Local or no local? As an intern I never gave local. Now I give the patient the option and about 80% ask for local. Lately I've been removing arch bars in the OR at the end of the case instead of leaving them for the clinic monkeys (interns like fowl language and jstars). I tell people to pick how they want it done. If they choose local they have to stay still while I block their entire mouth. If they choose no local I tell them I will stop at anytime and numb them up, but if they refuse the shots they MUST stay still while I pull the wires. One guy kept sitting up after every wire. I got pissed and sent him home for a week after removing one quadrant of interdental wires. The guy had half an archbar flopping around his mouth when he left.