The caudal maxillary nerve block in veterinary dentistry works well to block the maxillary teeth and the buccal soft tissues associated with them. The nerve anaesthetised is the maxillary, infra-orbital and anterior superior alveolar nerves. Indications for this nerve block would include treatment of the maxillary teeth, treatment of the soft tissues of the anterior portion of the mouth. The most common reason for failure to achieve adequate anaesthesia may occur when the tip of needle is not in the correct position. Complications may include a haematoma, perforation of the eye and neuritis.
This is an intra-oral injection. A 30 gauge long needle is recommended. The mouth should be opened fully to reveal the teeth and caudal soft palate. The caudal edge of bone on the hard palate is palpated disto-palatal to the molar teeth. The palpable hollow, distal to the bone edge is the ventral surface of the pterygo-palatine fossa in which the maxillary nerve lies and the point where you wish to deposit the local anaesthetic. Insert the needle through the mucosa just distal to the hard palate into the fossa. Advance the needle slowly level to a distance level with the ventral border of the zygomatic arch. Aspirate. Slowly deposit 0.1mls (cat) and up to 1ml (dog) over 30 seconds. Maximum volume is 1 cartridge per 10 kg body weight total volume from all sites. Little or no swelling should be visible. You cannot feel the solution under your finger.
Placement of the needle through the mucosa disto-palatal to the last molar tooth (110) in a dog.
Placement of the needle through the mucosa disto-palatal to the last molar tooth (109) in a cat.