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The fear of pain when undergoing a dental procedure done can be worrying enough to stop people from getting important treatment like a permanent tooth replacement. Most of these fears are overstated, as we explain in this article.

It is no surprise that the Number One Fear people have about going to the dentist is pain. TV, movies, comedy, your friends and your grandmother all reinforce the idea that sitting in the dentist's chair means pain, after all. This idea is also vastly overstated in today’s world. Very rarely would a dental procedure be considered painful even after an adequate amount of anesthesia has been given, and that includes the process of permanent teeth replacement.

That is exactly the question we are attempting to answer today. Is a permanent tooth replacement painful? Let us examine the three most common options offered to patients and break them down one by one.

Are Dental Implants Painful?

The simple answer is no [1]. Even though the procedure to place permanent tooth replacement — dental implants — is surgical, where drills will be used to make holes in your jawbone, the procedure itself is absolutely painless [2]. Any surgical procedure carried out anywhere in the body will sound painful if you really think about it. A tonsillectomy involves the doctor cutting inflamed tonsils from your mouth. Does the patient even realize anything that is going on? No.

Of course, dental implant surgery is carried out under local anesthesia in a large majority of situations, while most surgery in other parts of the body is carried out under general anesthesia. Does that make a difference? Once again, it does not. There is overwhelming and conclusive evidence to prove that local anesthesia is more than enough for adequate pain control.

Most patients seem to understand that the process of getting dental implants is not that painful and trust in the effects of local anesthesia [3]. What about afterward? This is where patients worry the pain will start.

Once the dental implants have been inserted, a large majority of patients will have no pain whatsoever. It is common to have a little soreness. Some precautions have to be taken to avoid secondary infections or excessive force to the area where the implants were placed. Some amount of swelling may be experienced as the bone healing begins to take place [4].

In patients where additional bone grafting procedures were done [5] or a sinus lift procedure was performed, an amount of postoperative pain may persist for some time [6]. All of this can, however, be managed with over the counter pain medication that your dentist will prescribe you.

It is only in the rarest of rare cases where the procedure has not progressed according to the expectation that patients complain of pain even after the initial healing has taken place [7[.  

Are Crowns And Bridges Painful?

We will tackle crowns and bridges under the same heading because bridges are an extension of individual crowns and involve the exact same procedures.

There is one important consideration when we are talking about the procedure involved in non-implant permanent tooth replacement: crowns or bridges. If the underlying supporting tooth or teeth were root canal treated prior to the process, then there will be absolutely no pain or sensitivity involved [8]. A root canal involves the removal of the nerve endings from the center of the tooth, leaving it "dead" and without feeling. In fact, supporting teeth of bridges that were root canal treated can become affected with secondary decay without the patient ever coming to know because there will be no pain [9].

If, however, the tooth preparation process is being carried out on vital (live) teeth then some amount of sensitivity could be present during the appointment and even afterward. There is also the chance that sensitivity and pain can develop in a vital tooth with a crown or bridge on it a number of years after the procedure was completed [10]. In such a case, either the dentist will have to remove the crown or bridge, perform a root canal procedure and then make a new crown or bridge or go through the crown on top of the offending tooth and perform the root canal without removing the prosthesis.

Now, you may be wondering — what about the pain involved in a root canal procedure itself? Once again, the likelihood of a root canal procedure being painful is dependent on a number of other factors like the presence of a crack in the tooth, persistent infection or a previously failed attempt at a root canal. In most cases, a root canal procedure will not be painful, especially when the tooth is not very badly infected.    

Conclusion

We think we have answered the question "is a permanent tooth replacement painful?" emphatically. Not having a missing tooth replaced for unfounded fears about the pain involved in the procedure can actually lead to a lot more problems which will compound over a period of time and require even more extensive treatment. 

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