i've had all 4 out but at different times. 1 by an oral surgeon and the other 3 by dentists and did not notice that much of a difference between them. i had my last 2 (both upper) pulled last thursday by a dentist w/just local anesthetic. i used the pain meds once the first day and have had no pain. he did suture the one side but that didn't hurt either....more of an annoyance than anything else