This technique has been around since the 70s and is a technique that I use often. (J Oral Maxillofac Surg 77:489-492, 2019). I must confess that I go back and forth with the techniques and often use the Gow-Gates technique as well. When I went through my training in the 80s we were taught multiple techniques with a prejudice toward a variation of the Halstead’s technique. The sited article suggests, that in training, alternative techniques are not shown. I did not find this to be true. At all of my training sites including Marquette Dental School multiple techniques were taught and shown. I am guessing that the experience could vary from person to person depending on their interests and basic skills. Certainly in my various residency experiences the different techniques were actually stressed and encouraged as it is not uncommon to run into special circumstances and special patient populations in a surgical practice requiring one to “think outside of the box.”

Anecdotally, I would make the observation that many patients are difficult to gain satisfactory local anesthetic for more invasive procedures and especially in the face of infections or other factors which normally reduce the effectiveness of the local anesthesia agents. In these patients, short of performing the treatment with sedation or general anesthetic agents, knowledge of and trying multiple local anesthetic techniques is often necessary.