Background: A “successful oral nerve block” is the key for a painless dental practice. The present study is aimed to report the use of alternatives after a failed block and explore the limitations for their use in their routine dental practice, despite the training received during the undergraduate period. Methods: A tailor made structured questionnaire was designed and its validity determined using principal component analysis and internal consistency was reviewed with a Cronbach’s Alpha value of 0.7. Data obtained was subjected to statistical analysis. Results: Out of 600, 444 (74%) responses considered. 56.8% of the practitioners reported a failure of block during the first attempt necessitating the use alternatives. Administration of second block at the same regionby 64.7% practitioners and Gow-Gates (2.3%), Vazirani Akinosi (4.9%) are reported. A significant correlation (p=0.03) was found with respect to the experience of the practitioner and use of mandibular Anaesthesia techniques. Conclusion: Unlike an institutional based practice, the Mandibular nerve blocks are rarely used, despite their higher demonstrated success rates.It should be a continuous process of learning to self assess their techniques and implement evidence-based practices into their routine dental practice for the benefit of the patient.