Unlike other oral surgeons, Dr. Ichikawa gave me a choice between general and local anesthesia, and he is willing to use only a local anesthetic in cases where other doctors will not. This avoids many risks, side effects, and inconveniences associated with general anesthesia. Also, local anesthesia is much less expensive than general anesthesia, which frees up insurance benefits for other work during the year.
That said, local anesthesia may not be for everyone. But if you have had previous dental work and the drills don't bother you, this is not bad. If you'd like to be awake but feel nervous, ask about a same-day sedative.
Assuming you are awake, Dr. Ichikawa will give you a play-by-play of everything he does during the surgery.
He also will allow you to inspect your tooth after it is removed, but you must ask the assistant just before the procedure begins; otherwise it is put into a disposal container with the teeth of other patients as soon as it is removed.
The only problem that I had during the course of my treatment was that (like many other doctors) Dr. Ichikawa was never in his office more than three days a week. This is only a problem if you will need post-surgical care, of course.