Dr. Christian Stanfield is a dentist, entrepreneur, and the founder of Elevate Dental Consulting where he helps dentists turn their practices into high-profit, low-stress businesses that actually support their lives.

After graduating in 2020, Dr. Stanfield went all in, buying and merging three practices (soon to be 4) into one thriving location: Glendale Gentle Dentistry. Paving a way in one of Arizona's most saturated markets, that bold move helped him hit seven-figure profitability while cutting stress and building a model that dentists can replicate in ANY market.

Today, he's on a mission to teach practice owners how to build wealth, reclaim their time, and fall back in love with dentistry through smarter systems, leadership, and strategy, not just more chair time.

• Website: elevateyourdental.com

• Instagram: @elevatedentalcoaching

• Elevate Dental Academy on Teachable: The Profitable Dentist Academy

• Practice: glendalegentledentistry.com

Evan Sampson is a practicing attorney with the law firm, Post and Schell. Evan has been representing dentists and dental organizations for over a decade in transactional, regulatory, and litigation matters. Not only has Evan counseled dentists in an outside counsel capacity, he has also served in-house with multi-site organizations including the largest dental support organization in New Jersey. Given Evan's in-house counsel background, he brings a pragmatic and business-minded approach to help dentists achieve their goals.

Episode #1682 of Dentistry Uncensored with Howard Farran dives into the legal side of dentistry with attorney Evan Sampson of Post & Schell — a seasoned expert who has spent over a decade guiding dentists through transactional, regulatory, and litigation challenges.

From practice transitions and corporate practice rules to billing risks, employment law, HIPAA, marketing compliance, and more, Evan breaks down the real-world legal issues dentists face every day — and how to reduce risk with practical, business-minded strategies.

🎧Tune in now https://bit.ly/DUwHF_1682

Disclaimer: This interview does not constitute legal or tax advice and does not create an attorney-client relationship.

Arjan de Roy joined Dentsply Sirona in 2015. In his position as Group Vice President of Essential Dental Solutions (EDS) he leads the Global Business Unit including Endodontics, Restorative and Preventive. Before that Arjan served as GVP Lab Strategy Commercialization, GVP of the Commercial Organization DACH (Germany/Austria/Switzerland) and General Manager at the VDW Division.

Prior to Dentsply Sirona, Arjan earned his first accolades in the dental industry with Ormco Europe, where he served as their Country Manager Germany/Austria/Switzerland. He is a graduate of Erasmus University Rotterdam and Michigan State University.

Max Milz is Group Vice President Connected Technology Solutions at Dentsply Sirona, leading its digital healthcare portfolio, which includes imaging, CAD/CAM, surgical equipment, and AI-based clinical software. A passionate tech leader, he previously spent 12 years at Siemens AG, including five years in China. He serves on the Advisory Board of the Value for Good Foundation and holds degrees from Harvard and Cambridge.

David Ferguson joined Dentsply Sirona as Senior Vice President, Global Business Units in March 2025. David Ferguson is a seasoned executive with extensive leadership experience in the medical device and healthcare industries. He has a strong track record of driving revenue growth, strategic transformation, and operational excellence across multiple global businesses. Most recently, he was President of Gore Medical, a unit of W.L. Gore. Previously, as EVP at Philips and President & CEO of Philips Respironics, he managed a global team of 6,000 people. At Baxter Healthcare, he led the global infusion therapy, IV solutions and patient monitoring business. He also held leadership roles at GE Healthcare. Mr. Ferguson is a Graduate of the Advanced Management Program of University of Chicago Booth School of Business and holds a PhD in Chemistry from Texas A&M University and Bachelor of Science in Biochemistry from David Lipscomb University. He has served on multiple boards, including AZBio, Philips PAC, and Baxter International Foundation, and is a co-inventor of two U.S. patents and author of ten peer-reviewed publications.

Howard was the keynote speaker of the ICCMO back in September to discuss all things business and dental in light of the AI wave.

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Joining just prior to the launch of the SOLO sensor in 2016, Aaron brings over 30 years of sales, sales management, and marketing experience between Silicon Valley startups, virtual training, and dental imaging technology to JAZZ Imaging. Aaron's first experience in digital radiography was with DEXIS in 2002 as a District Sales Manager and eventually a Regional Sales Manager for the West. His experience at startups like gForce, Docent and VirTra have helped shape the JAZZ brand and its sales and marketing efforts into the fastest growing sensor company in the US.

jazzimaging.com

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Dr Edward Rossomando DDS, PhD is presently an emeritus professor at the University of Connecticut School of Dental Medicine. Dr Rossomando earned a DDS from the University of Pennsylvania and a PhD from the Rockefeller University. He is the author of more than 200 research papers and two books. He is the founder and emeritus president of the Center for Research and Education in Technology and the founder of the dental discipline Biodontics. He is also the Editor in Chief of the e-journal Dental Hypotheses. He has started several companies around the patent to recover biochemicals from the gingival crevice. He has received several awards, including the Alumni award of Merit from the University of Pennsylvania.

During his nearly 50 year career he has been an educator, scientist, inventor, and entrepreneur, but he would like to be remembered as a loving father of two outstanding daughters and husband of the most wonderful wife, Nina.

Join Dentaltown.com today for more great dental content and discuss great dentistry with great dentists!

Howard joins UNLV's Advanced General Dentistry Fall 2025 class to share straight talk on what life looks like after graduation. From the impact of AI on dentistry, to the myths and realities of DSOs, to why private practice is still a strong path. This episode is packed with advice for new dentists!

A special thanks to Dr. Karen Kucharski for facilitating the discussion!

Want Howard to lecture your class for free? Email him at [email protected]

Join Dentaltown.com today and discuss great dentistry with great dentists!

Every dentist has faced it: the mandibular molar with a raging pulp that shrugs off your best IAN block like it was tap water. The lip's numb, your patient swears they're not, and now you're both sweating through the bib.

This wasn't just one Townie's bad day, it was the spark for one of the deepest, funniest, and most practical threads on Dentaltown in years. A global brain trust weighed in, debating anesthetic brands, injection techniques, pain management strategies, and just how much articaine is too much. What emerged wasn't a magic bullet, but a clear playbook for how to handle the dreaded "hot tooth" with skill, humility, and a few dirty tricks.

The Classic Scenario

It usually starts with #18 or #19, irreversible pulpitis, and a patient in pain. You give a textbook IANB, maybe even follow up with a buccal infiltration. But the second you pick up your handpiece or touch cold to enamel, they jump. You've blocked the lip, the tongue, the soul, but not the pulp. Now what?

Technique or Tooth?

Most Townies agree: when a patient doesn't go numb, don't rush to blame the anesthetic. It's usually technique. Articaine blocks? They're fine if you're hitting bone and working fast (onset in

The advice: don't stack carpules blindly. Instead, change the strategy. If you've blocked with lidocaine, try carbocaine. If that fails, it's time to break out the big guns.

Gow-Gates: The No-Gadget Upgrade

Gow-Gates was the most frequently recommended "next step" before fancy gear. It's free, reliable, and profoundly effective when done right. Wait five minutes after the injection, ask patients to move their jaw around while it sets, and you'll often get the profound anesthesia you were chasing.

Still not numb? Then it's time to get creative.

Intraosseous, Intrapulpal, and PDL—Oh My

You don't need an X-tip or Stabident to go intraosseous. Many Townies use a short, extra-sharp needle to sneak through the bone in areas where the crestal lamina dura is missing. A buccal infiltration with pressure against the cortical plate (especially in furcations) can work like magic. If all else fails, and you're into the pulp chamber, even slightly, hit it with an intrapulpal. Yes, it hurts. But it ends fast, and it works.

Pro tip: when intrapulpal is inevitable, warn the patient gently: "This may sting for just a second, but then it'll feel like magic." No one opts to go home.

The Lingual Trick You've Probably Never Tried

Several veteran clinicians described a simple but overlooked maneuver: a subperiosteal lingual infiltration at the apex of the tooth, especially second or third molars. Why? Because anatomical dissections (and some animal skulls in backyards) show a surprising number of accessory foramina on the lingual side. Sometimes that's where the nerve supply is hiding.

The Case for Articaine

Despite decades-old fears about paresthesia, most dentists in the thread now use 4% articaine routinely, including for blocks. The speed and depth of anesthesia, especially in hot pulps, is hard to match. Some protocols combine citanest plain to start (less sting), followed by lidocaine, then articaine to finish the job.

And yet, some Townies avoid articaine for blocks entirely, sticking to lidocaine or mepivacaine, especially in kids or patients with paresthesia history. Ultimately, it's a matter of preference, experience, and risk tolerance.

Buffering: The Quiet Revolution

BufferPro by Premier Dental got a few nods. The promise? Raising the pH of your anesthetic solution to speed onset and improve efficacy. Simple, cheap, and available. Townies using it swore it shortened the guesswork and the wait.

Pharmacologic Prep

Ibuprofen 600–800 mg taken 1 hour pre-op showed strong support. It doesn't just manage post-op discomfort, it reduces inflammation, improves anesthetic success, and helps you get ahead of the pain curve. A few docs also mix analgesics in recovery: Tylenol 1000 + Ibuprofen 600 is a go-to combo.

The Antibiotic Debate

Here, it got heated. Some dentists prescribe antibiotics pre-op to reduce inflammation and improve anesthetic success. Others called that malpractice, citing ADA guidelines and resistance risks. The consensus? Only consider antibiotics if there's systemic involvement or swelling. Otherwise, it's NSAIDs, definitive treatment, or reappointment.

The Mental Game

When nothing works, it's not just the pulp that's inflamed, it's your stress level. Several Townies described having a set protocol to reduce emotional strain: block, infiltrate, try again, then reappoint or refer. Telling the patient up front, "If this doesn't numb, we'll try again later," can preserve your sanity and their trust.

Final Pearls

Don't stack the same anesthetic. Change agents. Try carbocaine.

Don't wait too long, most anesthetics peak at 5–10 minutes.

Infiltrate attached gingiva, not movable mucosa, for stronger effect.

If your lip is numb but tooth isn't, think accessory innervation (mylohyoid, lingual, etc.).

Sedation? Not always an option. Master local first.

Bottom Line

Hot molars will humble even the most seasoned dentist. But with the right playbook, Gow-Gates, lingual infiltrations, buffered agents, and a willingness to think anatomically, you can win the numbness battle more often than not.

Because the only thing worse than a hot tooth… is a hot tooth with a numb lip and a wide-eyed patient asking, "Are you sure I'm numb?"

Thanks to the entire Dentaltown community for turning a clinical headache into a masterclass on anesthesia, and for keeping it real.

Follow the discussion at https://www.dentaltown.com/messageboard/thread.aspx?s=2&f=93&t=391919&g=1&st=Why%20can%27t%20I%20get%20this%20tooth%20numb?