How do you confirm that a molar is adequately anesthetized before beginning treatment?

Confirming pulpal anesthesia is critical before starting dental treatment. The cold test (using ice, Endo Ice/tetrafluoroethane spray, or CO2 snow) is the most reliable method to confirm pulpal anesthesia - if the patient has no response to cold stimulation, the pulp is adequately anesthetized. Asking if the lip is numb (option c) only confirms soft tissue anesthesia (inferior alveolar nerve block effect) but does not confirm pulpal anesthesia, since mandibular molars can fail to achieve pulpal anesthesia in up to 20-30% of cases (especially with irreversible pulpitis). Beginning preparation without confirming anesthesia risks causing significant patient discomfort.