Tooth rot a big hole especially painful need to be taken according to the specific causes of treatment, such as acute pulpitis, dental caries, apical periodontitis, after a clear diagnosis of filling treatment, root canal treatment, surgical treatment and other ways. 1. Acute pulpitis: acute pulpitis can cause teeth rot a big hole especially painful phenomenon, the treatment can choose root canal treatment, on the basis of retaining the original tooth, remove the pulp lesions, and then root canal preparation, root canal filling, and then cavity filling treatment. 2. Dental caries: teeth rot a big hole especially painful may belong to dental caries, you can remove the decayed material in the cavity, and then choose the appropriate material for filling treatment. If the caries is more serious, you can choose indirect pulp capping with filling treatment. 3. Periapical periodontitis: Periapical periodontitis can also lead to a big hole in the tooth rot especially painful, need to take root canal treatment, remove the pulp, root canal preparation, disinfection, and then filling treatment. If it belongs to the septic stage, it is necessary to take the pulp first to drain and other operations. There are a lot of reasons why a tooth rotting a big hole especially painful, after the symptoms suggest timely go to the hospital to improve the examination, follow the doctor’s instructions to take standardized treatment, do not ignore the symptoms, take it lightly.