In my clinical work, I often meet some patients who are very anxious because of toothache, and once they come to me, they will say, “Doctor, help, the toothache is killing me, hurry up and help me pull it out!” When I meet such a patient, as a doctor, I naturally want to help the patient to relieve the pain immediately, after all, there is a saying that “toothache is not a disease, but a pain that kills people”. But sometimes things are not that simple, and dental care cannot be quick and easy. Why won’t the doctor pull out the tooth when it hurts so badly? Patients want to have their teeth extracted immediately because of toothache, but in many cases, it is not necessary or not possible to do so because even good dentures are not as comfortable as real teeth, so the decision to extract or not should be based on the doctor’s examination. But why is it that sometimes a toothache requires tooth extraction but cannot be extracted? The reason is that when a toothache occurs, the tooth and the surrounding tissues are often in the acute inflammation period, when extraction is not only less effective than anesthesia, but also bleeding will be more serious than usual, and even more so, it will cause the spread of inflammatory substances and bring about systemic infection. Therefore, in acute peri-coronitis and acute peri-apical infection, doctors often recommend anti-inflammatory treatment before further treatment. If a child’s baby tooth is decayed, it can be replaced anyway, so why can’t it be extracted? Finally, there is another situation that children’s tooth decay causes pain, and many parents think that since it is a baby tooth, it is better to pull it out, as there will be permanent teeth growing out later. Although pulling out the decayed baby tooth can indeed relieve the symptoms, but I don’t know that the space originally reserved for the permanent tooth to replace the baby tooth will be reduced due to the long-term absence, which will eventually cause the permanent teeth to be out of alignment, that is to say, the teeth will not be straight. This is the reason why many children’s doctors still recommend to keep their baby teeth even if there is only a little root left. If the tooth decay has reached the pulp, you can consider to remove the root and keep the tooth! Root canal treatment, commonly known as nerve extraction and root extraction, is when the dentist opens the diseased tooth, removes the inflamed and necrotic pulp tissue inside the tooth with various instruments, disinfects and cleans the pulp cavity (including the pulp cavity wall), and finally seals the pulp cavity tightly with dental cement and other materials. After the perfect root canal treatment, most of the teeth will be pain-free, and the filling will be protected by a full crown and can be used normally again. To sum up, there is a saying: you should not try to get a convenient dental treatment. Don’t think of a one-time solution for fear of trouble, because this will often be too fast to achieve, and will also bring a lot of hidden problems. Instead of rushing to solve the problem after the tooth, you may want to develop the good habit of coming to the hospital for regular oral examination before the tooth problem, so that you can prevent it before it happens.