Topical anesthetics are routinely used to reduce the discomfort that patients perceive during dental injections. The purpose of this investigation was to correlate the expectancy of pain and the effect of pretreatment instructions with the severity of pain perceived upon topical anesthetic use and dental injection. The treatment, topical placebo versus topical anesthetic, was administered in a double-blind manner. Following testing for expectations, the administration of instructions, and placement of the topical, the injection was given. The patients were then asked to rate their injection experience on a posttreatment questionnaire. The results of this investigation reinforce the importance of psychological variables in the mediation of pain perceived during dental procedures.