Use a skull to familiarize yourself with the middle mental foramen. The needle is shown passing through the middle mental foramen into the mandibular canal.

To perform the middle mental nerve block, retract the mandibular labial frenulum ventrally with one hand.

With the other hand, guide the needle in a caudal and slightly ventral direction, passing into the middle mental foramen that exists one-third of the distance from the ventral border of the mandible. In dogs, this foramen is at the level of the mesial root of the second premolar. In cats, it lies halfway between the canine tooth and the third premolar.