Chapter 02 • Question 5

Does It Hurt to Have Dental Implants Put In?

📺 4:00 video📖 10 min read

BDS – Dental Surgeon (GDC Reg: 83324)

The fear of pain during dental implant placement is one of the most common concerns that prevents people from moving forward with treatment. The anticipation of someone drilling into your jawbone understandably creates anxiety. However, the reality of what you actually feel during the procedure is often dramatically different from what most people imagine.

The Simple Answer

No, you should not feel pain during dental implant placement. The procedure is performed under local anaesthetic, which completely numbs the area being treated. While you'll be aware of the dentist working and will feel various sensations, actual pain should not be part of the experience.

How Anaesthetic Works

Local anaesthetic blocks the nerves in the specific area being treated, preventing pain signals from reaching your brain. The same type of anaesthetic used for fillings, crowns, and extractions is used for implant surgery—it's simply applied to a larger area to ensure complete numbness.

The anaesthetic injection itself involves brief discomfort:

A pinch and slight burning as the needle enters the gum tissue and the anaesthetic solution is injected. This momentary discomfort typically lasts 5-10 seconds per injection site.
Multiple injection sites may be needed to thoroughly numb the surgical area, particularly for multiple implants or complex procedures. However, after the first injection begins working, subsequent injections are less uncomfortable because the area is already partially numb.
Topical numbing gel is often applied to the gums before injections to minimize even this brief discomfort. Many patients report barely feeling the injection when this technique is used.

Once the anaesthetic takes effect—which happens within 3-5 minutes—the entire surgical area becomes completely numb. You won't be able to feel your lip, tongue, or cheek on the affected side, and you certainly won't feel pain from the surgery itself.

What You Actually Feel During Surgery

While you won't feel pain, you will experience several other sensations during implant placement:

Pressure and pushing

As the surgeon prepares the implant site and places the implant, you'll feel pressure in your jaw. This is the sensation of the dentist working, not pain. The pressure can be significant at times—particularly when the implant is being threaded into the bone—but it remains a pushing sensation rather than discomfort.

Vibration

The surgical drill creates vibrations that you'll feel throughout your jaw and sometimes into your head. This sensation can be unsettling but isn't painful. Some patients find it helpful to listen to music through headphones to mask the sound and distract from the sensation.

Pulling and tugging

When gum tissue is being repositioned or stitched, you'll feel pulling sensations. Again, these are pressure feelings without pain.

Sound

The drill creates a high-pitched whirring sound similar to what you hear during cavity preparation, though often louder and longer-lasting. If sounds bother you, earplugs or headphones help significantly.

The key distinction is that while you're aware of the procedure happening, you don't experience it as pain. Most patients describe it as strange or uncomfortable at times due to the pressure and sounds, but not painful.

If You Do Feel Pain During the Procedure

On rare occasions, you might feel pain or sharp sensations during the surgery. This happens when:

The anaesthetic isn't fully effective in a particular area, which can occur in areas with inflammation or infection, or simply due to anatomical variation in nerve pathways.
The anaesthetic begins wearing off during a lengthy procedure before additional anaesthetic is administered.
A nerve branch wasn't adequately numbed by the initial injections.

If you feel any pain during the procedure, inform your dentist immediately. Don't try to tough it out or assume it's normal.

The dentist can quickly administer additional anaesthetic to ensure your complete comfort. Most dentists would rather give an extra injection than have you experience pain. Communicate clearly: raise your hand, make a sound, or use whatever signal you've agreed upon with your dentist. They want you comfortable and will stop immediately to address pain.

Sedation Options for Anxiety

While local anaesthetic prevents pain, it doesn't address anxiety or fear about the procedure. For patients with dental anxiety, several sedation options are available:

Nitrous oxide (laughing gas)

This is inhaled through a mask during the procedure and creates a relaxed, slightly euphoric feeling. You remain conscious and able to respond to instructions, but feel calmer and less concerned about what's happening. The effects wear off within minutes of removing the mask, allowing you to drive yourself home.

Oral sedation

Taking a prescribed sedative pill 30-60 minutes before your appointment creates a deeply relaxed state. You'll be conscious but drowsy and won't remember much about the procedure. You'll need someone to drive you to and from the appointment, as the effects take several hours to wear off completely.

IV sedation

Administered through a vein, this provides deeper sedation while keeping you conscious enough to respond to commands. Most patients remember little to nothing about the procedure. An anaesthetist or specially trained dentist monitors you throughout, and you'll need someone to accompany you home and stay with you for several hours.

General anaesthetic

Full unconsciousness is rarely used for standard implant placement but may be appropriate for complex cases, patients with severe anxiety, or those with medical conditions that make cooperation difficult. This requires a hospital or surgical centre setting with an anaesthetist present.

With appropriate sedation, many anxious patients report that the procedure felt like it took only minutes, and they remember little to nothing about it. The combination of local anaesthetic (for pain prevention) and sedation (for anxiety management) ensures a comfortable experience.

What Patients Say About the Experience

Most patients report being pleasantly surprised by how manageable the procedure was:

"I expected it to be terrible, but I didn't feel any pain at all during the surgery. There was pressure and vibration, which was weird but not painful."

"The worst part was the anxiety beforehand. The actual procedure was nothing compared to what I'd built up in my mind."

"I felt pressure when they put the implant in, like someone pushing down on my jaw, but it didn't hurt. I was amazed."

"The injection was the only uncomfortable part—a few seconds of pinching. After that, everything was just pressure and sounds."

The Psychological Factor

Pain perception has a significant psychological component. Patients who:

Understand what sensations to expect (pressure, vibration, sounds) experience less distress than those surprised by these sensations.
Trust their dentist and feel confident in their skill tend to relax more during the procedure, which reduces muscle tension and perceived discomfort.
Use relaxation techniques like controlled breathing or visualization during the procedure often report less anxiety and greater comfort.
Choose appropriate sedation when they know they have dental anxiety ensure a much more comfortable experience than trying to endure the procedure while terrified.

Managing your mental state before and during the procedure significantly affects your comfort, even though the anaesthetic handles the pain prevention.

Preparing for Comfort

To ensure the most comfortable experience:

Communicate your anxiety level honestly with your dentist. They can adjust their approach, offer sedation options, and check in with you more frequently during the procedure.
Ask questions beforehand about what you'll feel and hear. Understanding what's normal removes uncertainty and worry during the procedure.
Establish a signal for discomfort or needing a break—usually raising your hand—so you can communicate even with instruments in your mouth.
Consider sedation if you're very anxious. There's no prize for enduring anxiety when safe, effective sedation options exist.
Eat a light meal beforehand (unless sedation requires fasting). Having food in your stomach prevents light-headedness but being too full can feel uncomfortable while reclining.
Use the restroom before the procedure, as you'll be in the chair for 30 minutes to several hours.
Arrange support if using sedation, including transportation and someone to stay with you afterward.

💡 Key Takeaways

Dental implant placement should not hurt during the procedure—local anaesthetic completely numbs the area
You will feel pressure, vibration, and pushing sensations, but these aren't painful
The anaesthetic injection causes brief discomfort (5-10 seconds), but this is the only pain moment during the entire surgery
If you feel pain during the procedure, inform your dentist immediately for additional anaesthetic
Sedation options (nitrous oxide, oral sedation, IV sedation) are available for anxious patients
The procedure involves unusual sensations that can be unsettling, but pain should not be part of the experience
Most patients report being surprised by how manageable the procedure was compared to their fears
Longer procedures (multiple implants, bone grafting) may cause jaw fatigue from keeping your mouth open, but not surgical pain
Proper communication with your dentist about anxiety and any discomfort ensures your comfort throughout
The overwhelming majority of patients say the anticipatory anxiety was worse than the actual procedure