MRCEM Notes

Teeth

Teeth Key Figures

  • There are 32 permanent (adult) teeth
  • Adult teeth start to erupt from the age of 6
  • The third molar usually erupts after 17 years of age

Anatomy of a tooth


Innervation
  • Innervation of the teeth is an important factor when considering the use of nerve blocks.
  • The upper teeth (maxillary) are innervated by the superior alveolar nerves (anterior and posterior)
  • The lower teeth (mandibular) are innervated by the inferior alveolar nerve


Local anaesthetic nerve blocks
  • Lower teeth often anaesthetised using mandibular block or inferior alveolar nerve block. Local is injected into the pterygomandibular space using landmarks as pictured below. An additional block by infiltrating behind the 3rd molar anaesthetises the long buccal nerve
  • Upper teeth often anaesthetised by injecting locally either side of the base tooth.

image illustrating position of inferior alveolar nerve block
Full-size image