I've had three implants now. I've never had to be knocked out for any of them. My most recent implant was done just a few weeks ago! The whole process can take up to a year if you need an extraction and a bone graft.
Generally, the process is like this:
1. Extraction. Local anesthetics (e.g. Novocain) are sufficient. If you have a big tooth to extract, then the process can be a bit much. If you're at al squeamish like me, then you might want to keep your eyes closed and ask the surgeon and assistants not to be specific about what they're doing. Anyway, the pain after the surgery usually fades by the end of the day, though it can linger if the stitches are too tight. Generally, stitches in your mouth are really annoying. As they fall out, they might be pulled by your tongue or some food or something.
2. Bone graft. You might not need one, especially if you still have most of a tooth in there. Otherwise, you might get a bone graft at the same time as the tooth is extracted. If your gums are too swollen of if there's an infection, then the graft has to be done on a separate day, usually some weeks after step #1. Local anesthetics are again sufficient. The pain from this step tends to be more intense than the pain in step #1, but it should fade after a day or two unless the stiches are too tight. After a bone graft, you'll probably have to go back a week later for a checkup and then you'll have to wait 3-4 months while your bone replaces the grafted bone bits.
3. Guide. You might not need a guide. This step is painless, though. Someone will scan around your mouth with a weird scope that makes clicking sounds like a Geiger counter to generate a 3D model, which the surgeon can use later to make sure that the implant goes in the right way. Guides usually aren't covered by insurance and getting one can delay the process by a week or two while you wait for the lab to make it, but if your surgeon recommends one, then you should probably get one.
4. Implant. Again, local anesthetics are enough. The surgeon puts the guide in place, drills a hole, sticks the implant in, and then screws in a placeholder thing so that the hole isn't exposed. It feels weird when the dentist ratchets the placeholder in, but it doesn't hurt at all. This is probably the least painful step, honestly. By the end of the day, the pain should fade and you'll just have annoying stitches to deal with. After a week or two, those will be gone and you'll be in waiting mode for another 3-4 months. Then, you'll go in for some x-rays and make sure that everything is OK.
5. Crown Part I. When your surgeon gives the OK, you go to your dentist and get fitted for a crown. More weird clicking scanners, maybe some biting down into jelly stuff. Nothing painful. At the end of it, the dentist sends the information over to the lab and they make your crown. This used to only take a week, but last time, it took over a month. Ever since the pandemic, everything is slower.
6. Crown Part II. Your dentist will remove the placeholder and screw the crown in. Then, you'll bite on some papers, the dentist will file down the crown, you'll bite, the dentist will file, and repeat until everything looks and feels good. This is a painless procedure. And now, you're done!
Oh, and there aren't too many restrictions on what you eat and drink throughout the process, either. You just can't have anything hard and crunchy that might get stuck for a couple of days and you're not supposed to have uncooked dairy because of the bacteria.
