Which nerve block is commonly used to achieve pulpal anesthesia of the maxillary anterior region when infiltration is insufficient?

• A. Infraorbital nerve block
• B. Nasopalatine nerve block
• C. Anterior superior alveolar (ASA) nerve block
• D. Greater palatine nerve block

Answer: (C)

When infiltration isn’t enough to numb the teeth in the front of the upper jaw, directly blocking the nerve that supplies those teeth provides more reliable pulpal anesthesia. The anterior superior alveolar nerve block targets the branch that innervates the maxillary anterior teeth—the central and lateral incisors and canines (and sometimes the adjacent premolars). By delivering anesthetic near where this nerve runs as it enters the bone, you effectively shut down the pulpal nerves feeding those teeth, which is why this block is commonly used in this situation.

The other blocks don’t fit as well for pulpal anesthesia of the maxillary anterior teeth: a nasopalatine block numbs the palatal tissues behind the anterior teeth rather than the tooth pulps themselves; a greater palatine block covers the posterior hard palate and its gingiva; and while an infraorbital block can affect the same teeth, the anterior superior alveolar block is the direct choice for reliably numbing the maxillary anterior teeth when infiltration falls short.