As the saying goes, “A toothache is not a disease, but a pain that really kills you.” Recently, a patient was troubled by a toothache and took painkillers with little effect. “This tooth hurts a lot, I want to pull it out once and for all.” The patient wanted to pull the tooth now, but a colleague said that you can’t pull it when the tooth is inflamed. The issue of tooth extraction during acute inflammation is much debated. It is generally advocated to extract teeth in the acute phase because the drainage from the alveolar sockets can be achieved by extraction and early extraction of the infected focal tooth can shorten the course of septic lesions of the jaws and reduce complications. Those who do not advocate extraction during acute inflammation believe that the trauma of extraction can cause the spread of inflammation and serious complications, and that anesthesia is not effective in relieving pain. Whether tooth extraction is possible in the acute inflammatory period should be considered in terms of local anatomy, systemic condition, ease of surgery, and size of trauma. It is generally believed that the local situation refers to the ease of establishing drainage after extraction of maxillary teeth and the poor drainage of mandibular teeth, especially the 3rd molar, which is prone to complications of perimandibular cellulitis and should be extracted after the inflammation is controlled. People who are old and frail, have chronic diseases or poor body resistance may have their teeth extracted in the acute period to aggravate the disease, so it is not advisable to extract teeth in the acute period. Diseased teeth that are easy to extract, such as loose teeth and single-rooted teeth, can be extracted with little surgical damage, and the purpose of removing the lesion, establishing drainage, relieving pressure, reducing the spread of inflammation and shortening the course of treatment can be achieved after extraction, of course. On the contrary, difficult teeth, teeth that are not loose, and teeth with multiple roots should be extracted because they require flap and bone chiseling, and the surgery takes a long time and the damage may lead to the spread of inflammation and serious complications.