Nerve block: Supraperiosteal


  • Helpful for single tooth(ache)


  • Dental pain


  • Infection overlying injection site
  • Allergy to local anesthetic being used

Equipment Needed

  • Topical anesthetic: 20% benzocaine or 5% lidocaine ointment soaked in cotton/gauze
  • Local anesthetic (lidocaine 2%)
  • 3-5mL syringe
  • Blunt fill needle
  • 25-27ga needle



  • Allow patient to close jaw and relax rest of facial muscles
  • Dry area and apply topical anesthetic


  • Retract lip or cheek until mucobuccal fold is fully exposed
  • Puncture the mucobuccal fold with the bevel of the needle facing the tooth
  • Aspirate, then inject 1 to 2 mL of local anesthetic at the apex of the tooth
  • Goal is to allow anesthetic to penetrate the cortex of bone to reach the nerve of the individual tooth [1]


  • Failure to anesthetize if the anesthetic is deposited too far from the periosteum

See Also

External Links


  1. Amsterdam J and Kilgore K. Regional Anesthesia of the Head and Neck. In: Roberts and Hedges' Clinical Procedures in Emergency Medicine. 6th ed. Philadelphia, PA: Elsevier; 2014.