It can depend on how complicated your impaction is. Sometimes they look at you and go, "Yeah I can work that out no issues," other times they'll be like, "Nah fuck that, this is going to be a major surgery." The last thing you want is for them to realise it's the latter and not the former when they're halfway through the procedure 😅

I've heard of that happening, actually; the dentist ended up driving the patient around themselves trying to find an available surgeon to finish the job, and eventually gave up and just dropped them off at the emergency department.

Usually it's not that wild, but I feel safe in assuming that many dentists choose to book a general out of an abundance of caution, 'cause I'm sure that scenario features in their nightmares as much as it does the patient's.

It probably has something to do with licensing and costs for anaesthetists, too, come to think. Most dentists are qualified to give locals but not generals; verrryyy different ballgame, you can imagine.

Oh yeah, and finally, people's jaws are getting smaller. Seriously, though. The smaller the jaws, the more complicated dental surgeries are becoming, so there you go.

Was a dental nurse once upon a time. Assisted with many an extraction. Yes if conditions are good (the jaw is large, the tooth is straight, there's no tangling or bone issues) then not a problem. But I did not enjoy putting some people with poor neck strength in headlocks. Or the post extraction vomiting. Or the way the patient cringed as they heard the tooth snap in their skull. Or the complete look of trauma on their face after.

Just because they couldn't feel pain didn't mean the experience wasn't harrowing. I needed to go under because all 4 were badly impacted. But having insider knowledge on the process, I would've chosen to be knocked out regardless.