Do tooth extractions have to be done under anaesthetic and will the nerve being dead make a difference i have a massive fear of anaesthetic i've had it once and i'd rather never again?

Most extractions can be accomplished with local anesthesia and do not require sedation. Each case is different so you'll need to discuss with your treating dentist or oral surgeon. A tooth that has been treated with RCT is brittle and is prone to fracture during the procedure.

If you go to an oral surgeon, and take a 5mg valium before extraction, with a local anesthetic, than you should be fine. Sedation is usually done for those who are afraid like you or for difficult teeth, and or compromised patients. Sinc your young and healthy, a local anesthetic is well within your ability.

The decision about the appropriate anesthesia to be used for any procedure should be based on the procedure required, your medical history, including past anesthetic experiences, and the Surgeon's recommendation.