Local Anesthesia Evaluator Practice Exam

To numb maxillary teeth and also the buccal gingiva you need to cover both the tooth pulps and the buccal soft tissues. The ASA block specifically anesthetizes the pulps and facial gingiva of the maxillary anterior teeth, providing reliable pulpal anesthesia for those teeth. However, the buccal gingiva of posterior maxillary teeth is supplied by the long buccal nerve and isn’t reliably covered by the ASA block alone. Adding a buccal infiltration targets the long buccal nerve branches, numbing the buccal gingiva of premolars and molars. A maxillary infiltration by itself may not provide consistent pulpal anesthesia across multiple teeth or adequately numb the buccal gingiva, and Gow-Gates or mental blocks are mandibular techniques. So combining maxillary infiltration with an ASA block and buccal infiltration as needed achieves both pulpal anesthesia and buccal gingival anesthesia.