The buccinator is the muscle of the cheek, forming the muscular wall of the buccal vestibule and maintaining food between the teeth during chewing by pushing it back from the cheek onto the occlusal surface. It is the deepest of the muscles of facial expression and forms the floor of the buccal fat pad space. The parotid duct pierces the buccinator to enter the oral cavity opposite the upper second molar.
| Origin | Alveolar processes of the maxilla and mandible opposite the molars, and the pterygomandibular raphe |
|---|---|
| Insertion | Angle of the mouth, blending into the orbicularis oris |
| Nerve Supply | Buccal branches of the facial nerve (CN VII), motor; Buccal nerve from CN V3, sensory to overlying mucosa |
| Blood Supply | Buccal artery |
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Without the buccinator continuously pressing the cheek against the teeth, food would collect in the buccal vestibule between the cheek and the teeth during every chew, making efficient mastication impossible. This is exactly what happens following facial nerve palsy with buccinator paralysis.
The parotid (Stensen) duct pierces the buccinator at the level of the upper second molar and enters the mouth as a visible papilla in the buccal mucosa, an important anatomical landmark for parotid duct cannulation and laceration repair. The pterygomandibular raphe from which the buccinator originates is the anatomical landmark for the inferior alveolar nerve block injection, with the needle inserted just above the raphe to reach the nerve. Facial nerve palsy paralysing the buccinator produces food accumulation in the cheek and difficulty chewing.
The buccinator is palpable bimanually by placing one finger inside the mouth on the buccal mucosa and one finger externally on the cheek, becoming firm during cheek compression. The parotid duct papilla is visible intraorally opposite the upper second molar.
Facial nerve palsy producing inability to compress the cheek against the teeth, causing food accumulation in the buccal vestibule during chewing and difficulty with oral continence.
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