Tooth decay extraction is painless when the anesthesia is effective, but there may be some pain if the tooth decay becomes infected. 1. If the tooth decay is only carious or the nerve is inflamed, and there is no infection in the root tip, the anesthesia works well, and there will be no obvious pain when the tooth is extracted. If there is inflammation around the root of the tooth, the spread of anesthesia is poor, the effect of anesthesia is not satisfactory, and there will be different degrees of pain during tooth extraction. 2. Some of the decayed teeth can be preserved through dental treatment, and teeth with preservation value are not recommended to be extracted. Therefore, tooth decay extraction is not painful in most cases, combined with the impact of apical inflammation, the effect of anesthesia will have a certain pain response.