wolf,
As a pre-teen, one of my adult front teeth was accidentally broken. A root canal was done and a crown affixed. A few years ago, the underlying tooth gave out. I elected to have a dental implant which entailed oral surgery. The remaining tooth was extracted, the gums incised, a hole was drilled into the jaw bone, a threaded titanium post embedded, the gums sewn back together, and I was wide awake for the entire procedure which was done with local anesthetic and without nitrous oxide. The only pain I felt was the insertion of the needle when the anesthetic was injected. That stung enough to autonomically make my eyes tear; but, lasted only a few seconds. After the gums healed, an artificial tooth was threaded onto the titanium post and permanently sealed. It will last me the rest of my life.
I had an advantage going into the procedure in that I knew what to expect. My prior military occupation as a Special Forces medical specialist included formal training in basic dentistry (i.e. administering anesthetic for nerve blocks and local infiltration, simple extractions, excavations, and temporary restorations). On my first day of clinicals (on the job training), I performed 17 extractions. My supervising dentist was looking over my shoulder for the first two and then he was down the hall, in his office, should I need him for the rest. I subsequently performed many more extractions.
Here's the deal:
When the needle is inserted to inject the anesthetic, you may feel a sharp stinging or burning sensation; but, it will last for only seconds. There may be several injections depending on which tooth is to be extracted. Once an area is numbed, subsequent injections to keep it that way do not hurt if you alert the dentist at the first inkling of pain sensation (which may not occur at all depending on the duration of the procedure).
While you're completely numbed up, you may still perceive a disconcerting amount of pressure (not pain) being applied to the tooth and jaw as the tooth is rocked in its socket to loosen it, levered up and/or pulled out. Sometimes a tooth can be alarmingly stubborn due to its contours. I've seen a dentist spend a lot of time wrestling with a tooth to avoid complications.
It there are complications (e.g. the tooth won't loosen enough to be pulled out intact; or, the crown breaks), the dentist may use a drill to bisect the tooth an take it out in pieces in which case you may perceive a disconcerting amount of vibration (not pain).
The entire procedure can be messy, noisy, aggravating, fatiguing, and even disappointing if complications arise. More typically, all goes smoothly and it's just an annoying inconvenience for anyone with a decent pain threshold.
It's somewhat analogous to learning to shoot centerfire. At first, the recoil seems like it should be painful; but, you immediately realize that it isn't. Still, the recoil is quite disconcerting, so you flinch. After awhile you get used to it though it remains a nuisance. A few hundred rounds later, your hands get fatigued and you're not having fun at all anymore. Now you're hoping there aren't any malfunctions so you won't have to perform immediate action drills; because, you have to keep shooting until the dentist says you're free to go.
