The mandibular first premolars lie just behind the lower canines (Universal 28 on the right and 21 on the left, FDI 44 and 34). They have a large, pointed buccal cusp and a very small lingual cusp, so they look rather like a canine, and usually a single root. They erupt at about 10-12 years.
| Location | Lower dental arch, behind the canine on each side |
|---|---|
| Parts |
|
| Nerve Supply | Inferior alveolar nerve (mandibular division of the trigeminal nerve); Mental nerve (buccal gingiva); Lingual nerve (lingual gingiva) |
| Blood Supply | Inferior alveolar artery (from the maxillary artery) |
| Venous drainage |
|
| Lymphatic drainage |
|
Hold and tear food, acting partly like a canine and partly like a back tooth.
The mental foramen usually lies below and between the root tips of the two lower premolars, so the mental nerve is at risk during surgery, implants and abscess drainage here, causing numbness of the lower lip and chin. Some have a divided root or a second canal that can make root canal treatment difficult. A small extra cusp on the biting surface (dens evaginatus) can break off and expose the pulp.
A small tubercle on the biting surface containing pulp tissue; when it wears or breaks, the pulp can become infected.
Damage to the nerve as it exits near the premolar roots, causing numbness or tingling of the lower lip and chin.
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