Mental nerve block anesthesia has proven safe and successful modality to anesthetize the soft tissues of the ipsilateral chin and lower lip. It is given through the mental foramen of the mandible with easily distinguishable landmarks to act on the mental and incisive nerves.

Mental nerve block can be accompanied with inferior alveolar nerve block when working on the mandibular premolars. However, mental nerve anesthesia can work alone successfully on mandibular lateral incisors and centrals. For mandibular second premolar and canine, it was found that better anesthesia can be achieved when the injection is given inside the foramens (mental foramen for second bicuspid and incisive foramen for the canine).

Allergy to local anesthesia as well as current oral/facial infections are the major contraindications of mental nerve block.

The required apparatus for mental nerve block includes a 2–5-mL syringe, a 25–30-gauge needle and local anesthetic solution with/without epinephrine. Topical anesthetic gel is recommended before injection; and adequate retraction of the lower lip is mandatory. The patient has to be seated with the head supported on firm surface for better stability. Aspiration is recommended before anesthesia infiltration to avoid injury of the surrounding vasculature. The anesthesia must be injected 1 cm away from the exit of the mental nerve to avoid intra-foramen injection; that is, at the inferior labial sulcus in the apical area of the first premolar. Slow injection over average 1 minute is recommended to avoid any complication anesthetic, to make the patient more comfortable during injection and to get more profound anesthetic action. The clinician needs to pull the lip in lateral direction and to put his/her thumb below the foramen to palpate the area continuously. Again, the needle must be withdrawn gradually to avoid nerve injury.