affected side when protruded

38. Summary
Peripheral nervous system comprised of nerves
traveling away from the central nervous system
12 pairs of cranial nerves providing innervation to the
right and left side of the body
Designated by roman numerals
31 pairs of spinal nerves

39. Additional Resources
https://slideplayer.com/slide/1701488/
Complete pages 265-266 in your text book
Complete Chapter 7 in your Dental Assisting
Workbook
You should be able to answer all questions from this
chapter
This would be a good idea for your final exam as well…..