The Anatomy of the Buccal Nerve

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The buccal nerve, often called the long buccal nerve by dentists, supplies sensory information to areas of the face and mouth, specifically the cheeks and the gum areas near the second and third molars. The buccal nerve is not to be confused with the buccal branch which originates from the trigeminal nerve and supplies motor information to the facial muscles that control certain expressions and lip movements in chewing.

Often, we are aware of the buccal nerve when receiving dental treatment. When anesthetized, the buccal nerve will make dental work on the molar areas more comfortable. Because the nerve supplies sensory information to the cheeks, if the nerve is damaged through oral or facial surgery, or trauma, patients will experience varying sensations on their cheeks and jawbones, from numbness to tingling or pain.

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Anatomy

The buccal nerve sits high up in the corner of your cheek. It moves downward and emerges as a branch from the mandibular nerve, which controls the muscles of chewing. The buccal nerve starts at the deep corners of the mouth, passes between the two heads of the lateral pterygoid muscle which control jaw movements, and spreads to the cheeks.

There are two branches of the nerve—superficial and deep. The superficial branches end in the cheeks and supply sensation to the skin of the cheeks and the deep branches supply sensation to the lining of the cheeks and gums near the molar areas. 

While the buccal nerve is a sensory nerve, it has been known in some cases to join the buccal branches of the facial nerve which provide motor function to facial movements, such as smiling or curling the lip.

Function

The buccal nerve innervates the mucous membrane, vestibular gingiva, and gum area that begins behind the first and second premolars. By providing nerves to these areas, the main function of the buccal nerve is to supply sensation to the outside of the cheeks, the linings of the cheeks, and the gum areas near the molars.

Associated Conditions

In dental procedures such as removal of the third molars or wisdom teeth, or other work being done on teeth that requires that the patient cannot feel the work being done, dentists will administer a nerve block. This common nerve block is referred to as the inferior alveolar nerve block. During this procedure the buccal nerve is anesthetized.

This procedure produces numbness in the cheeks and gums. Administering anesthesia to the buccal nerve can help patients experience a pain-free dental visit when work needs to be done on their teeth.

The buccal nerve is also susceptible to injury during the removal of the third molars, commonly referred to as wisdom teeth. This is widely known by oral surgeons. If damage occurs, it may repair itself, but sometimes it may not. If it does not repair itself, there are options for treatment.

Since the buccal nerve emerges from the corners of the mouth, it can be affected by dysfunction in the jaw bone, also referred to as temporomandibular joint disorders (TMJ).

Rehabilitation

Most buccal nerve pain will resolve on its own, however, sometimes surgical intervention is needed. A doctor will examine the area and determine the origin of the pain. To do this they may administer a nerve block.

The nerve block will stop the sensation from the buccal nerve. If the buccal nerve is causing your pain, then the pain will disappear when the nerve is anesthetized.

Once it is determined that the pain is indeed coming from the buccal nerve, the doctor may perform surgery. The surgery can determine the cause of the pain. In some cases, the nerve is being compressed by scar tissue from the original surgery and the scar tissue can be removed to alleviate the pain.

In other cases, the pain can be caused by the muscles of the jaw compressing the nerve. Tight muscles of the jaw, often seen in TMJ, can compress the buccal nerve and cause pain, numbness, or tingling. Physical therapy and other methods to reduce the tension in the jaw can be used to treat these symptoms.

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Additional Reading
  • Siddik A, Sapra A. Anatomy, Head and Neck, Buccal Nerve. Ncbi.nlm.nih.gov. https://www.ncbi.nlm.nih.gov/books/NBK560732/. Published 2020.