Fig. 7: Use an anesthetic warming dispenser. They're only about $75 and it will last for years. Having the anesthetic solution close to body temperature will make a big difference in patient comfort. Turn the anesthetic warmers off at the end of each workday. It takes about 30 minutes in the morning for the carpules to reach the desired temperature of 105 degrees Fahrenheit, and leaving them on 24/7 can eventually affect the efficacy of the anesthetic if stored there for too long. Speaking of efficacy-again, avoid a generic local anesthetic and use a name-brand product! In my experience, there is definitely a difference in the effectiveness. You are not saving money by using a cheaper product here. Fig. 8: I never give an injection directly on the palate. After administering the infiltration anesthetic as previously described, you should be able to inject into the mesial and distal buccal mucosa in a minute or less. Inject a second time into the buccal interproximal areas. Figs. 9 and 10: Start the palatal soft-tissue injection in the palatal interproximal area. I count to 15 using very light pressure, then to 15 using moderate pressure, then to about 10 or longer using stronger pressure. Visualize the tissue blanching. Advance the needle to the periphery of the blanched tissue, as seen in Fig. 10. The patient will not feel the next injection if the needle penetrates blanched tissue. Generally, in four minutes or less you can anesthetize any maxillary tooth with minimal or no discomfort. dentaltown.com \\ DECEMBER 2019 69http://www.dentaltown.com