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Scared! Extraction and implant under local



Junior member
Feb 24, 2024
Hi there. I just joined this forum but have been reading for months. I am scheduled for an extraction and an implant in a little over a week. I am now having nightmares about it because it’s all I think about. I have panic disorder so of course I am afraid of having a panic attack in the chair. I’ve had extractions before but never an implant. It will all be done same day and I chose local anesthesia as I am afraid of being sedated. Any help would be so wonderful or success stories of same procedure
@emcd Hi I had an implant under local anesthesia and it was a painless procedure that was very mild. Lots of mild drilling with no tugging or jolting around or anything. It was very boring because it took a long time, though. I had my extraction in a different appointment. It was also painless, though I felt more pressure and tugging. Neither were really bad though.
Thank you so much for your reply! I think the main thing I am scared of is having a panic attack and just feeling stuck there. Also, the surgeon really seemed like he wanted me to go under IV sedation but I didn’t feel it necessary for one implant. Just hoping I can be brave and make it through the appointment.
How have you been coping with dental things in the past and have you had a panic attack in the chair before? I am sure there may be ways to deal with it and make sure that you won't get one. It's about working together with your dentist and doing things on your terms.
@emcd Maybe it would work to set up a stop signal? https://www.dentalfearcentral.org/help/ So you wouldn't be stuck and you could take a break if needed? I refused offered/pushed sedation too for my single implant, and think it was the right choice, neither the extraction or the implant were particularly rough or intense. The extraction felt weird and mildly unpleasant at the worst, and the implant just kind of long and boring, feeling almost nothing, so I was certain it was the right choice. I thought the push for sedation that I experienced might have just been because I would have had to pay $1000 more (I saw price quotes with and without it), not because it was necessary.
@Enarete I have for sure felt panic but probably haven’t had a full blown panic attack while in the chair. I usually take a prn benzo prior to going. It’s more the what if and feeling out of control.
@NervousUSA yes I basically refused it too and he was being quite pushy. I am a nurse so I know it’s because he wanted to charge more and that’s really disappointing… I think if I knew he would just be patient with me, I might feel a little better about all of it. It was almost like he doesn’t want to be bothered by anyone’s anxiety.
@emcd Hopefully he will still be patient, did he seem nice other than being pushy about sedation?
@NervousUSA He’s nice enough, I just wouldn’t say overly warm and friendly if that makes sense. I definitely have more of a fear and intimidation when it comes to male dentists etc. I just remember before I left from the initial consult, his assistant said if there’s any issues, I would need to come back and get anesthesia. This in my mind led me to believe, if I was too anxious etc but this was just my assumption. I wasn’t thrilled that she said that as if they don’t believe in me 🤷🏻‍♀️
@Enarete I have for sure felt panic but probably haven’t had a full blown panic attack while in the chair. I usually take a prn benzo prior to going. It’s more the what if and feeling out of control.

Okay, so not having had a panic attack before is a good sign. Also, with benzos it would be very difficult to get one anyway. There are couple of things that can help you feel more in control in the chair, such as stop signal or regular breaks. Maybe discussing those whith your dentist may be good if you feel comfortable to do so. Here are some ideas on the topic of control:

@emcd I know what you mean about male dentists, I have more of what I think is instinctive fear of them, I think that knowing they are bigger and stronger than women can trigger the subconscious. I would say it is likely enough that the assistant's comments about coming back to get anesthesia are more to do with their preferences or the surgeons preferences, and not so much to do with you. I came across an account of an oral surgeon who required sedation for all patients for implants, even if the patients were not at all anxious, I seem to remember the account I read was by a person who had previously had an implant without sedation before with no issues, but then went to a new surgeon who required it. I think they may find it is easier and more profitable for them, so prefer it for those reasons, and not because of something about you.
@NervousUSA I think you’re right on the money “pun intended” about what you said. I definitely agree that it comes down to wanting to charge that anesthesia fee but also that yes it’s probably much easier for them. I am just hopeful he will be patient and just overall kind when I go in on Tuesday. My anxiety over all of it has already kicked in….
@emcd I hope he will too, I think he most likely will, from your description. Anxiety in the run up to an appointment is so hard, I can relate to that, for me it is worse than the appointment itself. Do you have methods you like to use to deal with that, like distracting your self, or using relaxation techniques? At this stage one I like is telling myself it will soon all be over, and I will be feeling relieved because it will be over.
@NervousUSA I will be taking a prn benzo prescribed for my panic attacks but even still I feel the symptoms of anxiety. I will also be listening to either an audio book or music during the procedure to help distract. I really like what you said though and am going to use that!! It’s definitely the anticipatory anxiety that makes it so difficult in the days leading up the actual appointment ugh.
@emcd I am glad you have a prescription that it sounds like you have had good results with. The book or the music sounds like a good idea for the procedure! I hope things are going as well as possible and I am sending you positive thoughts for tomorrow!
@NervousUSA I am all done! The entire procedure from extraction to implant was about 20-25 minutes long and absolutely nothing to it!! Knowing this and being a nurse, truly I cannot get over that he wanted me to go under anesthesia for such a short procedure. The worst was the anticipatory anxiety but after that, so quick and painless. I am just glad I stuck to my guns and said no to being under anesthesia besides a local.
@emcd Hey good for you! Fantastic job! You are so lucky it was so quick, my implant procedure was over 2 hours. I am sorry they pushed you for that anesthesia, and you had to have that experience, I know it leaves a bad taste in ones mouth to be pushed for something like that when it is not for your benefit, but for the benefit of the provider. I have had too many experiences like that. You stood up for yourself and advocated for yourself sucessfully though which is something to be proud of!
@NervousUSA Yes he uses this wonderful guided technology so it allows complete control of where implant should go. You know, I hadn’t thought of that before, how I stood up for myself and what I wanted so thank you for pointing that out to me!!! Also for your support 🥰