Implants without general anaesthesia: why the clinic uses only local anaesthesia, and how it helps patients manage fear

Key points

• At Tursunov Clinic, implants — from a single one to a full jaw — are placed under local anaesthesia. The clinic offers no general anaesthesia or sedation, and that is a deliberate choice.
• Under local anaesthesia there is no pain — only pressure and sound. The patient stays conscious, can stop the doctor at any point, eats afterwards, and drives home an hour after surgery.
• General anaesthesia carries its own risks (heart, breathing, drug reactions), requires an anaesthesiologist, fasting from the night before, someone to accompany you, and a day to recover. For surgery inside the mouth, that is rarely justified.
• Fear is handled differently: preparation, a clear plan, breaks, and splitting treatment into two visits when needed.

What "implants while asleep" means, and why it is not really about sleep

By "asleep," clinics usually mean either sedation — an intravenous drug that relaxes the patient and blurs their memory of the procedure — or general anaesthesia, where the patient is unconscious and on a breathing machine. Either way, the operating room needs an anaesthesiologist, heart and breathing monitors, readiness for resuscitation, and the clinic needs the matching licence. The patient arrives fasting, cannot drive afterwards, and usually needs someone to accompany them.

That level of care makes sense for major maxillofacial surgery. For placing implants it is a genuinely open question: the surgery itself, in terms of trauma, is comparable to a tooth extraction, while the risks of general anaesthesia remain exactly the same.

Why the clinic uses only local anaesthesia

Three reasons.

Safety. Local anaesthesia is the most studied and safest form of pain control there is. It does not affect the heart, breathing or consciousness. For patients 60+, with hypertension or diabetes — who make up most All-on patients — that matters fundamentally.

Contact. A conscious patient means the surgeon can see their reaction, ask "is that pressing?", take a break, and the patient can raise a hand. None of that is possible under sedation.

Simplicity. No fasting, no one accompanying you, no day spent in bed. An hour after surgery, the patient drives home on their own.

The honest downside: under local anaesthesia you hear the sound and feel the pressure, and that is unpleasant for anyone who is anxious. That is exactly what the clinic works with.

What it actually feels like

The anaesthetic injection — 10–20 seconds, the most unpleasant part of the whole procedure. Within 5–10 minutes, half the jaw goes "wooden." After that:

pressure — while the site for the implant is being prepared, it feels like being pushed on; no pain;

sound — of the instrument and the water; headphones help many patients;

vibration — briefly, when working with bone;

time — one implant takes 40–60 minutes, All-on-4/5 on one jaw takes 2–3 hours; more anaesthetic is added if needed.

If something starts to hurt, that is a signal to add more anaesthetic, not to 'tough it out.' This is agreed on before anything begins.

How anxious patients are prepared here

The consultation is separate from the surgery. No one places an implant at the first visit: first comes an exam, a scan, a conversation — and you go away to think it over.

A minute-by-minute plan. The surgeon explains what will happen and when. The unknown is more frightening than the pressure itself.

A "stop" signal. A raised hand, and the doctor stops. This works, and patients use it.

Breaks. During longer procedures: a pause, a sip of water, stretching the jaw.

Two visits instead of one. If someone is scared, an All-on procedure can be split: one side today, the other a week later. It takes longer but is easier to get through.

Premedication — [pending the clinic's answer: whether a sedative is prescribed an hour beforehand].

Someone nearby. You can bring a family member; they wait in the lobby, and just knowing that lowers anxiety on its own.

The article "Afraid of the Dentist" tells the story of a clinic patient who went through implant placement and cleaning exactly this way, starting from a first, frightening visit.

When local anaesthesia is not enough

Some patients cannot have surgery while conscious at all: a severe anxiety disorder, a strong gag reflex, certain neurological conditions. They are told this honestly at the consultation and referred to a clinic with anaesthesiology services. That is better than promising 'asleep' without the proper conditions in place.

Related services and guides

• Dental implants in Astana
• All-on-5 in Astana

Frequently asked questions

Does getting an implant hurt?

Not under anaesthesia. What is unpleasant: the injection, the sound, the pressure. After surgery, 2–3 days on a pain reliever.

Can I take a sedative before the appointment?

Only after checking with the doctor — some medications increase bleeding.

How long will I be in the chair for All-on-5?

2–3 hours per jaw; for both jaws, usually the same day with a break, or across two visits.

Can I drive after the surgery?

Yes, local anaesthesia does not affect that; but it's still a good idea to have someone drive you, just for peace of mind.

What if I'm allergic to the anaesthetic?

Mention it at the consultation; there are alternative drugs and a test can be done.