CRDTS Local Anesthesia Practice Test

The long buccal injection is aimed at the long buccal nerve as it travels along the buccal mucosa near the posterior mandible. Placing the anesthetic distal and buccal to the second mandibular molar position the needle where the nerve runs under the buccal mucosa, effectively numbing the buccal gingiva and mucosa of the mandibular molars and premolars. If you go mesial to that tooth, you risk missing the nerve; if you target the lingual area, you’d anesthetize the lingual nerve instead; and if you place distal to the first molar, the exposure to the nerve is less reliable. Thus, distal and buccal to the second mandibular molar is the correct location.