Inclusion Criteria:  Per patient:  Medical status: ASA I: a normal, healthy patient; Age range: from 4 to 10 year old patients (males and females); Past history of dental treatment using local anesthetic; Cooperative for dental treatment (Frankel 3 or 4); Obtained informed consent to participate in the study; English speakers;  B. Per tooth:  • Primary mandibular molar; Tooth that requires restorative dental care, including intracoronal or extracoronal restorations, due to:  Caries; Pulp treatment (indirect pulp therapy, pulpotomy, or pulpectomy); Developmental defects; Tooth surface loss (erosion/attrition);  Exclusion Criteria:  A. Per patient:  Medical status: patients in category II,III, IV, V, VI of the ASA physical status classification system: Age: younger than 4 years of age or older than 10 years of age; No history of dental treatment using local anesthetic; Uncooperative for dental treatment (Frankel 1 or 2); Informed consent to participate in the study not obtained; Non-English speakers;  B. Per tooth:  Tooth other than mandibular primary molar Tooth requiring extraction