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Implant with local anesthesia only - how bad is it?

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sharon

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The surgeon who did my first implant insisted it be done under general anesthesia, he said he never ever does it under local as it's too uncomfortable, especially for an upper tooth, as it feels like the drill is going into my brain. :scared: :scared:

Now it's time for implant #2 with a new surgeon. He said he can do it under twilight or local whichever I prefer. I have a hard time with general so I'm opting for local only (with 10 mgs of valium). But of course I'm very concerned because of what the earlier surgeon said.

So tell me honestly, how bad is it going to be? The tooth is upper left (#13). Am I a fool for opting to be awake? One of my big concerns is that he will put something in my mouth (I don't know the official word for it) that holds my mouth wide open. Is this usually used if I'm awake but under valium influence? Or will he use something to keep my tongue out of the way? I'm good about keeping my mouth wide open but my tongue has a way of wandering around no matter how hard I try to keep it still. Big tongue plus small mouth makes dentistry hard for me and the dentist.

A good part of my dental phobia revolves around not being able to swallow as well as gagging. It's hard enough to swallow as it is while in the chair but with that in my mouth I know I won't be able to swallow.

Oddly enough the thought of pain isn't my top worry but I still need to ask, will local anesthesia be enough to cover the pain of my jaw bone being drilled into?
 
Gordon

Gordon

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I know this sounds really weird, but don't worry about the pain part, there are no pain receptors in bone, in fact if you peeled back the mucosa (gum) over it, you could drill into it without local at all and totally painlessly!!! So all the local needs to do is freeze up the mucosa, which is fairly easy.

Implant placement demands a very, very strict protocol in terms of not heating up the jaw bone excessively, this means that the drill has to go really slowly, with lots of cooling spray. I've not had it done but watching it being done I think it looks slightly less vibration inducing than say the regular slow drill for a filling.

I can't answer your other point about your mouth being propped open, that's one for your surgeon to deal with, sorry.
 
drhirst

drhirst

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Hi sharon,
I have performed implant placements for patients using both intravenous sedation and just local anaesthetic alone.
The local anaesthetic will be more than adequate to prevent any pain during the procedure. I second what Gordon said about the bone itself being very insensitive.
You say you are having local + valium. that will do the trick nicely!

Just mention your concerns about any mouth props to the dentist and I am sure he will be able to work around your concerns.

Hope it goes well

Lincoln
 
krlovesherkids777

krlovesherkids777

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Sharon,

I had an implant placed about a year and a half ago . They did it with local only. It really was not painful , it felt odd.. and I definately would recommend closing your eyes when they drill it.. My dentist at the time didn't prepare me for that or tell me to do this so I looked as it was drilled up my jawbone. I'd just advise against it..
But for pain during it was not painful. After , I don't think was too bad, I had a bad extraction right next to it which seems like most the pain was coming from after . but the implant part wasn't too bad. I would do it again and not be too scared this time. but I wouldn't look :) to me Local was totally sufficient for pain.

Hope that helps.
 
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sharon

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Hi and thank you for your responses. It's good to know pain shouldn't be an issue.

KR - do you remember if you had to have your mouth propped open? or have one of those things to keep the tongue out of the way? (It's not a dental dam, it's bigger and stronger but I don't know what it's called.) Having that scares me more than the drill or pain.

I don't plan on looking, that's for sure. I'll be wearing my sunglasses and listening to my music and hopefully will fall asleep (yikes, no I can't do that because then my mouth will relax and I'll have to have it propped open:cry:.)

My appointment is scheduled for an hour. Can anyone tell me approximately how much of that time will be spent actually working on me? And I mean exclusive of chit-chat, and novacaine. I mean from the first incision in my gum to the last stitch.
 
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LittleLynnie

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Just wanted to join the chorus and agree that local anaesthetic should be enough. I had my first one done that way and it was a piece of cake. I don't remember if I had the rubber block or not though, and may have just kept my own mouth open. I actually like that big block, because then my own jaw muscles don't have to do all the work. I'm not familiar with the UK tooth numbering system, but in North America, my tooth was 22. That is the second tooth from the front on the upper left, and may be the same one that you're having done soon. Good luck!
 
krlovesherkids777

krlovesherkids777

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Hi and thank you for your responses. It's good to know pain shouldn't be an issue.

KR - do you remember if you had to have your mouth propped open? or have one of those things to keep the tongue out of the way? (It's not a dental dam, it's bigger and stronger but I don't know what it's called.) Having that scares me more than the drill or pain.

I don't plan on looking, that's for sure. I'll be wearing my sunglasses and listening to my music and hopefully will fall asleep (yikes, no I can't do that because then my mouth will relax and I'll have to have it propped open:cry:.)

My appointment is scheduled for an hour. Can anyone tell me approximately how much of that time will be spent actually working on me? And I mean exclusive of chit-chat, and novacaine. I mean from the first incision in my gum to the last stitch.
Sharon,
They did not use anything to prop open my mouth, I just kept it open.. and I am pretty sure it was 5-10minutes at the most . It was one implant on #4. It was alot quicker than expected a bit surreal. I'm not sure if that is a normal time on this or not.. but mine was very very quick.. Its good they schedule for an hour I would think that would be a good amount of time for everything with one implant. When are you having it done again? I can tell you I'm very happy I did it .. and have my implant now. it was worth it.
 
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sharon

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Sharon,
They did not use anything to prop open my mouth, I just kept it open.. and I am pretty sure it was 5-10minutes at the most . It was one implant on #4. It was alot quicker than expected a bit surreal. I'm not sure if that is a normal time on this or not.. but mine was very very quick.. Its good they schedule for an hour I would think that would be a good amount of time for everything with one implant. When are you having it done again? I can tell you I'm very happy I did it .. and have my implant now. it was worth it.
Wow, that's fast. I'd like to think mine will only be 5-10 minutes but I don't think so, Glad to know they didn't have to prop your mouth open. I'm concerned that with the valium I might tend to relax my mouth a bit too much so he'll stick that in me. . I'm not having it done until January (and secretly hoping for a blizzard so I can cancel).
 
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sharon

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Just wanted to join the chorus and agree that local anaesthetic should be enough. I had my first one done that way and it was a piece of cake. I don't remember if I had the rubber block or not though, and may have just kept my own mouth open. I actually like that big block, because then my own jaw muscles don't have to do all the work. I'm not familiar with the UK tooth numbering system, but in North America, my tooth was 22. That is the second tooth from the front on the upper left, and may be the same one that you're having done soon. Good luck!
Thank you for the reassurance, glad to hear you say it was a piece of cake. My first implant I was under GA so really have no idea what to expect.
 
krlovesherkids777

krlovesherkids777

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Sharon,

Have you had the valium before? I 've had it with other procedures and you should be fine to hold your mouth open as they want you too. HOpefully they will be considerate how you really do not want that in your mouth. I don't like those things either. Hopefully your new surgeon will be very kind and help you through it in a good way. I think you will find it well worth it once its done, I'm very happy for mine. and hoping there are no blizzards here :)..
 
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sharon

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I usually take 5 mgs of valium for my dental appts and that's enough, but that's for the the easy stuff. This time I've been prescribed 10 mgs. I have no problems holding my mouth open for that. My mouth is so tiny it makes it hard for the dentist to work in there. I want an implant on my molar (#31) but he won't do it because there's not enough room.
 
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