What are the indications for a greater palatine nerve block?

• A. Procedures involving palatal hard and soft tissues distal to the canine
• B. Procedures involving buccal mucosa anterior to canine
• C. Anesthesia of the mandibular teeth
• D. Anesthesia of the nasal septum only

Answer: (A)

The key idea is that the greater palatine nerve block is used to numb the palate behind the canine. The greater palatine nerve, a branch of the maxillary division, travels to the greater palatine foramen and provides sensory innervation to the posterior part of the hard palate and the overlying palatal mucosa and gingiva from the canine rearward. Therefore, procedures involving palatal hard and soft tissues distal to the canine are precisely within its distribution, making this block the appropriate choice for that region.

This block would not reliably anesthetize the buccal mucosa anterior to the canine, which is served by other branches such as the buccal nerve. It also does not anesthetize the mandibular teeth, which require an inferior alveolar-type block. And while the nasal mucosa can be affected by palatal injections, anesthesia of the nasal septum alone is more associated with nasopalatine nerve anesthesia, not the primary target of the greater palatine block.