To anesthetize teeth 14, 15, and 16, which nerve blocks are indicated?

• A. PSA block and GP nerve block
• B. Nasopalatine nerve block and ASA block
• C. Infraorbital block and nasopalatine block
• D. PSA block alone

Answer: (A)

The key idea is that anesthetizing the posterior maxillary teeth relies on blocking the posterior superior alveolar nerves, while the palatal tissues over those teeth need separate coverage if a full region anesthesia is planned. For teeth 14, 15, and 16 (the maxillary right premolars and the first molar), a posterior superior alveolar (PSA) block provides pulpal anesthesia to the tooth roots in that quadrant, and often includes the MB root of the first molar. To also numb the overlying palatal tissue and gingiva around these teeth, you add a greater palatine nerve block. Using both blocks ensures the teeth and the adjacent palatal tissues are fully anesthetized for procedures in that area.

The other options wouldn’t reliably cover both the buccal/pulpal aspect and the palatal tissues for these posterior maxillary teeth. Nasopalatine and ASA blocks target the anterior region and don’t reach these posterior teeth, while a palatal block alone wouldn’t give the needed pulpal anesthesia. A PSA block alone may not guarantee complete palatal coverage, hence combining PSA with a GP block is the most effective approach for teeth 14–16.