SDN Members don't see this ad. (About Ads) This sometimes happens when I extract lower molars. ( also on upper posteriors but to a lesser extent ) Whenever I try inserting an elevator within the interdental papilla of the tooth to be extracted, the patient starts complaining of pain or discomfort. Other than that, the patient does feel numb. My block injections are usually successful, as my patients generally admit feeling numb to the midline of their lips. For difficult molar exos, I use at least 4 carpules of lidocaine. I usually only have topical gel, lidocaine, and short/long needle as my anesthetizing armamentarium. I don't have anything like articaine, PDL injection guns, etc so I have to make do with what I have. What should I do for pain control when patients complain of pain whenever I stick in an elevator in between teeth?