I've had two done. front tooth and molar. I didn't go under, he did it with a local. Most people choose twilight sleep but i don't like it, so chose local. There was no pain, but my jaw got sore from being propped open for 45 minutes. Also I could smell that burnt bone smell when he drilled the holes for the posts (unpleasant). He screwed in the posts and sutured a flap of skin over the posts. Around 4 months later both bone grafts showed good on the Xray, so the surgeon worked with my dentist to make the crowns. Two weeks later he cut the skin and applied the crowns. Front tooth had a gap between the teeth, so had new crown made at no cost. He had to break the first one he affixed to the post off which was a little creepy. All in all, very straight forward and painless. I've never had any problem chewing on that molar, but like Dingle said, it did get red and a little sore occasionally for about a year after. Be advised insurance only paid half of the $16K for the two.