This is what I do. It's clockwork and I don't even think about it anymore. haven't found a tooth yet that has escaped this plan.
palpate the anterior border of the ramus with a retractor
visualize the pterygomandibular raphe
the 2 form a triangle
inject in the "soft" area within this triangle
try and angle it as far laterally as you can
don't go too superior or else it it will take forever to set in
forget about the gow gates
my policy now is if they aren't profoundly numb after a second carpule, i go ahead and give an ansa cervicalis block at the angle of the mandible
if i'm going to take the tooth out, PDL is my next option (if its grossly carious, intrapulpal, tell the pt to hang tight)
Sometimes I give the mylohyoid nerve block in the floor of the mouth(i think i've had about 10 patients in about a couple thousand blocks)