Regional Nerve Blocks for Equine Dentistry
Authors: M. Rice
Journal: Journal of Veterinary Dentistry
Summary
# Editorial Summary: Regional Nerve Blocks for Equine Dentistry Standing sedation with targeted regional anesthesia remains the standard approach for equine oral surgery, yet many practitioners lack confidence in performing the anatomically precise nerve blocks required for adequate pain control across different dental quadrants. Rice provides detailed procedural guidance for the four most clinically relevant blocks—infraorbital, maxillary, middle mental, and inferior alveolar—clarifying the anatomical distinctions that determine their application, particularly the critical difference between mental foramen injection (which anaesthetises only incisors and canines) and mandibular foramen injection (which provides complete ipsilateral mandibular quadrant coverage). The infraorbital and maxillary blocks both target branches of the maxillary nerve and suffice for all maxillary dental work, though successful caudal tooth anesthesia with the infraorbital approach specifically requires needle advancement into the infraorbital foramen itself—a technical detail that distinguishes effective from ineffective procedures. Aseptic preparation of injection sites is emphasised throughout, reducing infection risk during intraoral procedures. For farriers, equine vets, and dental specialists, mastering the anatomical landmarks and needle placement depth for each block substantially improves procedural success rates and horse welfare, allowing more complex dental interventions to proceed safely in the standing patient without resorting to general anaesthesia.
Read the full abstract on PubMed
Practical Takeaways
- •Master these four core blocks (infraorbital, maxillary, middle mental, inferior alveolar) to safely perform standing dental procedures in sedated horses without general anesthesia
- •Choose your block location based on which teeth need treatment: mental foramen for incisors/canines, mandibular foramen for entire lower jaw quadrant, and infraorbital/maxillary for upper teeth
- •Proper needle placement into the foramen is critical—superficial injection around the foramen will fail to anesthetize caudal maxillary teeth
Key Findings
- •Infraorbital and maxillary nerve blocks provide adequate anesthesia for all maxillary dental procedures in standing sedated horses
- •Mental foramen anesthesia blocks incisors and canines; mandibular foramen anesthesia blocks entire mandibular dental quadrant
- •Needle advancement into infraorbital foramen is critical to achieve anesthesia of caudal maxillary teeth
- •Aseptic preparation of injection sites is essential for all regional nerve blocks