Arterial supply to the floor of the mouth and lingual gingiva

According to many anatomy textbooks, the blood supply to the mandibular lingual gingiva and the floor of the mouth is derived from the sublingual branch of the lingual artery. Sometimes a variation exists in which the submental branch of the facial artery pierces the mylohyoid muscle to supply this region in addition to or in lieu of the sublingual artery. The purpose of this study was to detail the vascular supply to this region and to delineate the relative contribution and importance of the sublingual versus the submental artery in humans. A large branch of the submental artery that perforates through the mylohyoid muscle was found in 60% of the cases. The sublingual artery was found to be small, missing, or insignificant in 53% of cases. In these 53% of cases, a large perforating branch from the submental artery was present. Consequently, the submental artery can be considered the main arterial blood supply to the floor of the mouth and mandibular lingual gingiva. This study demonstrates the need to change the procedure of extraoral ligation for control of hemorrhage in the floor of the mouth. On the basis of the results of this study, the submental artery or its parent facial artery should first be ligated. Then, if bleeding is not controlled, the lingual artery should be ligated to insure satisfactory hemostasis in this region.