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Mandibular anaesthesia
The lower face which includes the cheek, lower lip and chin, and the mandible including teeth, the temporomandibular joint, the mucous membrane of the mouth and the anterior two-thirds of the tongue are mainly innervated by the mandibular division of trigeminal nerve (V3). It is further branches off three areas, namely the undivided nerve, anterior and posterior divisions. The sensory innervation of anterior division is by the long buccal nerve. For the posterior division, the sensory innervation are by the lingual nerve, inferior alveolar nerve, incisive branches and mental nerve.

Inferior alveolar nerve block
Inferior alveolar nerve block involves the anaesthetisation of the inferior alveolar nerve, which is part of the posterior division of the mandibular division of trigeminal nerve. It runs anteriorly within the mandibular canal and gives sensory supply to the ipsilateral mandibular teeth, buccal mucosa, gingiva and the lips and chin. It is the most common technique for dental procedures.

The landmarks of inferior alveolar nerve block include the coronoid notch and pterygomandibular raphe. Firstly, palpate the anterior border of the ramus to locate the coronoid notch. To achieve an efficient nerve block, the needle insertion should be in between the two landmarks. The conventional technique is to position the syringe at the contralateral mandibular premolar. The long needle should be aspirated prior to depositing local anaesthetic to ensure proper needle insertion. As the needle penetrates into the mucosa, the local anaesthetic should be deposited simulateously and slowly until it contacts with the bone. The long needle should penetrate around 19 to 25mm into the mucosa to ensure correct contact with the bone; premature contact or penetration more than 25mm of the needle indicates wrong positioning.

Lingual nerve block
The lingual nerve is a branch from the mandibular division of the trigeminal nerve. It runs anteriorly into the oral cavity after separating from the inferior alveolar nerve. It gives the sensory supply to the anterior two thirds of the tongue, floor of the mouth and lingual gingiva.

Lingual nerve block is commonly done after performing inferior alveolar nerve block to anaesthetise particularly the lingual gingiva in clinical practice.

Long buccal nerve block
Long buccal nerve is also known as buccal nerve and buccinator nerve. It is a branch of the mandibular division of trigeminal nerve (V3). It is important to note that the long buccal nerve The steps in performing long buccal nerve block is to firstly insert the long needle into the buccal mucosa posterior to the mandibular third molar. The needle should be inserted about 2mm only. Then, inject the local anaesthetic after aspiration result is negative.

Mental nerve block
The mental nerve supplies sensation to the lower teeth, skin of the chin and lower lip as well as buccal mucosa. It exits through the mental foramen and typically located below the second premolar. This type of nerve block is useful when indicated for multiple procedures, typically in dermatological procedures. It is contraindicated when patients have active intraoral or facial infections such as viral infections or cellulitis.

The technique to performing mental nerve block is to retract the patient's lower lip, palpate for the mental foramen according to the anatomy and insert the small needle from the long axis of the mandibular second premolar approximately 1cm in depth. Slow injection is preferred as it is less painful to the patients as compared to brisk injection