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Successful extraction + bone graft + implant (local anesthesia + valium)



Junior member
May 7, 2023
Oregon, USA
(33M, located in the US, non-smoker, non-drinker.)

Back story: due to Covid, I skipped going to the dentist for over 2 years, before going to the dentist last July due to pain when eating. My dentist made me extract all 4 wisdom teeth, but that was already too late to save one of the 2nd molars (tooth 31) next to one of the extracted wisdom teeth. Tooth 31 had a huge cavity that was giving me pain when eating and having anything cold (so bad that drinking tap water hurt enough to make me want to kick someone every time). After considering doing a root canal vs. extraction/implant, I went the extraction/implant route, since the overwhelming feedback from other dentists I consulted was that a root canal will not save the tooth.

I had the extraction + bone graft + implant done on tooth 31 this past Tuesday (~48 hours ago). I went back to the same oral surgeon who extracted my 4 wisdom teeth (under IV sedation) last year and who did a great job.

Before the procedure, they gave me 4 pills of amoxicillin (antibiotics) and some mouth wash to rinse. I mentioned to the assistant that one of my biggest fears was getting my throat numb with the numbing gel (which happened once many years ago, and I chickened out of that procedure because I was in so much panic). She was very understanding and used some gauze to make sure that the gel doesn't go down my throat, which worked really well. I barely felt any of the pricks of the multiple shots of injection of local anesthesia - way better than my current dentist, honestly...

The extraction was OK. I think at first they tried to pull the tooth out, but I felt some pain and raised my hand to indicate pain, and they immediately stopped. Then they tried to break the tooth into pieces to take out (I heard some drilling), but they still had to pull out the root, which hurt for a couple of seconds and that was it. I did feel a weird pulling sensation, but aside from a few moments of some pain, it wasn't bad - and the pain was nothing compared to the cold sensitivity... I wouldn't say it was fun, but it was a lot better than I had expected.

The bone graft was nothing. I felt nothing and have no idea when it was even done! I guess it's easy after an extraction...

The implant was actually pretty fun (I'm weird - or maybe it was the Valium). They used some kind of fancy 3D X-ray guided system (with a small dental guard thing on the opposite side of the mouth?) to make sure that the drill doesn't hurt a nearby nerve. There was a fair amount of drilling and vibrating, but zero pain - and I rather enjoyed the vibration feeling, kind of like a massage. And then it was done!

I'll be going back in 4 months to put the healing abutment on it - the oral surgeon said that it wasn't stable enough right now to put the abutment on immediately, so he'll put it on when he tests it in 4 months.

I was honestly a little anxious about the valium before going in, since I've never taken any anxiety meds before and had no idea what to expect. It was... interesting? I think it just made me not nearly as anxious or care about things, a little like walking on clouds, even though I knew what was going on, remembered everything, and was able to talk, etc, just fine (though my wife said I was louder than usual, probably because I was more carefree). I think it also made time feel like it went by faster - I thought the procedure took 20 minutes, but in reality it took around 50 minutes. Perhaps I fell asleep...

Recovery-wise, everything has been going well so far (knock on wood) in the last 48 hours since the operation. I've taken a grand total of one pill of ibuprofen (200mg) and one pill of Tylenol (acetaminophen, 500mg) on the day of the operation when the local anesthesia wore off - that's it. Very minimal pain since, nothing compared to the toothache before the extraction - I honestly had to check in the mirror to see that, yes, they did take a tooth out... The worst pain, frankly, is the stomach pain from the antibiotics, which can be soothed with some yogurt and peppermint tea. I'm also taking all the other precautions for dry socket, soft foods, no straws, slow rinses, no spitting, avoid exertions, etc. So far so good!!

Some other tips if you are going through something similar and are anxious like I was:
1. Find a good oral surgeon. I interviewed multiple oral surgeons for my wisdom teeth extraction last year and this one really impressed me with his no-nonsense but caring bedside manner (and the fact that he's a maxillofacial surgeon at a hospital 2 blocks away and is well-trained in handling IV sedation, also a big fear of mine) - and, somehow, he turned out to be the cheapest... It is well worth it to spend a bit of time to find a good surgeon.
2. Practice exposure therapy for fear factors. Everything from night guards and bite blocks scared me (the first time my dentist used a bite block for a filling, it freaked me out because I felt like I couldn't swallow and had no control over anything), so I bought a night guard ($20 on Amazon) and a set of bite blocks ($11 on Amazon for 6 bite blocks of various sizes) and, for the week before the procedure, practiced wearing those (obviously not at the same time) while at home. At first, I couldn't wear either of them for more than a minute before gagging and having to take them out, but after a few days of practice, I could have the bite block in my mouth for 30 minutes without caring and could wear night guards overnight! I think that really helped me feel at ease during the procedure, because I didn't care at all when they put in the bite block, since I was confident that I could handle it (and that it was actually a familiar feeling by now).
3. Bring headphones and listen to something you like!
4. Talk to people who've done it before - though you are already doing that and reading this, right? :)

Happy to answer any questions!
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