Many patients can tolerate filler injections into many areas of the face with simple topical techniques such as ice or numbing cream. However, it's rare that patients are comfortable with these techniques when injecting the lips. Because of the density of nerves in the lips they are very sensitive. In my experience, the great majority of patients benefit from dental blocks - two injections for the upper lip and two injections for the lower lip. These dental block injections are quick and make the remainder of the procedure pain free. You can certainly try to tolerate a lip injection without the blocks, but if you're doctor doesn't feel comfortable using blocks, I would recommend you seek out other options. Hope thats helpful